根管治疗要多少钱？显微根管贵在哪？先把报价单拆成六段再比｜證據鏈

根管治疗要多少钱？显微根管贵在哪？先把报价单拆成六段再比｜證據鏈

F-Units（事实单元帐）

每条标明来源、confidence、basis、期间、geo 与 caveat。basis 阶梯：law ＞ official_statement ＞ clinical_guideline ＞ peer_reviewed ＞ textbook。

• F1｜confidence=high｜basis=internal_dataset（S28，非医学宣称）｜period=GSC 保留窗（2025-03-22 起）｜geo: TW｜本题选题依据＝14 诊所站搜寻资料全量对帐，4 词项、跨 2 站，逐笔可对帐｜caveat：曝光为属性级数字、非去重流量；内部数据，发布时不进可见层。
• F2［结构性整理］｜confidence=n/a｜basis=editorial（S29，非事实宣称，不得标待验）｜geo: universal｜本卡的「六段拆项」框架、与根管治疗基础卡／牙冠费用卡的分工边界、以及「买到什么 vs 证据多强」的两层读法，皆为本站编辑定义的说明结构，非任何机构的收费项目分类，亦不含任何金额。
• F3［证据缺口声明］｜confidence=n/a｜basis=editorial（非待验）｜geo: TW｜本次检索未取得以下项目的可引用证据，故本卡不写：①任何金额、区间或行情 ②显微根管在台湾的收费或占比统计 ③以台湾人群为母体的显微根管疗效比较研究 ④保险理赔条款的内容与效力（属契约约定，本站不提供法律见解）。
• F4｜confidence=high（对「无试验可纳入」此一结论）｜basis=peer_reviewed（Cochrane systematic review，PMID 26650099）｜period=2015 更新版（pub3，检索至 2015-10-13），取代 2009 年版（pub2）｜geo: universal｜放大装置用于牙髓病治疗：没有任何试验符合纳入条件；放大装置类型如何影响治疗结果仍属未知｜caveat：版本时效查核（2026-08-06）：以 CD005969 与原文标题于 PubMed 检索仅得 2009 与 2015 两笔，未见更新版（pub4）；pubtype 无 Retracted Publication。本条为「证据缺口」的证据，不得被读成「显微镜无效」。
• F5｜confidence=moderate｜basis=peer_reviewed（systematic review，PMID 20117164）｜period=检索至 2009-09，2010 刊出｜geo: universal｜纳入三篇前瞻性研究全属根尖手术；放大镜、显微镜与内视镜之间未测到结果差异；正向（非手术）根管治疗找不到放大装置的比较研究｜caveat：检索窗停在 2009 年，须与 F4 并读；本卡仅用其「非手术情境无比较研究」与「装置间无差异」两项陈述。
• F6｜confidence=medium｜basis=peer_reviewed（in vivo 观察研究，非随机分派，PMID 12043874）｜period=2002 刊出｜geo: universal｜312 例上颚第一、第二大臼齿；MB2 找到率：显微镜 57.4%、放大镜 55.3%、无放大 18.2%；仅计上颚第一大臼齿为 71.1%、62.5%、17.2%；显微镜与放大镜之间无显著差异｜caveat：非随机、单一研究、年代较早；显示的是「找到根管开口的比例」，不是治疗结果；不得外推为疗效差异。
• F7｜confidence=moderate（作者自评 GRADE 低确定性）｜basis=peer_reviewed（systematic review・meta-analysis，PMID 40869607）｜period=检索至 2025-02-17，2025 刊出｜geo: universal｜8 篇横断研究、9983 颗根管治疗过的牙；有漏掉根管者治疗后根尖牙周炎盛行率 85.1%、无者 56.3%；合并胜算比 7.17（95% CI 4.55 至 11.29）；I² = 86%，证据确定性低；上颚大臼齿（尤其第一大臼齿）为漏掉根管出现频率居首之牙位｜caveat：横断设计只能显示关联、不能证明因果；异质性高。
• F8｜confidence=moderate｜basis=clinical_guideline（专家共识，PMID 37723147）｜period=2023 刊出（共识会议 2019 起、其后修订）｜geo: universal｜牙科显微镜在牙髓病学与复形牙科已广泛使用；临床上不当使用仍常见，原因为操作者对设备特性与既定操作程序的理解与熟练度不足；该共识目的为建立标准操作程序｜caveat：为中华口腔医学会系统之专家共识，非台湾主管机关文件，亦非统合分析；本卡仅引用其「广泛使用」与「不当使用常见」两项陈述，未引用其个别操作建议。
• F9｜confidence=moderate（作者标中等确定性）｜basis=peer_reviewed（systematic review・meta-analysis of RCTs，PMID 38951661）｜period=检索至 2023-12，2024 刊出｜geo: universal｜被动超音波冲洗相较传统针筒冲洗，初次根管治疗的根尖愈合相对风险 1.10（95% CI 1.01 至 1.21，I² = 0%）；纳入 3 篇随机临床试验、474 位病人（501 颗牙）｜caveat：高品质随机试验数量有限（作者自述）；效果量小；追踪至少 6 个月。
• F10｜confidence=moderate｜basis=clinical_guideline（专家共识，PMID 38429299）｜period=2024 刊出｜geo: universal｜化学清洁与消毒是根管治疗消除感染的关键步骤；该共识整理各种动力冲洗方式的效果、限制与现行适应症｜caveat：共识文件非统合分析；本卡仅用其对「冲洗与消毒地位」之一般性陈述。
