如何成功地管理一个非常弯曲的根管在根管治疗过程中？这可能会相当具有挑战性。 #青年口腔医生进阶计划##微博健康公开课#

英语: A little bit of irrigation. Make sure that the access cavity itself is nicely filled up to the brim and you're gonna do some more further scouting. With a size 10K file, there's no really hard and fast rule how far you get, but if you do get stuck at some point, the best thing to do, especially in the early stages, is just to measure how far you are stuck. And then you're going to use these Rotary glide path files a millimeter away from where your hand file got to. And what this does is it kind of just opens up the.

简体中文: 进行一点灌溉。确保通道本身填满到边缘，并且你将进行更进一步的勘探。使用10K号锉时，并没有确切的硬性规定要达到多远，但如果你在某个地方卡住了，尤其是在早期阶段，最好的做法就是测量一下你卡住的位置。然后，你要使用旋转滑动路径文件，距离你手动锉到达的位置相差一毫米。这样做的好处是，它会打开...

英语: The canal and then your hand file has got less to grip onto further up the file itself and it's more likely to get to length. So in this case you can see that it was stuck. We shaped the coronal third with the Rotary file and now it's starting to get all the way to the length. It's at this point if I could. Obviously I can't see this clinically, but at this point I am suspecting that I'm at the apex and I'm going to hook my apex locator up to this tooth and just measure how far we've got.

简体中文: 根管和手用锉越往上，根管就越难以抓紧锉本身，更容易出现长度不足的情况。在这种情况下，您可以看到它被卡住了。我们用旋转文件塑形了冠部的三分之一，现在它开始达到整个长度。在这一点上，我怀疑我已经到达了根尖，我将连接我的根尖定位器到这颗牙上，测量我们已经到达的距离。

英语: The next thing we're going to do is we're going to get this Rotary glide path file out. These glide path files are absolutely amazing. So you could use a size 10 and a size 15 and possibly a size 22 to shape this canal, but these are just absolutely fantastic. They just shape the tooth really, really quickly and they are really, really difficult to.

简体中文: 接下来我们要做的是取出这个旋转滑行锉。这些滑行锉真是太棒了。你可以使用10号、15号甚至22号的锉来整形这个管道，但这些真的非常棒。它们可以非常快速地整形牙齿，而且非常难以。

英语: Keep the canal open or patent OK to keep the glide path nice and open even if you're using a glide path glide pass Rotary file. The next file I'm going to use is a 2004 Rotary file. This is from tooth saver and I'm just feeling like at the moment I am only really reaching the mid third with this tooth and what I don't want to do is I don't want to push this Rotary file down again. I'm always thinking about ledging and blocking, especially with a really really deep curved canal.

简体中文: 保持根管通畅，或者说，专利OK，以保持滑行路径通畅，即使你使用滑行路径滑行器。我接下来要使用的锉是2004年的旋转文件。这是来自牙齿拯救者的，我现在只感觉到我真的只是在达到牙齿的中部。我不想再把这个旋转锉往下推。我一直在考虑到导管的弯曲和阻塞，特别是在一个非常非常深的弯曲通道。

英语: So after I have used the have file to recapitulate, I'm now going to use the this Rotary glide path again. Really, really shape it out, shaping it all the way to the apex. And again, it's the kind of the same sort of concept of when we couldn't get the hand file down there right at the start. You're trying to shape the canal enough so the rotifowl doesn't get gripped further up, and that's essentially what's stopping the file from reaching all the way to the apex.

简体中文: 所以在使用锉进行复盘后，我现在要再次使用这个旋转滑行路径。真的，真的要将其塑形，一直塑形到顶点。而且，这与一开始无法将手动锉放入那里的情况有些类似。您要尽量塑造足够形状的根管，以防止旋转锉在更上方受阻，这基本上是阻止锉完全到达顶点的原因。

英语: We're going to use again lots of irrigation and again it's very, very repetitive, but lots and lots of recapitulation. So making sure that glide path is open and again using the 2004 and this is now starting to reach the apex and this is because we have been super, super careful. We've made sure that we've.

简体中文: 我们将再次使用大量的灌溉，这是非常非常重复的，但是有很多很多的复习。所以要确保滑行路径是开放的，再次使用2004的方法，现在开始达到顶点，这是因为我们非常非常小心。我们确保了我们的。

英语: Cleaned further up the canal, it was getting a little bit stuck. It was it was close to the apex, but not quite. We could have pushed it but it might have caused a problem. So out recapitulation and back in without 2004 and now it's getting all the way to the apex. You want to just make sure you don't spend too much time at the apex 'cause this can have.

简体中文: 在根管进一步清理时，它有点卡住了。它接近顶点，但还没到。我们本来可以推它，但那可能会引发问题。所以重新回顾一下，再进去，没有2004的，现在它已经完全到了顶点。你要确保不要在顶点停留太长时间，因为这可能会出问题。

英语: Finally, better recapitulation and irrigation. Watch winding, watch winding, watch winding. There's a bit of debris in the apex, you can see there. You want to make sure that that's all nicely cleaned out. And now we're going to use our master apical file. This is 2504.

