Page 50 - 根管治療的美麗與哀愁 (柒部曲)

ˀࡀ 21 ۃϣٙ࣬၍طᐕ ( ၑԸ൷ʦʊਗ਼ڐ 30 ϋ ) ᆽྼπίϞܘɽٙҷഛ٤ගd˲Չ˫
࣬ʘ೯ԃ޴༰ቌڐ˫኉ʔҁ዆dה˸ٜᙂкᓙͦۃ࣬φ X Έٙ׳࢛ீ࢛௕ᅂ฽Ϟ̙ঐ݊
ԸІ 21fΪϤdܔᙄ΋ʔഗʚ҅௅௦ቑdٜટ࿁ 22 ٙ኉ڿЪ၊ݸ኉᜖ݺ׌಻༊ (cavity

test for pulp vitality)dν؈ᝤݸɓ༩Ց᜖ഢ͂කdேӚϞ΂Оชᙂdԟჿఱ࿁ 22 ҁϓ
࣬၍طᐕdԨ༶͜ᜑฆᗝᏨd޶޶ 22 ݊щʊϞᆑί൓७iν؈၊ݸ಻༊ɓ͇ᆽႩ 22 Ϟ
ชᙂe኉᜖ʥϞݺ׌ˀᏐdԟჿఱਗ਼಻༊ٙ૵၊ݸ෬໾λdਖ਼ːҷ࿁ 21 ආБҁഛٙ˜࣬

၍Ύطᐕ™dʘܝ̙Ա֛ಂᎇஞ̜ΫᏨൖٙഐ؈dΎӔ֛݊щცࠅ˸˓ஔᅼόԸ࿏ֵ༆
Ӕவࡈ࣬φषΊf
षʾձՉ˃థ౤ਪəʔˇ࿁ൢᐕʕeձطᐕܝٙ޴ᗫਪᕚd຅ɓɓ੻Ցഈᔧܝdᎇ
уટաطᐕܔᙄdᗴจٜટ΋࿁ 22 Ъ၊ݸ኉᜖ݺ׌಻༊fνΝ΋ۃѓٝdʔഗʚ΂О

҅௅௦ቑd࿁ 22 τɪዖͤღd΋˸ᜑฆᗝᏨ 22 ኉ڿd೯ᙂԨೌ׼ᜑ̙Ԉ൓७fᎇܝd
І 22 ٙᕛਉࠦ˸͍੬᜖ഢ၊ݸක࢝ᓃdක֐᝝ݸd຅ટڐ˫͉ሯᄴࣛdषʾڌͪʊঐ
ชաՑ೭़i׵݊d๝ݓٙѓٝઃ٫d̀ც೹ฆΎ᝝ઞଉɓᓃdषʾۈ੶ΝจiШ຅᝝
᎘ɦۃආɓᓃdઃ٫ΫᏐॆٙঐ੄ชᙂՑfΪϤᎇу৾˟಻༊dԨԱ๟ۆҁϓ࿁Ϥ၊ݸ

ٙ෬໾f՝ɨዖͤღdᜫषʾ೹Ъఁࢹdઃ٫ձ˃థଉաұ؂d၈஢Ңࡁٙཫкग़๟i
Ϥࣛषʾɦڌତʔτٙઋၫdᙂ੻߰ʔഗʚ௦ቑd21 ॆٙঐ੄તཀ˜Ύطᐕ™෗kՍจ
˸ِ३ٙɹѕΣषʾˀዧdܣჿϋ๋ฏڗdฏ׊೨eฏ࢔׊޶˫ճkઃ٫३३᎗࠯Ⴍj
λыdఱΥЪᓃdટա˜዆™طᚿf

