Most people have experienced the pain of toothache, which is probably a nightmare to everyone . Toothache is usually caused by infected nerves in the dental pulp. By the way, severe cavity, periodontal disease, cracks on the teeth would lead to the toothache as well.

Pulpitis is closely related to bacteria. If one doesn’t tackle it as soon as possible, it is possible to lead to not only toothache but suppurative infection, or even worse, the cellulitis. If one misses the prime section to treat it, one may have to seek other ways such as extraction, implantment or bridge to remain the function of occlusion. 

 

root canal treatment/

  • under  local anesthesia
  • place the rubber dam around the tooth (to lower the risk of infection)
  • remove the cavity and the filling
  • respectively enlarge the pulps with dental Instruments in order to remove the destroyed pulp and the infected dentin
  • make sure that all the pulps are clean and fill them up, in order to prevent them from being infected again
  • During the observation, the doctor should make the crown or CAD-CAM to remain the appearance and the function of occlusion. If the situation doesn't get better after the treatment, one could discuss further treatments with the doctor.
  • make a return appointment to follow up the recovery
  • The number of the pulps are different according to the position of each tooth. The complexity of nerves and the level of calcification should be considered in the treatment as well, so the length of follow-up would not be the same for everyone. 
 

Microendodontics/

Microscopes assist a lot in root canal treatment. The usage of dental microscopes and lighting equipment helps the doctor to observe the inner parts of the tooth more easily. If the doctor could use dental microscopes and advanced equipment when dealing with some complex cases in the very first stage of root canal treatment, the whole procedure could be more completed, furthermore, the length of the treatment could be dramatically shortened, which helps a lot for saving the dentin and the pulp, also for reducing the risk of complication. Nowadays, dental microscopes are also operated in radicular surgery. According to the research, compared to traditional radicular surgery, micro  radicular surgery has reached the success rate by 90 percent, which is a great accomplishment of saving one’s own teeth.


前言/

幾乎每一個人都曾有牙痛的經驗,而牙痛的成因很多時候是牙齒內部牙髓神經的發炎反應或感染造成的。太嚴重的蛀牙、外傷外力撞擊、牙齒磨損或出現微細裂痕及、牙周病等等都會是牙髓生病的主因。
牙髓組織生病與細菌息息相關,如果不積極處理,除了有機會引發疼痛不適、化膿腫脹,甚至可能引發蜂窩性組織炎,對身體健康構成威脅。錯過了搶救牙齒的黃金時間也有可能必須面臨拔牙的厄運,日後必須以植牙、牙橋或活動式假牙重建缺牙區咬合功能。


根管治療/

  • 局部麻醉施打
  • 牙齒周圍置放隔離障(降低口水細菌感染)
  • 清除蛀牙、舊的填補物,打開髓腔並找到根管入口
  • 使用專門器械,依照管道原始路徑,把根管完整暢通並依序擴大,以清除壞死的牙髓組織以及受感染的牙本質;
  • 確認以上步驟已經盡可能將根管清潔乾淨且沒有發炎,再把根管緊密地充填,以防止再度感染。
  • 觀察沒症狀後,應盡快製作牙冠、嵌體(齒雕)等等,以恢復牙齒外形及咀嚼功能。若治療後症狀仍未改善,可與醫師討論是否進一步採取手術性治療。
  • 定期回診,追蹤牙齒的狀況。

 
根據齒位的不同,牙齒的根管數目也會不一樣,每個人牙齒的複雜度也不一,同時也需要考慮到根管彎曲鈣化的程度,所以療程所需的回診次數也會不同。
 
顯微根管治療/

「顯微鏡輔助根管治療」 運用牙科顯微鏡放大照明設備,將牙齒高倍數放大後將內部細節呈現一覽無遺。較為複雜的案例若能在第一次根管治療就採取 「顯微鏡輔助根管治療」 的方式進行, 同時搭配精細的器械、可將根管治療的工作進行得更加保守徹底, 縮短了大量的治療時間; 對於齒質和根管型態保存的程度以及併發症的減少都是大大有幫助的。現今牙科顯微鏡也運用於「顯微根尖手術」, 根據文獻研究,相較於「傳統根尖手術」, 現代的「顯微根尖手術」的成功率已經可達到接近90%, 提升了保留自然牙齒的機會!