Page 33 - 根管治療的美麗與哀愁 (轉、合篇)

࣬၍طᐕٙߕᘆၾۑฎ ( 轉、合篇 )

心得與結語 ( 綜合彙整上册「起、承」以及下册「轉、合」篇章 )

ᐼʘd࿁࣬၍ٙ૶௴ၾࡌҖdί݄ஔۃd݄ஔ٫ːʕ̀඲΋࿁ӊɓ˫࣬ٙ΢ࡈ࣬
၍ஷ༸dϞࡈйʔΝʈЪڗܓٙཫП (tWL)iϾ࿁࣬φݬʘ၍ഢஷ༸dһ੻ԱՉה᙮˫

࣬ٙێྼܓeձ༈˫࣬ʫ௅̥Ϟπίɓࡈאεࡈ࣬၍eޟЇՉ࣬φմࣙ݊щʊϞषᜊҖ
ϓnഃഃdண֛̈΢Іዹ᙮ٙ፿ܓක࢝ͦᅺi್ܝdਗ਼༈࣬၍ԱҏІڿ௅஼နֻ࣬φᓒ
௴dಂග᎖ᐿһอәݹ૰d( ̀ࠅࣛdቇ຅ሜ዆ዢܓ )dܙ˓ɪٙʃ໮ቛ০ (#10 file)d
ଉɝՑʊଫމ৻ଋٙ࣬φݬ˴ࠅ၍ഢʕdӚϞ༾ՑڜᖟeԨ˲уਗ਼ᢖ༺ஔۃהཫПٙ
࣬၍ʈЪڗܓ (tWL) ࣛdਗ਼ቛ০ɓᗙࡀৗΫזeɓᗙ˸܆଄༶ਗ (EOM) ˓جdᎇዚ૶

ৰֻڿਉ˙Σd( уቛ০ܝৗૅᔷࣛ ) הຠՑٙʔ஝ۆ၍ኣfܙҁΌৗ̈ܝdᏨൖԨ૶
ᆎቛ০ٙᑮૅග൷d߰೯ତϞतࣿෆ଱אڥᓃࣛdϤቛ০ۆʔ֝ΎԴ͜i߰кᓙϤቛ
০ᒔঐԴ͜dۆࠠอ࿁Չ০၌ɓʃݬཫᛃ (precurve)d˸ᄣ੶Չઞ॰ձ༪ᅁٙઽชܓi

Ύਗ਼ʃ໮ቛ০ࠠอ๞ආ࣬၍dίଉ༺ཫПʘ࣬၍ʈЪڗܓ (tWL) ࣛd˸ՍจШɦঐҁ
Ό౛છٙɢ༸߉ॎ࣬φ॥ᐵڜɢdᎻ༊ᜫቛ০ (#10f) ๞̈࣬φ၌ٙஷ༸̈ɹ (peeking
through)dԨ຾͟ X Έᅂ྅ᆽ֛Չφ၌ʊ຾ת༺࣬၍ஷ༸୞ᓃ ( у RT-inner reference
point)iϤࣛਗ਼З׵༈ቛ০ڐݛ၌ٙዖͤ˟ྦ (rubber stop)d( ίʔࠅזҰՑቛ০ઋرɨ )d
̻ᖢήપΣ௰ટڐ༈˫࣬׵኉ڿࠦɪٙɓࡈᖢո̨̻ (outer reference point)i຅ਗ਼ቛ০