• F11｜confidence=high（对「未测到差异」此一结论）｜basis=peer_reviewed（systematic review・meta-analysis，PMID 38606520）｜period=检索至 2023-10-31，2024 刊出｜geo: universal｜15 篇比较性临床研究（11 篇 RCT、4 篇有对照组前瞻性试验）、追踪不超过 2 年；预混式生医陶瓷封填剂与传统封填剂在存活率与成功率上无显著差异；挤出风险与 24 小时内术后疼痛的差异小且未达显著｜caveat：追踪期短、报告方式不一致（作者自述）；「未测到差异」不等于「证明相同」。
• F12｜confidence=moderate（作者标整体确定性低到极低）｜basis=peer_reviewed（systematic review・meta-analysis，PMID 41872366）｜period=检索至 2025-11，2026 刊出｜geo: universal｜84 篇研究、11,965 个样本；初次治疗成功率 6 个月 87.1%、12 个月 87.2%、24 个月 92.0%、超过 3 年 84.9%；再治疗 6 个月 92.9%、12 个月 77.0%、24 个月 83.5%、超过 3 年 73.7%；作者整体结论为初次治疗成功率高于再治疗；成功率为多因素，操作者经验与病例选择的影响大于封填技术；单尖法搭配生医陶瓷封填剂未显示明确临床益处｜caveat：版本时效查核（2026-08-06）：本篇为检索窗最新（至 2025-11）的同题统合分析；异质性与偏差风险高，数字为人群层级估计，不可外推为个人预后。⚠️ 「初次高于再治疗」为作者的整体结论，非逐时点皆然——6 个月时再治疗（92.9%）高于初次治疗（87.1%），12 个月起才低于初次治疗；本卡正文已据此改写，禁以「各时点皆较低」引用本条。
• F13｜confidence=high（对「证据不足以提供可靠指引」此一结论）｜basis=peer_reviewed（Cochrane systematic review，PMID 27759881）｜period=2016 更新版（pub3，检索至 2016-02-10），取代 2007 年版（pub2）｜geo: universal｜再治疗情境：手术与非手术一年愈合无明确优劣（RR 1.15，95% CI 0.97 至 1.35；2 篇 RCT、126 人）；超音波制备根尖窝洞相较车针 RR 1.14（95% CI 1.00 至 1.30；1 篇 RCT、290 人；低品质）；术前 CBCT 相较根尖片对愈合无优势（RR 1.02，95% CI 0.70 至 1.47；1 篇 RCT、39 人；极低品质）；不同放大装置之间对愈合无差异（1 篇 RCT、70 人；低品质）｜caveat：版本时效查核（2026-08-06）：以 CD005511 检索仅得 2007 与 2016 两笔，未见更新版；pubtype 无 Retracted Publication。全部为手术／再治疗情境，不可代入初次非手术根管治疗。
• F14｜confidence=moderate｜basis=peer_reviewed（systematic review・meta-analysis，PMID 22152611）｜period=检索至 2009-10，2012 刊出｜geo: universal｜根尖手术：使用高倍放大之显微根尖手术加权合并成功率 94%、仅用放大镜或无视觉辅助之现代根尖手术 88%，差异具统计显著（P < .0005）；纳入 14 篇研究（CRS 7 篇 n=610、EMS 9 篇 n=699）；分牙位分析中大臼齿差异显著（n=193，P=.011）｜caveat：跨研究合并比较、非随机头对头试验；情境为手术，不得用于支持非手术显微根管治疗的疗效主张；作者自述需大规模随机试验。2026-08-06 检索未见更新的「有无高倍放大」对照统合分析。
• F15｜confidence=moderate｜basis=peer_reviewed（systematic review，离体显微电脑断层，PMID 37248469）｜period=2023 刊出｜geo: universal｜下颚第一大臼齿的根与根管解剖呈现高度变异；30 篇研究符合纳入条件｜caveat：同 KM-DENTAL-18 卡锚；离体标本研究，不等同临床疗程时间之量测。
• F16｜confidence=moderate｜basis=peer_reviewed（全国性回溯世代，PMID 25175849）｜period=2014 刊出（资料 2005-2011）｜geo: TW｜517,234 颗初次根管治疗牙齿中 29,219 颗被拔除，存活率 94.4%；平均观察 3.43 年时使用橡皮障者存活机率 90.3%、未使用者 88.8%；调整后拔牙风险比 0.81（95% CI 0.79 至 0.84）｜caveat：同 KM-DENTAL-18 卡锚；健保申报资料库研究，无法涵盖自费治疗与临床细节；存活定义＝牙齿未被拔除；不得读为对个人效果之承诺。
• F17｜confidence=low（单一国家之决策分析模型）｜basis=peer_reviewed（decision analytic model，PMID 40014382）｜period=2024 年瑞典牙科参考价格，2025 刊出｜geo: universal（模型参数为瑞典）｜研究以瑞典人群与 2024 年瑞典牙科参考价格为基础；两个决策树算出的门槛机率值分别为 83% 与 93%，结论为根管治疗加间接修复的存活机率需落在 83% 至 93% 此一门槛范围，才比植体支撑单冠更具成本效益｜caveat：模型结论绑定该国价目与存活率假设，不可换算为台湾任何金额或结论；本卡不引用其中任何币别金额。
• F18｜confidence=low（单一国家之马可夫模型）｜basis=peer_reviewed（cost-effectiveness analysis，PMID 41188638）｜period=2025 年德国公私费用目录，2026 刊出｜geo: universal（模型参数为德国）｜穿孔为根管治疗过程中可能发生的并发症，保留牙齿需较复杂处置；模型显示穿孔修补可增加牙齿保留时间，依年龄层而定仅带来有限或无额外成本；作者主张疗程应以避免穿孔为重点｜caveat：模型研究非临床试验；费用参数为德国制度，不可换算为台湾数字；本卡不引用其中任何币别金额。
