Page 27 - 根管治療的美麗與哀愁 (轉、合篇)

࣬၍طᐕٙߕᘆၾۑฎ ( 轉、合篇 )

合 篇 樂章

施德氏根充技術，經驗分享

施德氏「三度空間暖牙膠垂直緻密填充根管系統」技術
Schilder's three dimensional filling of the root canal system with warm gutta-percha
by using vertical compaction Technique

຅ᒔӚۃֻߕ਷تɻ཭ɽኪΣ ݄ᅃᔼࢪኪ୦ࣛdϘʊහːᓋֻɽࢪٜٙۧ܆෬Ҧ
جf׵݊ܘႩॆή੽̙˸ટᙃ੻Ցٙ઺߅ࣣeಂ̊˖௝ٙሞࠑʕdІҢౣᅙᏐ͜dɰί

ᑗґषԷɪԱᅵ೥໡ᘻdϞᅼϞᅵή݄БৎԸdԨ˲໮၈Іʉɰ݊ɓЗЪᆠᇭٜۧ෬̂
ٙᔼࢪfኋ၍ಂගрɢήࡌ͍Ҧஔdʥ್Ъʔ̈νࣣ͉eಂ̊ɪהࣩ࢝ͪٙԷdяତϞ
ഹݓձІ್Ϝᇞٙ˴฀eձ̈ତ஢஢εεͣʕ੭ͣልᕏٙਉ˕ஷ༸d˸ʿί˫࣬մࣙၛ
׳̈ϢϢʃͣڀٙᎴߕ౻൥fϾ຅ટա ݄ᅃᔼࢪܸٙኬʘܝdІʉהЪࣩٙԷɰఱ୭ߣ
౬৶ঐ੄Ϟνཫಂছή࢝ତ̈྅ᅵٙϓ؈dΎ຾εϋٙᑗґଏᒠdһ஼န᜗ࢻՑࠅঐ੄

ቇʲήяତ݄̈ᅃˤ࣬̂Ҧஔٙࣖ؈d̀඲ঐ౛છֵɨՇࡈࠠᓃj

A. ༈νОഗʚ৵Ըᇭ᜗ቇ຅ٙᆠܓdᜫᇭ᜗ՈϞ̙෧ݴਗ׌k
ۃ˖ʕʊଫމሔʿ৵Ըᇭ᜗ίաᆠܝdՉ޴Зٙᔷ౬fίϤdਗ਼Ύਂһଉɝήሞ
ࠑfɓছ຾ཀਠۜʷܝٙ৵Ըᇭ᜗dਿ͉ɪ݊ஈί޴࿁༰މᖢ֛ٙ β-phasef( Ϊ᙮΢ Υ
࢕ᅀ೐ʘਠุዚ੗dҢࡁೌ੽ᆽႩ݊щΪࡈйה૴̋ٙၳΥيdאᜫᇭ᜗੻˸ᖢ֛ϓۨ ᇐ

ٙ෧ʷيdί΢ϞʔΝٙઋرɨdՉഐ؈ਗ਼ߧԴᇭ᜗ί޴Зᔷ౬ʘගdהცٙᆠܓϞה
ʔΝkא΢ࡈϓۨᇭ᜗աᆠܝdՉႅᆠঐɢɰਗ਼ึʔɓᅵk ) ΪϾίϤሔሞٙdਗ਼ස˸
Schilder's technique הપᑥdא຾಻༊ᗇྼୌΥಂܙٙ৵Ըᇭ০ЪމԱኽf
1. ߰ঐቇ຅ή౛౥ᆠܓ̋መ׵৵Ըᇭ᜗ɪdԴՉ͟ β-phase ਗ਼஼နᔷ୅Ї α-phase( ί

ᙲˤ 42 ä 49 ܓ ) ࣛdϤචݬᇭ᜗ʊՈ௪ə̙෧ݴਗ׌dШՉ౺ࣸ֠͊ҁΌҷᜊ ( ʥ
ၪܵί β-phase)dவࣛࡉ࿁ᇭ᜗ה݄БٜٙۧᏀᏚd̥݊રৰᇭ᜗ίႡிཀ೻ʕ
ʫ௅ٙ٤ქd˸ʿਗ਼ᇭ᜗ၾ၍ኣගٙהϞქᐻਂආɓӉήᏀྼ (compaction)fɓ
͇࿁ᇭ᜗̋ᆠཀ᎘ ( ༺Ցᙲˤ 50 ä 59 ܓ )dఱึऒʿʔΝ޴Зගٙᔷ౬ (beta to

alpha; alpha to amorphous)dՑϤචݬᇭ᜗ІԒٙيଣ౺ࣸʊ೯͛ᜊʷfࡊ߰̋
ᆠ๝ܓ൴ཀ 59℃dԟჿ৵Ըᇭ᜗ίᆠပиᐵʘගdਗ਼࢙׸ପ͛᜗ጐٙᜊʷdɰʔ
׸౛౥Չݴਗ׌f
2. ϘϋІҢ࿟॰ٜۧ܆෬Ҧجࣛd̥݊Դ͜Ցৢၚዱeא͉͛ዱਗ਼ኬᆠኜ૛ (heat

carrier) ʘφ၌̋ᆠЇعߎdΎ̘ᙃድ৵Ըᇭ᜗ԴՉழʷf್Ͼd຅ኬᆠኜ૛ᕎ
කৢၚዱ˦d຾ཀ٤ंиۍdΎՑषɛɹʕࣛdʔٝ༸ʊϞεˇᆠܓ੽ኜ૛ʘφ
၌౳̰fה˸dԴ͜வ၇˙όԨೌجၚ๟છՓ̋መՑᇭ᜗ɪٙᆠܓfϾ˲dϞࣛ
ࡉᒔึʔʃːድෆІʉeпଣޟЇषʾdତίซԸᒔॆϞᓃΚᎈiϤ̮d຅ίઃ

٫ࠦۃЪ̈ᓃ˦ਗЪࣛdֻֻᒔึிϓषʾٙઋၫၡੵd຅್݄ஔ٫Ϥࣛɰᗭе

15