(#10f) ٙφ၌פᕎৗ̈࣬φ၌ஷ༸̈ɹܝdΝᅵήɰ݊ਗ਼ՉɓᗙࡀৗΫזeɓᗙ˸܆଄
༶ਗ˓جdֻڿਉ˙Σ ( ቛ০ܝৗ ) ༶ਗdΝӉ૶ৰᎇዚהຠՑٙʔ஝ۆ၍ኣf຅ቛ০
(#10f) ҁΌৗ̈࣬၍ܝdඎ಻ՇࡈਞϽᓃʘගٙ൷ᕎdఱ੻Ցڋ֐࣬၍ʈЪڗܓ (iWL)f
Υ
຅್dᛇڎᛘ٫ኪึ༶͜ ݄ᅃᔼࢪהܔᙄٙ˙ό [ ʔࠅ͜ඎˉ (ruler)]dΎ՟ɓ˕޴Ν ᇐ
໮ϣٙ (#10f)eձϣɽɓ໮ٙ [ ν #15f or #2f (Series 29 ߒഃΝ׵ #13f)] ቛ০d΢ਗ̴਼
ࡁቛ০ʘφ၌ձ࡝࡝๞̈࣬φ၌ஷ༸̈ɹٙԟ˕ඎ಻ቛ০ (#10f) ίΝɓЗໄɪeཫᛃϓ
Ϟഹ޴ΝʘᛃϜ೻ܓiʘܝdՇՇ־ϤԻΐˢ࿁eᆽႩᛃܓձЗໄேΥ֝ܝdΎਗ਼๟௪
อٙ͜ቛ০Չڐݛ၌ٙ˟ྦdપՑ޴Ν׵ඎ಻ቛ০Չɪʘ˟ྦהίЗໄfϤܝdԱҏਗ਼

ʊண֛Ϟڋ֐࣬၍ʈЪڗܓٙӻΐቛ০ (files set, such as #15f, 20f, and 25f) ๞ආ࣬၍d
ਗ਼࣬၍ڿ௅ɧʱʘɚٙஷ༸dЪආɓӉٙᓒ௴ၾක࢝ (recapitulation)dίʔᓙһอәݹ
૰ऍᆗɨdʔࣛΫ᎘Ύ˸ʃ໮ቛ০ (#10f) Ըᆽ֛Ա್౛છഹ࣬၍ஷ࿫ (patency) ೌ໬d

௰ܝΎԱːʕהண֛࿁Ϥ࣬φݬɧʱʘɓٙ၍ഢஷ༸d஼နࡌҖЇͦᅺ፿ܓfΎϣ౤፴d
࿁வࡈͦᅺ፿ܓٙ኿֛dᐼ݊ࠅ˸Ϥ࣬၍הί˫࣬ٙێྼܓމਿ๟dί͍ᆽٙ࣬၍ஷ༸
ʕdቇʲήၪܵɓ၇݅ฆѶɦঐ੄ѩፅᓒ௴வࡈ࣬φݬٙ၍ഢஷ༸dආϾ༺ՑːʕމՉ
הண֛ٙ፿ܓͦᅺf[ ᙅν຅ঐ੄˸˓ਗᕃ⌹ቛ০ (ProTaper F2jtip=25; taper= ɞܓ )
ӚϞ༾Ցڜᖟd̙˸නлת༺၍ഢஷ༸ٙ RT(WL=20mm)dఱ̙ක֐ආБ˴ᇭ০༊φ೻

ҏ ]f
ஷ੬dܔᙄ΋ܿ፯ɓ˕፿ܓ (taper) ೹ฆɽɓᓃٙ࿕͜Υ֝ۨόٙ৵Ըᇭ০
(conventional type Gutta-Percha)dԸආБ˴ᇭ০ٙ༊φ಻༊fɓছ࿕ۨ͜όٙ৵Ըᇭ

᜗dՉφ၌ (tip) ே஗ႡிϓᗳЧ௢ᗳϻˣdяତφ୚ً (feathered)fΪϤdՉˉʂɽʃ
ʱᗳ (sizing) ஷ੬݊Ա዆᜗፿ܓԸЪਜཞd( ʔ྅ standard type GP ݊મո֛፿ܓɚdϾ
˸φ၌ٜࢰɽʃᅺͪνΝ K ۨቛ০ଡ଼dνj20e25e30nഃഃ )dᒱ್ʔΝᅀ೐ٙ࿕͜

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