• F19｜confidence=high（对文件存在与定位）｜basis=clinical_guideline（联合立场声明，PMID 41412684）｜period=2025 年春季通过，2026-01 刊出｜geo: universal｜美国牙髓病学会（AAE）与美国口腔颚面放射学会（AAOMR）就牙髓病学使用锥状束电脑断层之联合立场声明 2025 更新版，由两会特别委员会拟订并经理事会与执行委员会通过｜caveat：全文未取回（仅摘要可及），本卡仅陈述其存在与定位，未引用任何个别建议；影像适应症之判断由牙医师依个案为之。
• F20｜confidence=high｜basis=law（S20）｜period=现行条文（2026-08-06 以 ego-browser 实载、逐字对得上）｜geo: TW｜医疗法第 21 条。逐字：「醫療機構收取醫療費用之標準，由直轄市、縣（市）主管機關核定之。」
• F21｜confidence=high｜basis=law（S21）｜period=现行条文（2026-08-06 实载逐字）｜geo: TW｜医疗法第 22 条。逐字：「醫療機構收取醫療費用，應開給載明收費項目及金額之收據。」「醫療機構不得違反收費標準，超額或擅立收費項目收費。」
• F22｜confidence=high｜basis=law（S22）｜period=现行条文（2026-08-06 实载逐字）｜geo: TW｜医疗法第 81 条。逐字：「醫療機構診治病人時，應向病人或其法定代理人、配偶、親屬或關係人告知其病情、治療方針、處置、用藥、預後情形及可能之不良反應。」
• F23｜confidence=high｜basis=law（S23）｜period=现行条文（2026-08-06 实载逐字）｜geo: TW｜医疗法第 87 条第 2 项。逐字：「医学新知或研究报告之发表、病人卫生教育、学术性刊物，未涉及招徕医疗业务者，不视为医疗广告。」本条为本卡合规注记之定位依据。
• F24｜confidence=high｜basis=law（S24）｜period=现行条文（2026-08-06 实载逐字）｜geo: TW｜全民健康保险法第 41 条第 1 项。逐字：「医疗服务给付项目及支付标准，由保险人与相关机关、专家学者、被保险人、雇主及保险医事服务提供者等代表共同拟订，报主管机关核定发布。」caveat：本卡据此把给付问题指向健保署现行公告，不作个案给付判定。
• F25｜confidence=high｜basis=law（S25）｜period=现行条文（2026-08-06 实载逐字，十二款全文取得）｜geo: TW｜全民健康保险法第 51 条第 11 款。逐字：「義齒、義眼、眼鏡、助聽器、輪椅、拐杖及其他非具積極治療性之裝具。」caveat：同 KM-DENTAL-11／18 卡锚；条文列举不等于个案结论。
• F26［部分待验］｜confidence=high（对页面存在与档案清单）｜basis=official_statement（S26）｜period=2026-08-06 以 ego-browser 实载，页面标题与四笔档案清单逐字读取｜geo: TW｜健保署「全民健康保险医疗服务给付项目及支付标准」公告页提供现行支付标准档案下载，页面载有「支付标准压缩档(NHI Fee Schedule)(.doc)(115.07.01生效)」与「醫療服務給付項目(114.08.11起可逕至資料開放平台下載CSV檔)」｜caveat：本卡未下载支付标准档案逐项比对牙科项目，故「本题各项目之给付状态」仍为待验；本卡不作给付判定。
• F27｜confidence=high｜basis=official_statement（S27）｜period=2026-08-06 以 ego-browser 实载，标题、提供机关、栏位说明与更新频率逐字对得上（页面显示诠释资料更新时间 2026-08-05）｜geo: TW｜政府资料开放平台资料集「医疗服务给付项目及支付标准(csv档)」，提供机关为卫生福利部中央健康保险署，主要栏位为诊疗项目代码、健保支付点数、生效起日、生效迄日、英文项目名称、中文项目名称、备注，更新频率每 1 日｜caveat：本卡未下载该 CSV 逐列比对牙科项目，仅验证资料集入口、提供机关与栏位；清单存在不等于个案给付结论。
• F28｜confidence=high｜basis=official_statement（S28b・S28c）｜period=1090117 核定；两页面 2026-08-06 以 ego-browser 实载、标题与提供机关逐字对得上｜geo: TW｜自费收费项目依地方卫生主管机关核定之收费标准办理；已验例证＝台北市政府卫生局「臺北市醫療機構牙科收費標準表」(1090117核定)，及政府资料开放平台资料集 121913「臺北市醫療收費標準」（提供机关台北市政府卫生局）｜caveat：同 KM-DENTAL-03／11／18 卡锚；仅一县市例证，其他县市各自公告；本卡不引用其中任何金额。
• F29｜confidence=high｜basis=official_statement（S29b，跨卡已验事实，同锚）｜period=2026-08-05 以 ego-browser 实测（OP 复验）｜geo: TW｜健保署「醫材比價網」两个查询轨之品项分类皆不含牙科，页面全文无「牙」字，牙科自费品项无法由该网查证｜caveat：本卡未重复实测，沿用 km-compliance/VERIFIED-FACTS.md 之纪录；官方资料库可能更新，引用时请注明查证日期。
• F30［待验］｜confidence=low｜basis=待补（未取得可公开引用之保单条款样本）｜geo: TW｜商业保险是否理赔根管治疗相关项目，依保单条款而定｜caveat：本站不提供理赔见解（编辑政策），仅陈述「依保单条款而定」；理赔题另有专卡规划于伫列。