Աృֻ݅d࿁ 21 τɪዖͤღdආБᜑฆ࣬၍Ύطᐕfනл͂ක᜖ഢ၊ݸd༶͜ᜑ
ฆᗝᆽႩ࣬၍˴ഢɝɹd΋ᜫϣಣაॶ๓૰ (5.25%) ऍᆗ˴၍ഢdഃՇeɧʱᙒܝdΎ
࣬͜၍ઞ০ (DG-16)dɓ˕ɓ˕ਗ਼ᔚϞᕦ౳ٙ৵Ըᇭ࣬̂ي઱̈dԨίᜑฆᗝᏨɨdᆽ
֛ʊೌवπٙ࣬̂يܝdሜࠥәݹ૰ዢܓ (2.5%)dਗ਼Չ᎖ᐿһอऍᆗ׵၍ഢdಂග˸܆

଄༶ਗ (Envelope of Motion) ˓جdᜫӻΐ׌ቛ০ᎇዚᓒ௴࣬၍˴ഢʘڿ௅eձʕݬ௅
ЗdԨεϣภৣ൴ࠪتਗɢዧ᛻eݺʷәݹ૰ٙ૶ᆎၾऊݭ̌ࣖf຅Սจ͂ၑࠅ˸ʃ໮
ቛ০๟௪ઞ॰࣬φ̈ɹࣛdΎሜࠥәݹ૰ዢܓՑˇ׵ 1%dᆽ֛ʃ໮ቛ০̙˸૩ೌڜɢ
ఱ๞̈࣬၍ஷ༸୞ᓃ (peeking through to RT, radiographic terminus)dᆽ֛੻Ց࣬၍ஷ࿫

(patency)dԨண֛əڋ֐࣬၍ʈЪڗܓfϤܝdίʔ൴ཀϤڗܓɨdʥ˸܆଄༶ਗᜫቛ
০ᎇዚᓒ௴ڿ௅eʕݬձ࣬φݬٙ࣬၍˴ഢf຅ᜑฆᗝᏨɨӚϞ̙Ԉ૿ዤאᘔओٙᕏሯ
ࣛdซᔟൢהʕତϞٙɽ໮ϣቛ০dԸଫฆඎܓவࡈ࣬၍̈ɹٜٙࢰɽʃeձ࣬φݬ၍
ࢰ፿ܓd೯ᙂԨʔ̙੻dΪމ̴ʊჃ൴ཀ፿ܓɤɚ (taper 12) ձɓϵ໮ (ISO size #100)f

ᎇܝdҷ͜ EDTA(17%)dәݹऍظ࣬၍˴ഢdԨᅰϣภৣ൴ࠪتਗɢԸዧ᛻๓૰d˸
̋੶૶ৰ̙ঐᒔڝ䋠׵၍ኣɪٙᛪϮf௰ܝdΎҷΫዢܓˇ׵ 1% ٙϣಣაඒ๓૰dਗ਼
Չ̂຅ϓɨϣΫൢഃࡉಂගٙ࣬၍ʫ͜ᖹيd್ܝਗ਼৻ଋಗଢ׳ආ࣬၍ɝɹdΎ˸ԑ੄
ێྼٙᅲࣛ෬໾ي੗܆᜖ഢ၊ݸකɹf՝ɨዖͤღܝdשᙲ࣬φ X Έ˪ ( ྡ 76C)dᅂ

྅ᜑͪ 21 Ϟ߰࡝഼̈ɹഢd˫࣬֠͊೯ԃҁΌdяତ̈ක׳׌࣬φٙᅵႶfШ࿁ˢቌ
˫ 11 ձ 22dᒱ೯ᙂ 21 ͦۃٙ၍ኣێྼܓ݊ᑛࢮəᓃdШ߰ซवπɨԸdᒔ̙݊˸וዄ
ቇ຅ٙէᘍաɢfΪϾdਗ਼࡝࡝ᐕ೻הԈѓٝषʾձՉ˃థdԨ˸ᑗґ຾᜕ཫк 21 ຾
Ύطᐕܝd஗ϓ̌वπɨԸٙዚึܘɽdЇˇʊ຾ᆽ֛༈࣬φٙषΊ๕᎘ԨڢԸІ 22f

38 ʔᓙіϗอٝdܵᚃ৛ᔳ᜕ᗇd޴ڦԒ᜗ଡ଼ᔌٙᆑঐ