Page 20 - 根管治療的美麗與哀愁 (肆部曲)

ϞЪ֛ಂ৛ᔳeאᎇஞᏨൖٙ୦࿕ )eא݊Ӛঐɢཫкष೨˫኉ձՉ˫࣬մࣙषΊdί
ટա࣬၍طᐕʘܝdՑֵ݊ึҷഛҵא݊ึһ̋ెʷk ( ΪމӚϞ˸षԷމࢪdԸІҢ

ኪ୦ၾᄣᄿ຾᜕ )fΪϾdίഗʚᔼᐕܔᙄࣛdᐼ݊ึʷᐿމᔊdѓൡઃ٫வᒶष೨˫
኉ٙཫܝᗭ˸ಂܙdᎇу˸נৰ˫኉Ъމطᐕٙ஝ྌdԨආϾᓙԊܝᚃٙಔ˫˓ஔdਗ਼
݊ઃ٫ਬɓ˲݊௰λٙ፯኿iίԟϋ˾d࣬၍طᐕ྅ЧԐආəᇊ௄ࠤ༩d஼နή஗ᗙᇝ
ʷfШ݊dɘཧϋܝdϞഹ੶ʷΈ๕ၾᅂ྅׳ɽᕐࠠ̌ঐٙɹഢᜑฆ˓ஔᗝٙ༶͜dภ
ৣ൴ࠪتᚨਗٙ΢ۨᜄ୚ኜҿٙʧɝdᜫ࣬φ˓ஔ (Surgical Endodontics) אڢ˓ஔ׌࣬

၍Ύطᐕ (NonSurgical Endodontic Retreatment) ᜊ੻̙˸஗ಂܙeאႭһ̋੻ːᏐ˓i
Ͼ຅ආɝɚɤɓ˰ߏܝd͟׵ᕃ⌹Υږٙ࣬၍ቛ০ʔᓙή஗޼೯ҷԄe߉ॎ዁Ъଧ᎕d
˸ʿ΢၇Ոଡ଼ᔌ޴࢙eא̙ڮආՉΎ͛ٙ͛يҿࣘʔᓙήਪ˰d̋ɪਖ਼࿁ɹഢଡ଼ᔌᏨൖ

ٙ͜ཥ໘ᓙᄴᙲᅂ (Cone Beam Computed Tomography, CBCT) ஼န౷ʿd໾હəෂ୕
ɚၪ̻ࠦ X Έᅂ྅кᛘٙʔԑdίɓϣᙲ྅ܝd̙˸ 3D ࠠଡ଼dяତ̈ͭ᜗dԨঐᎇจ
ᔕᔷe׳ɽतйซᝈ࿀௅ʱٙᅂ྅dᜫ˫ᔼࢪҁΌ૶ู˫኉ʫ௅࣬၍ӻ୕ٙ༩ᇞԐΣe
אषᜊהίeձ΢ࡈ࣬၍ٙɝɹৎᓃၾ̈ɹ୞ᓃdʿՉɹࢰɽʃၾҖ࿒ৃࢹnnഃഃi
Դ੻݄Б࣬၍طᐕܝdष೨˫኉஗ϓ̌वπٙዚึɽᄣdఘၾಔ᜗˓ஔٙڌତʱࢬҤᓿd

ʔ޴ɪɨi̋ɪઃ٫ซࠅڭवІ್˫᜗ٙจᗆ৷ပdᐼҎૐঐ੄ீཀҁഛٙ࣬၍طᐕd
ഗष೨˫኉ࠠอΫూࡡ͉༈Ϟ̮ٙҖၾ̌ঐd˸ڭܵІ್኉ΐٙҁ዆dʔߧաՑฦෆf
Ύ٫d˫ᔼࢪਖ਼ุٙᙂ፴dഛᛓⲌⲌʘԊdΝ኎ග־Ϥ˸һ৷ᅺ๟ٙ༸ᅃ዁ςdձᔖุ

