Page 18 - 根管治療的美麗與哀愁 (玖部曲)

ࣛdΎԸᔾ૶Ցֵ༈षᜊ݊щॆٙԸІ᜖ഢ࣬၍ٙชݑ (lesion of endodontic origin)f
வ఻̩༑ᒱ್ႭԸᔊఊჀᕦdШɰ஢ᒔ݊Ϟᓃᜫɛᙂ੻Ѣ౅ၾ෇଻dᗫᒟί׵Ցֵ༈ν

О࿁வࡈဲЧषᜊٙᅂ྅dঐ੄׼Ҟή࿁ՉЪ͍̈ᆽٙ፫ᗆճkෂ୕ί˫߅ٙൢᐕʕd
ֻֻ̥Ա፠ X Έீൖቬ৶ʫ௅ଡ଼ᔌഐ࿴הᐏ੻ٙɚၪᅂ྅dԸ፫ᗆମ੬ၾщk್Ͼdೌ
ሞ݊મ͜ PAeBite-Wingeא݊ Pano ආБשᙲdᏨൖᅂ྅ࣛdεˇᐼึΪהשᙲٙ௅
ʱͭ᜗ഐ࿴־Ϥᛌᅂdኬߧίкᛘɪ̈ତѢᓔiא݊ྼ᜗ഐ࿴աՑשᙲԉܓٙזڗאᏀ

ᐵϓɚၪ̻ࠦܝdᅂ྅яତ̈ҩϜᜊҖϾᗭ˸፫ᗆfٜՑɚɤɓ˰ߏڋdᔟഹᔼ͜ཥ໘
ᓙᄴண௪ ( ೯׼ɛjGodfrey Hounsfield and Allan MacLeod Cormack ΍Νᐏ੻ 1979 ϋ
ፕԎဧ͛ଣၾᔼኪᆤࣿ࿲ )dঐ੄࿁ᕙࠦቬ৶ഐ࿴੽εࡈʔΝൿᇞשᙲdΎԱҏ௓ΐԨ
રהש੻ٙᅂ྅d੽Ͼ࢝ତ̈ɧၪٙနᄴྡ྅dԸ౤ԶЪމ፫ᗆԱኽfɓක֐dᆽྼᜫ

ۡࡁᔼ٫଻ຒɓڥdλ྅ॆٙঐ੄߉ॎཀֻᑎ಻׌ٙкᛘᅼόf್ϾdϘಂᔼ͜ཥ໘ᓙ
ᄴધ౜ٙ൬͜਋৷dɦცࠅձࠠसઃ٫نวשᙲࣛݬdߧԴɓছ˫߅ઃ٫ʔ˄࢙׸રՑ
ᏨݟٙዚึdϾ˲ӊϣધ౜שᙲٙࣛගڗdઃ٫աՑٙష࢛ኒඎ৷dɦΪᔼ͜ཥ໘ᓙᄴ
ᏨൖԨڢਖ਼މɹഢᔼᐕהணࠇdኬߧϓ྅ۜሯٙ༆ؓɢא፫ᗆܓd੬ʔঐୌΥ˫ᔼࢪٙ

ಂܙfה˸d຅ϋ࣬၍طᐕࣩԷึᏐ͜Ցཥ໘ᓙᄴЪႾпൢ࿀ٙˢଟԨʔ৷f
ٜՑ˫͜፿ًҼཥ໘ᓙᄴ (cone beam computerized tomography, CBCT) ਪ˰dϾ
˲ڐ఻ϋdৰəᄃኜண௪͉Ԓ຾ཀʔᓙή௴อҷԄ̮d஢εʔΝᅀ࢕ɰ޼೯̈ε၇޴ʝ
ৣࢁٙᝈൖழ᜗dᜫᔼࢪঐ੄І͟ή፯޶dԸІʔΝൿᇞהᙲ੻ٙᅂ྅dʔШঐ੄ਗ਼ʘ