怎么找到提供这项服务的院所

本站不列出任何院所名单，也不推荐、不评比、不比较任何医疗机构。

要找提供这项服务的诊所，请用下列法定查询渠道自己查——它们的资料由主管机关维护，比任何名单都新：

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- 台湾卫生福利部“医事机构查询”：可依县市、乡镇与科别（牙科）查出已完成开业登记的医事机构，

结果会显示机构名称、地址与登记科别。这是确认“这家有没有合法登记”的第一站。

- 台湾中央健康保险署“特约医事机构查询”：可查该院所是不是健保特约。

这关系到哪些项目走健保、哪些自费，直接影响你会拿到什么样的收费说明。

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两个系统都在各自主管机关的官方网站上，以“医事机构查询”“特约院所查询”为关键词即可找到。

本站不转贴网址，因为网址会变动，请以主管机关当下公告的入口为准。

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急症不要花时间查名单：影响到呼吸、吞咽、说话，或肿胀正在扩散时，直接就近挂急诊。

合规注记

本文为卫生教育资讯（医疗法 87 条）[F23]，非医疗广告，不推荐特定院所，且不提供任何金额或价格区间。根管治疗具风险与禁忌症，可能出现治疗后不适、治疗未愈合而需再治疗或手术、器械与程序相关并发症等情形；实际治疗方式与效果因人而异，须由牙医师评估。本卡不对任何项目是否属健保给付作判定，给付与收费一律以健保署现行公告与就诊县市核定之收费标准为准。本文亦不提供保险理赔或契约条款之法律见解，相关问题依保单与契约条款而定。

