Page 51 - 根管治療的美麗與哀愁 (貳部曲)

࣬၍طᐕٙߕᘆၾۑฎ ( ൩௅Ϝ )

࣬၍dШΪՉʊ຾̈ତʔʃٙ˫࣬մࣙषᜊdԨಀ̈ତཀ኉ᚹᑓ㺭dซԈՉ࣬φ၌ٙช
ݑᏐ༈ʊ຾ᝇᘌࠠٙdν؈Ңࡁ࿁ 45 ̥ոςਿ͉፿ܓʬٙ࣬φݬᓒ௴dٵ֛݊ʔ˄ԑ

੄ٙf
௰ܝdӔ֛ਗ਼ 45 ࣬φݬᓒ௴Ї፿ܓɤd( ձ 46 ٙჃː࣬၍޴Ν )f຅࿁Չ૶௴ၾ
ࡌҖ༺ᅺܝd΋Ꮋ༊፯͜ɓ˕፿ܓɤٙ৵Ըᇭ০Ъ༊φ (Non-standard or conventional
gutta percha point, size medium; try cone fitting)d೯ᙂ͊ঐ׳Ցಂܙٙ࣬၍ଉܓ ( ྡ
28B)f[ ίᑗґ઺ኪࣛdֻֻա৅ኪࡰேึ˸މ຅Դ͜ӻΐٙቛ০ଡ଼ ( Ϊ rigid ༰೷ )d Ϝ ൩ ௅

࿁࣬φݬٙ࣬၍ஷ༸݄Б૶௴eࡌҖʊ຾༺Ցࡡ΋ண֛ٙ፿ܓͦᅺܝ ( ԷνϤࣩԷҎ
ૐ༺Ց፿ܓɤ )dఱঐჀᕦή፯͜Ո޴Νͦᅺ፿ܓٙ৵Ըᇭ ( ޴࿁׵ቛ০༰ழ )d׳Ց
Ꮠ༈Ց༺ٙ࣬၍ଉܓdՉྼʔɓ֛ึνϤනлf] ϤࣛdϞՇ၇˙ό̙Ъҷഛאࡌ͍j

ୋɓ̙һҷ፯͜༰ʃ፿ܓ (size fine-medium Էν፿ܓɞ ) ٙ৵Ըᇭ০Ъ༊φdࠅᆽ֛
̴݊щ̙˸ೌڜᖟή׳ՑΥ֝ٙ࣬̂ଉܓdϾ˲ᒔ੻Ցəʔ፹ٙΫזڜɢ (tug back
sensation)fШ݊dϤࣩԷΪ 45 ˫࣬ٙ၍ኣێྼܓԑ੄d˲Չ˫࣬մࣙʊϞ׼ᜑषᜊd
ԑᗇቊաชݑ೻ܓᘌࠠiΪϤdึහΣમ͜ୋɚ၇˙όdԟఱ݊ΎԴ͜ӻΐቛ০ଡ଼dԱ
ృ܆଄༶ਗٙ๟ۆdεࠠል఻ϣਗЪ (recapitulation)dਗ਼ʔ஝ۆٙ၍ഢ ( ഹࠠڿਉʿʕ

ݬ௅З ) ЪආɓӉٙᓒ࢝dᎇܝԨ͜ʃ໮ٙቛ০d˸ʃషܓ (1~2mm) ɪɨ̬մჀฆٙቛ
זਗЪdԸࡌ዆࣬φݬʔ஝ۆٙ၍ኣ ( Ъ smooth)iಂග຅್ʔҙᎇࣛ಻༊࣬၍ஷ࿫ܓd
Νࣛɰ᎖ᐿήһอәݹ૰dԨภৣ൴ࠪتਗɢዧ᛻ݺʷәݹ૰ٙ૶ᆎၾऊݭࣖঐfʘ

ܝdΎ˸ࡡ፯͜Ъ಻༊ٙԟ˕፿ܓɤٙ৵ԸᇭࠠЪ༊φfஷ੬dϤՍ̴ఱঐჀᕦή஗׳
Ցಂܙٙ࣬̂ଉܓЗໄdʔසঐၪܵИ݅Ϟٙ࣬၍ݴΣdΝࣛɰঐ੻Ցቇ֝ٙΫזڜɢ
( ྡ 28C)f( ߰ᛘ٫࿁࣬၍૶௴ٙ˓جϞጳሳdሗ༉Ԉ˜וᇐ™ٙሞࠑf) ׵݊dਗ਼Ϥᇭ
০ᅺ֛λ܆෬ڗܓd኿̴֛ఱ݊ܙึࠅ݄Б܆෬ࣛٙ˴ࠅ৵Ըᇭ০ (master gutta percha
cone)dᎇܝکਗ̴਼ձ̤̮Շeɧ˕ڝ᙮ᇭ০ (size fine-medium, or size fine) ऍظ׵ସϞ

ऊݭ૰ (NaOCl) ٙޚᆨʃͥʕ௪͜f

ྡ 28B ຅࿁ 45 ່኉ڿٜટᝤݸdԨԱ͍ ྡ 28C Աృ๟ۆdࠠᔧεЪ఻ϣ܆଄༶
஝݄Б࣬၍૶௴ࡌҖʘܝd˸፿ܓɤٙ৵ ਗd࿁၍ഢΎЪቇܓٙᓒ࢝dࡡ኿֛፿ܓ
Ըᇭ᜗Ъ༊φd೯ᙂ͊ঐ׳Ցಂܙٙ࣬၍ ɤٙ৵Ըᇭ᜗dఱঐୌΥಂܙ׳Ցཫ֛ٙ
ଉܓ ࣬̂ଉܓdԨϞʔ፹ٙΫזڜɢ

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