ࡐଣ஝ᇍԸΫᏐषʾࡁٙँँಂ޸d୞Ӻᜫ࣬၍طᐕɦΎϣ஗˴ݴᄆ࠽הٵ֛ၾટաd
ɰᜫϓɷɪຬٙष೨˫኉ί஗נৰۃdɦϞəɓϣवπٙ͛ዚf

追求嚴格規範成功定義的治療？或只求安穩留存齒體於口腔就算及格的治療？

ಔ˫ᆽྼίɚɤɓ˰ߏҷᜊəɹഢᔼᐕٙ͛࿒dΌଢ΢ήࠬৎථಪήن޴ኪ୦΢၇
޴Ꮠٙ˓ஔᅼόdٝΤಂ̊ɰʔࣛே೯ڌಔ˫ձ࣬၍طᐕࣩԷϓ̌ˢԷٙ޴ʝˢ༰i࣬
၍طᐕჯਹٙਖ਼࢕ኪ٫ࡁһίಔ˫ጳৎۃdఱʊމ৛ᎇ٫֛ɨəהፗ࣬၍طᐕϓ̌ٙᘌ
ࣸ஝ᇍdመνj˴ᝈɪઃ٫ٙष೨˫຾ཀطᐕܝd੽ϤʔᏐΎϞ΂ОІ೯׌़೨eైദ

ชאʔቇi܄ᝈɪ༈˫ஔۃࡡϞٙᙃeϔൢઽชאʔቇdᏐ༈ࠅঐᇠ༆אऊৰd߰ઃ˫
ʊϞਗศdۆࠅঐҷഛdϾ X Έᅂ྅ɪࡡϞٙ˫࣬մࣙ׳࢛ீ࢛षΊdࠅঐ஼နᐵʃd
ޟЇࠅӋঐ੄ҁΌᓹΥూࡡdࡡʊቊॎᕸϾʔԈٙ኉ᅻ৶ؐdࠅঐ੄Ύϣяତdуکஔ

ۃ֠͊̈ତٙ޴ᗫ኉ᅻ৶ॎᕸഃ܄ᝈᅄࡉd׵ஔܝत֛ಂගʫdɰࠅঐ੄ڭܵӚϞᜊʷf
߰˸ɪϞ΂Оɓࡈ൙ПࠅᓃʔঐୌΥಂܙd༈࣬၍طᐕఱʔঐၑ݊ϓ̌ (success)fவჿ
ᘌࣸٙІҢࠅӋdࡡ͉͜จί౤፴݄ஔ٫׵ӊɓࡈطᐕᐑືdேცࠅᔫฐ˸࿁f್Ͼd
வԬ஝ᇍࠅᓃdˀࡀԴ੻Ϟːซኪ୦࣬၍طᐕٙϋჀᔼࢪૐϾ͛ޡdʔ኷ϾৗdᔷϾኪ
୦һᔊఊd̥ࠅঐ੄τᖢवπ (survival) ίɹഢʕdఱၑʿࣸٙطᐕஔόfࡈɛϞֱಀ
ίࠏᔼ৫؂ਕd຾੬̙Ԉ኷ɻΝசאϘϋਞ኷ٙ࿲͏ϼЬdуԴ˫࣬ʊ຾ᐽ൓ (vertical

root fracture) ədʥ್ᙂ੻༈˫ᒔঐ͜dवπίɹʕʔᖟԫdϾʔᗴנৰiɰ޶ཀʔˇ
ઃ٫ʊ຾Ъཀ࣬၍طᐕٙ˫኉dՉ޴ᗫ˫࣬մࣙʥ್ᒔϞאɽאʃٙ׳࢛ீ࢛षΊdۍ

ക૩ʔึᙂ੻ʔബ؂eא೯ᙂϞṫਪᕚπίdΪމ˼ࡁႩމίԒ᜗Չ˼௅ЗdᐼึϞԬ

4 ܭςطᐕࡡۆdҤלлूႰ౅