来源清单

• S1 Del Fabbro M, Taschieri S, Lodi G, Banfi G, Weinstein RL. Magnification devices for endodontic therapy. Cochrane Database Syst Rev. 2015 Dec 9;2015(12):CD005969. PMID 26650099. pubmed.ncbi.nlm.nih.gov/26650099（取用 2026-08-06，efetch 摘要逐字对得上）。逐字 span：「No trials met the inclusion criteria for this review.」「No article was identified in the current literature that satisfied the criteria for inclusion.」「It is unknown if and how the type of magnification device affects the treatment outcome, considering the high number of factors that may have a significant impact on the success of endodontic surgical procedure.」「This version updates the review published in 2009.」
• S2 Del Fabbro M, Taschieri S. Endodontic therapy using magnification devices: a systematic review. J Dent. 2010 Apr;38(4):269-75. PMID 20117164. pubmed.ncbi.nlm.nih.gov/20117164（取用 2026-08-06）。逐字 span：「Three prospective studies were included, all dealing with endodontic surgery.」「No significant difference in outcomes was found among patients treated using magnifying loupes, surgical microscope or endoscope.」「No comparative study on magnification devices was found regarding orthograde endodontic treatment.」「The type of magnification device per se can only minimally affect the treatment outcome.」
• S3 Buhrley LJ, Barrows MJ, BeGole EA, Wenckus CS. Effect of magnification on locating the MB2 canal in maxillary molars. J Endod. 2002 Apr;28(4):324-7. PMID 12043874. pubmed.ncbi.nlm.nih.gov/12043874（取用 2026-08-06）。逐字 span：「The participating endodontists documented 312 cases of root canal therapy on maxillary first and second molars.」「Participants that used the microscope or dental loupes located the MB2 canal with a frequency of 57.4% and 55.3%, respectively.」「Those using no magnification located the MB2 canal with a frequency of 18.2%.」「When the maxillary first molars were considered separately, the frequency of MB2 canal detection for the microscope, dental loupes, and no magnification groups was 71.1%, 62.5%, and 17.2%, respectively.」「There was no significant difference between the use of the microscope and dental loupes in the frequency of locating the MB2 canal.」
• S4 León-López M, Montero-Miralles P, Cabanillas-Balsera D, Saúco-Márquez JJ, Martín-González J, Segura-Egea JJ. Association Between the Presence of Missed Canals, Detected Using CBCT, and Post-Treatment Apical Periodontitis in Root-Filled Teeth: A Systematic Review and Meta-Analysis. J Clin Med. 2025 Aug 15;14(16):5781. PMID 40869607. pubmed.ncbi.nlm.nih.gov/40869607（取用 2026-08-06）。逐字 span：「Eight cross-sectional studies (9983 RFT) were included in the review.」「The pooled prevalence of PAP was significantly higher in RFT with missed canals (85.1%) than those without (56.3%).」「The meta-analysis showed a strong association between missed canals and PAP (OR = 7.17, 95% CI = 4.55-11.29), indicating a sevenfold increased likelihood.」「Heterogeneity was high (I2 = 86%), and evidence certainty was low, due to methodological limitations.」「Maxillary molars, especially first molars, most commonly had missed canals.」
• S5 Liu B, Zhou X, Yue L, et al. Experts consensus on the procedure of dental operative microscope in endodontics and operative dentistry. Int J Oral Sci. 2023 Sep 18;15(1):43. PMID 37723147. pubmed.ncbi.nlm.nih.gov/37723147（取用 2026-08-06）。逐字 span：「The dental operative microscope has been widely employed in the field of dentistry, particularly in endodontics and operative dentistry」「However, the improper use of this microscope continues to be common in clinical settings, primarily due to operators' insufficient understanding and proficiency in both the features and established operating procedures of this equipment.」「The objective of this meeting was to establish a standard operation procedure for the dental operative microscope.」