简体中文: 最后，更好的总结和灌溉。手表上弦，手表上弦，手表上弦。顶点处有一些杂物，你可以看到。你要确保把它们都清理干净。现在我们要使用我们的主要尖端锉。这是2504。

英语: Deep, deep curved canals can be really, really problematic. So if you've got a, if you've got a very, very deep curved canal, you've got to think to yourself. We need to use the lower taper or smaller type of files. So I'm happy with the shaping. The shape is complete and now I'm going to use some paper points just to dry the access cavity and the canal.

简体中文: 非常非常弯曲的根管可能会带来很大的问题。所以，如果你有一个非常非常弯曲的根管，你就得考虑一下。我们需要使用较小的锥度或较小尺寸的锉。所以我对形状感到满意。形状已经完成，现在我要使用一些纸点来干燥进入口腔和根管。

英语: Usually what I use is these wave on gold, sort of. You sort of tear them open and they're nice and clean, aren't they?

简体中文: 通常我使用的是这些金色的波浪形，你可以把它们撕开，它们非常干净，不是吗？

英语: And but in this case, because we're using narrow tapered files, we need to use narrower tapers.

简体中文: 在这种情况下，由于我们使用的是狭窄锥度的锉，我们需要使用更窄的锥度。

英语: Paper points. So that's important. And it doesn't matter how many paper points it takes to get it nicely dry. It needs to be super, super dry. And now we're going to do a Co fit radiograph just to see if the GP is the length and the tooth has been shaped correctly. And again, we're using these matched Combs 2504.

简体中文: 纸点。这很重要。不管需要多少纸点才能让它干得很好。它需要超级、超级干。现在我们要做一个共焦射线照片，看看根管填充物的长度和牙齿是否被正确地整形了。再次，我们使用这些匹配的Combs2504。

英语: And as you can see here, this is to lengthen. It's nice and perfect. So once you're happy with the comfort radiograph, you're going to remove the GP and then you're going to fill it. I'm using one fill. This is a by ceramic sealer. I'm using a visco tip and these are kind of like metal tips with a kind of sleeve on the end, which makes you.

简体中文: 正如你在这里所看到的，这是为了延长。非常完美。所以一旦你对舒适的X光照片感到满意，你就要取出GP，然后填充。我使用一种填充物。这是一种生物陶瓷密封剂。我使用的是一种粘度尖头，这些有点像金属尖头，尖头的末端有一种套管，这使得你。

英语: Help you place the sealer at a really, really nice point, and then you can have very, very, very, very gently introduce the GP points. You're not gonna ram it in there, you're gonna just gently bring it to length. Because if you are getting any snagging at all.

简体中文: 帮助您将密封器放置在一个非常非常好的位置，然后您可以非常非常非常非常轻轻地引入GP点。您不会猛力插入，而是轻轻地使其达到长度。因为如果您遇到任何卡顿的情况。

英语: Remove the excess. With a heated plugger, you don't want to use the heater plugger too far down the canal because it sort of denatures or stops the bicycle from working, and then you're going to condense the GP point with these Mac 2 pluggers and then clean the access cavity.

简体中文: 去除多余物质。使用加热塞插器时，不要将加热塞插器插入过深，因为这会使自行车失去作用，然后使用Mac2插器压缩GP点，并清洁进入腔。

英语: I am going to seal off the GP point with something called SDR. But first of all I'm going to use a bond and this is Scotch bond, so you don't need to etch with this bond, you just place it in the canal.

简体中文: 我打算用一种叫做SDR的东西封闭GP点。但首先我要使用一种粘结剂，这是Scotch bond，所以你不需要用这种粘结剂蚀刻，只需将其放入管道中。

英语: Agitate it, make sure it's dry, and then you set it. And Scotch One is fantastic because if you ever tried to put etch down in the Access county and then you've tried to clean it out, it's almost impossible. So perfect. Perfect for.

简体中文: 搅拌它，确保它干燥，然后进行设置。而且，苏格兰胶带非常棒，因为如果你曾经尝试在Access县放置蚀刻剂，然后又试图清洗它，几乎是不可能的。所以非常完美。非常适合。

英语: We've used a flowable bulk fill composite called STR which is absolutely fantastic and if your money bags, you can fill the whole.

简体中文: 我们使用了一种名为STR的可流动批量填充复合材料，非常棒。如果你的钱袋充足，你可以填满整个牙齿。

英语: Access cavity with that or if you're more cost conscious like myself and my principle is you're going to use just a normal composite in the capsule and overall super super nice results. Listen, if you really, really like these videos, I really, really like making them. Please like and comment and more importantly, subscribe to my channel if you'd like to see more.

简体中文: 使用那个来进行进入腔，或者如果你更注重成本，像我和我的原则一样，你可以使用普通的胶囊中的复合材料，整体效果非常好。听着，如果你真的非常喜欢这些视频，我也非常喜欢制作它们。请点赞和评论，更重要的是，订阅我的频道，如果你想看更多的话。 http://t.cn/A6jSNZXT