ᎇจ׳ɽeᒔঐІ˴ήᔕᔷʔΝൖԉזڐᏨൖeɦঐΥଡ଼ྡ྅dϓɓͭ᜗ீൖᅼۨdԶ
ЪਞϽˢ࿁dɓɨɿۡࡁᔼࢪఱঐd( ༪୭ཀ̘ᝈൖᅂ྅ࣛdεˇ̀඲੻Ո௪Ԭ஢ซ྅
ɢdא੭ᓃଚ಻ԸЪкᛘ )dჀ׸ήᆽႩ̈༈ମ੬ഐ࿴ٙԸ๕᙮׌ՑֵމОkආϾܘҞ
ঐ੄Փ֛̈Υ֝ήطᐕࠇྌdԨ૶ูήΣઃ٫ЪႭ׼f͟׵อۨ CBCT ٙண௪ၾᄆࣸ޴

༰ᔼ͜ཥ໘ᓙᄴdࠅԸ੻Ⴠ̷ک֝஢εdϾ˲ӊࡈɹഢᔼᐕਖ਼߅ேึϞᏐ͜Ցவࡈɧၪ
ͭ᜗ྡ྅ᏨൖٙცӋfΪϤdʕʃ஝ᅼٙᔼ৫ձ˫߅ൢהdکॸॸᄣ૴ৣໄਖ਼᙮˫߅Ꮠ
ٙ͜ CBCT ˸౤Զ؂ਕfԴ੻ซމϞცӋٙઃ٫dτરЪ CBCT Ꮸݟdᜊ੻޴຅࢙׸e
൬͜ɰ޴࿁Эก஢εfˈՉd߰މݔԬत֛ͦٙd( νjซݟᗇ݊щϞ፲ဍ࣬၍eאᆽ
Ⴉ၍ኣॎˆЗໄdn)dᒔ̙˸፯኿Դ͜ʃᇍఖٙၳೊᏨ಻ᅼό (limited field of view,

FOV)dԸࠥЭઃ٫׵աᏨࣛٙᖅ๫፧࢛ኒඎdΝࣛɰ̙ᐵ೵שᙲધ౜ٙࣛගdೌҖʕ
ᜫݔԬԒ᜗ʔቇ٫d( νjೌجІ˴ၪܵո֛۶ැٙ৷ᙧ٫eא̰౽٫n)dɰঐટա
CBCT ٙᏨݟdΪϾա౉f຅್޴༰׵ෂ୕ɚၪ X ΈᏨݟdCBCT աᏨࣛdઃ٫הცו

աٙష࢛ኒඎᒔ݊ึ৷̈ܘε࠴dϾ˲ CBCT Ա್ᒔ݊ೌج࿁ழଡ଼ᔌ౤ԶϞࣖٙᏨ಻
( νj࿁Љ᎘eɹഢᓂᇫeאఌ૰໗᜗ٙषᜊ )iΝࣛdCBCT ٙ፿ًҼ࢛๕࿁Ϟږ᙮ي
΁πίɨd( νj贋ూ኉ڿe࣬ݒe࣬၍܆෬يn)dਗ਼ึପ͛ᔎ࢛e౳࢛dΪϾኬߧ࿁
޴ቌڐഐ࿴ٙкᛘ̈ତʍᓔd( νj࿁୚ฆ൓଱ٙਈ಻eאਉ˕࣬၍ٙฤరnഃഃ )fΪ

Ϥdۡࡁᔼ٫ᒔ݊੻੽ᑗґᏨݟʕd΋࿀ᙂ̈ίࡳࡈಃΣא௅Зd̙ঐϞ̀ࠅЪһଉɝ
୚ጰήઞ॰i್ܝdʑঐίשᙲܝdԘ஺੽መεٙʲࠦྡ྅ʕd֛ӞԨరᐏᗫᒟᇞ॰d
˸ᆽႩڋࣛٙᑎᓙॆᆽೌႬfϾவε̒ɰ݊ਖ਼ุɛɻ੬ึഗ̈ٙܔᙄd˜ॆϞ̀ࠅdʑ
ᜫઃ٫̘ટա CBCT ٙᏨ಻™d˜ɷຬйҪ CBCT ຅Ъ੬஝Ꮸݟධͦ™d( ˈՉ݊࿁ϋ

6 ͍ᆽٙൢᓙ̋ɪΌᆵٙطᐕ஝ྌdϓఱ̈௰Գٙ๫ᚐᅼό