• S6 Gobbo LB, de Araújo LP, Vieira WA, de-Jesus-Soares A, de Almeida JFA, Ferraz CCR. Impact of passive ultrasonic irrigation on the outcome of non-surgical root canal treatment: a systematic review and meta-analysis of randomized clinical trials. Evid Based Dent. 2024 Dec;25(4):212-213. PMID 38951661. pubmed.ncbi.nlm.nih.gov/38951661（取用 2026-08-06）。逐字 span：「The meta-analysis incorporated three RCTs, involving 474 patients (501 teeth).」「The analysis revealed that PUI led to a higher rate of periapical healing compared to CSI (Relative Risk: 1.10; 95% Confidence Interval: 1.01-1.21, I² = 0%), with moderate certainty of evidence.」「Despite the limited number of high-quality RCTs, the findings showed a positive impact of PUI on periapical healing rates in primary root canal treatments, in comparison to CSI.」
• S7 Zou X, Zheng X, Liang Y, et al. Expert consensus on irrigation and intracanal medication in root canal therapy. Int J Oral Sci. 2024 Mar 1;16(1):23. PMID 38429299. pubmed.ncbi.nlm.nih.gov/38429299（取用 2026-08-06）。逐字 span：「Chemical cleaning and disinfection are crucial steps for eliminating infection in root canal treatment.」「The evolution of different kinetic irrigation methods, their effects, limitations, the paradigm shift, current indications, and effective operational procedures regarding intracanal medication are also discussed.」
• S8 Zamparini F, Lenzi J, Duncan HF, Spinelli A, Gandolfi MG, Prati C. The efficacy of premixed bioceramic sealers versus standard sealers on root canal treatment outcome, extrusion rate and post-obturation pain: A systematic review and meta-analysis. Int Endod J. 2024 Aug;57(8):1021-1042. PMID 38606520. pubmed.ncbi.nlm.nih.gov/38606520（取用 2026-08-06）。逐字 span：「Fifteen Comparative clinical studies were finally included. Eleven were randomized clinical trials, and four were prospective clinical trials with control group.」「The follow-up of these studies was not greater than 2 years.」「No significant differences were observed between the two groups in terms of survival and success rates.」「A small non-significant lower risk of extrusion was observed for bioceramics.」「Tooth survival, treatment outcome, post-operative pain and periapical extrusion were similar and presented no significant differences between the two sealer types.」
• S9 Mushtaq A, Alsanafi S, Elmsmari F, et al. Effect of root canal filling techniques and materials on endodontic treatment outcomes: a systematic review and meta-analysis. Sci Rep. 2026 Mar 23;16(1):9552. PMID 41872366. pubmed.ncbi.nlm.nih.gov/41872366（取用 2026-08-06）。逐字 span：「Eighty-four studies (11,965 samples) met all inclusion criteria.」「In primary treatments, overall success rates were 87.1% at 6 months and 87.2% at 12 months, without significant differences among techniques.」「At 24 months, success increased to 92.0%」「Beyond 3 years, success decreased to 84.9%」「In retreatments, success rates were 92.9% at 6 months, 77.0% at 12 months, and 83.5% at 24 months.」「Beyond 3 years, success decreased to 73.7%」「Overall, primary treatments presented higher success than retreatments.」「Success appears multifactorial, with operator expertise and case selection having greater impact than obturation technique.」「Bioceramic sealers used with SC techniques have not demonstrated clear clinical benefits or improved retreatment outcomes.」「The overall certainty of evidence remained low to very low, particularly for long-term outcomes.」
• S10 Del Fabbro M, Corbella S, Sequeira-Byron P, Tsesis I, Rosen E, Lolato A, Taschieri S. Endodontic procedures for retreatment of periapical lesions. Cochrane Database Syst Rev. 2016 Oct 19;10(10):CD005511. PMID 27759881. pubmed.ncbi.nlm.nih.gov/27759881（取用 2026-08-06）。逐字 span：「There was no clear evidence of superiority of the surgical or non-surgical approach for healing at one-year follow-up (RR 1.15, 95% CI 0.97 to 1.35; two RCTs, 126 participants)」「there was some inconclusive evidence that ultrasonic devices for root-end preparation may improve healing one year after retreatment, when compared with the traditional bur (RR 1.14, 95% CI 1.00 to 1.30; one RCT, 290 participants; low quality evidence)」「There was no evidence that using CBCT rather than radiography for preoperative evaluation was advantageous for healing (RR 1.02, 95% CI 0.70 to 1.47; one RCT, 39 participants; very low quality evidence)」「nor that any magnification device affected healing more than any other (loupes versus endoscope at one year: RR 1.05, 95% CI 0.92 to 1.20; microscope versus endoscope at two years: RR 1.01, 95% CI 0.89 to 1.15; one RCT, 70 participants, low quality evidence)」「Available evidence does not provide clinicians with reliable guidelines for treating periapical lesions.」
• S11 Setzer FC, Kohli MR, Shah SB, Karabucak B, Kim S. Outcome of endodontic surgery: a meta-analysis of the literature--Part 2: Comparison of endodontic microsurgical techniques with and without the use of higher magnification. J Endod. 2012 Jan;38(1):1-10. PMID 22152611. pubmed.ncbi.nlm.nih.gov/22152611（取用 2026-08-06）。逐字 span：「In total, 14 studies qualified according to the inclusion and exclusion criteria, 2 being represented in both groups (7 for CRS [n = 610] and 9 for EMS [n = 699]).」「Weighted pooled success rates calculated from extracted raw data showed an 88% positive outcome for CRS (95% confidence interval, 0.8455-0.9164) and 94% for EMS (95% confidence interval, 0.8889-0.9816). This difference was statistically significant (P < .0005).」「The difference in probability of success between the groups was statistically significant for molars (n = 193, P = .011).」「Large-scale randomized clinical trials for statistically valid conclusions for current endodontic questions are needed to make informed decisions for clinical practice.」
• S12 Al-Rammahi HM, Chai WL, Nabhan MS, Ahmed HMA. Root and canal anatomy of mandibular first molars using micro-computed tomography: a systematic review. BMC Oral Health. 2023 May 29;23(1):339. PMID 37248469. pubmed.ncbi.nlm.nih.gov/37248469（取用 2026-08-06；同 KM-DENTAL-18 卡锚）。逐字 span：「the selected studies showed high anatomical variability in mandibular first molars」「thirty met the inclusion criteria」
• S13 Lin PY, Huang SH, Chang HJ, Chi LY. The effect of rubber dam usage on the survival rate of teeth receiving initial root canal treatment: a nationwide population-based study. J Endod. 2014 Nov;40(11):1733-7. PMID 25175849. pubmed.ncbi.nlm.nih.gov/25175849（取用 2026-08-06；同 KM-DENTAL-18 卡锚）。逐字 span：「Of the 517,234 teeth, 29,219 were extracted, yielding a survival rate of 94.4%」「The survival probability of initial RCT using rubber dams after 3.43 years (the mean observed time) was 90.3%, which was significantly greater than the 88.8% observed without the use of rubber dams」「the tooth extraction hazard ratio for the RCT with rubber dams was significantly lower than that observed for RCT without rubber dams (hazard ratio = 0.81; 95% confidence interval, 0.79-0.84)」
• S14 Savolainen N, Frisk F, Kvist T. Is root canal treatment and an indirect coronal restoration of a mandibular first molar cost-effective compared to extraction and an implant-supported crown? A decision analytic approach. Acta Odontol Scand. 2025 Feb 27;84:95-103. PMID 40014382. pubmed.ncbi.nlm.nih.gov/40014382（取用 2026-08-06；本卡不引用其币别金额）。逐字 span：「The study was based on Swedish population and the reference prices for dental treatments in Sweden.」「The initial costs were from the Swedish dental reference prices in 2024」「The threshold probability values were 83 and 93% for RCT survival.」「Given the assumptions and limitations of this decision analysis, the probability of survival for RCT + PC needs to be in the range of 83-93% in order for it to be more cost-effective than ISSC, when deciding about treatment on a compromised first mandibular molar.」
• S15 Benz L, Leontiev W, Schwendicke F, Walter E. Effects of Endodontic Perforations on Tooth Retention and Treatment Costs: A Cost-Effectiveness Analysis. Int Endod J. 2026 Feb;59(2):215-224. PMID 41188638. pubmed.ncbi.nlm.nih.gov/41188638（取用 2026-08-06；本卡不引用其币别金额）。逐字 span：「Perforations are complications that may occur during root canal treatment (RCT), requiring complex management if the tooth is to be retained.」「Tooth or implant costs, as well as costs for treatments during follow-up were drawn from public and private fee item catalogues (BEMA and GOZ) in Germany.」「Perforation repair increases tooth retention time and comes with only limited or no additional costs depending on the age group.」「Perforations are associated with significant treatment needs and costs, and endodontic therapy should focus on avoiding them, likely justifying additional efforts if needed to do so.」
• S16 Sousa Melo SL, Fayad MI, Gohel A, et al. AAE and AAOMR Joint Position Statement: Use of Cone-Beam Computed Tomography in Endodontics 2025 Update. J Endod. 2026 Jan;52(1):4-13. PMID 41412684. pubmed.ncbi.nlm.nih.gov/41412684（取用 2026-08-06；全文未取回，仅记录存在与定位）。逐字 span：「The following statement was prepared by the Special Committee to Revise the Joint Position Statement on Cone-Beam Computed Tomography of the American Association of Endodontists (AAE) and the American Academy of Oral and Maxillofacial Radiology (AAOMR), and was approved by the AAE Board of Directors and the AAOMR Executive Council in the spring of 2025.」
• S17 版本时效查核纪录（2026-08-06 于 PubMed 实跑）：以 `CD005969` 检索得 2009（PMID 19588377）与 2015（PMID 26650099）两笔，未见 pub4；以 `CD005511` 检索得 2007（PMID 17636803）与 2016（PMID 27759881）两笔，未见更新版；以 magnification／loupes／microscope 并 endodontic outcome 限 2018-2026 刊期检索无新的随机试验或统合分析命中。13 篇入卡文献的 pubtype 逐笔检视，无 Retracted Publication、无 WITHDRAWN。
• S18 （保留编号，未使用）
• S19 （保留编号，未使用）
• S20 医疗法 第 21 条（全国法规资料库）。law.moj.gov.tw pcode=L0020021 flno=21（2026-08-06 以 ego-browser 实载，页面标题「醫療法§21-全國法規資料庫」，条文逐字对得上）
• S21 医疗法 第 22 条（全国法规资料库）。law.moj.gov.tw pcode=L0020021 flno=22（2026-08-06 以 ego-browser 实载，两项条文逐字对得上）
• S22 医疗法 第 81 条（全国法规资料库）。law.moj.gov.tw pcode=L0020021 flno=81（2026-08-06 以 ego-browser 实载，条文逐字对得上）
• S23 医疗法 第 87 条（全国法规资料库）。law.moj.gov.tw pcode=L0020021 flno=87（2026-08-06 以 ego-browser 实载，两项条文逐字对得上）
• S24 全民健康保险法 第 41 条（全国法规资料库）。law.moj.gov.tw pcode=L0060001 flno=41（2026-08-06 以 ego-browser 实载，第 1 项条文逐字对得上）
• S25 全民健康保险法 第 51 条（全国法规资料库）。law.moj.gov.tw pcode=L0060001 flno=51（2026-08-06 以 ego-browser 实载，十二款全文取得，第 11 款逐字对得上）
• S26 卫生福利部中央健康保险署「全民健康保险医疗服务给付项目及支付标准」公告页。nhi.gov.tw/ch/lp-3778-1.html（2026-08-06 以 ego-browser 实载，页面标题与四笔档案清单逐字读取；本卡未下载档案逐项比对）
• S27 政府资料开放平台 资料集「医疗服务给付项目及支付标准(csv档)」，提供机关卫生福利部中央健康保险署。data.gov.tw/dataset/174450（2026-08-06 以 ego-browser 实载，标题、提供机关、栏位说明与更新频率逐字对得上）
• S28 内部资料：`analysis/reports/km-dental-backlog.md` 第 26 题附录（14 诊所资产 GSC 全量对帐，资料窗 2025-03 起），4 词项跨 2 站，逐笔可对帐。非医学事实 basis，仅为选题依据，发布时不进可见层。
• S28b 台北市政府卫生局－收费标准：「臺北市醫療機構牙科收費標準表」(1090117核定)。health.gov.taipei 收费标准页（2026-08-06 以 ego-browser 实载，页面标题逐字对得上）
• S28c 政府资料开放平台 资料集 121913「臺北市醫療收費標準」，提供机关台北市政府卫生局。data.gov.tw/dataset/121913（2026-08-06 以 ego-browser 实载，标题与提供机关逐字对得上）
• S29 编辑框架（无外部来源）：本卡的六段拆项结构、与根管治疗基础卡／牙冠费用卡的分工边界、以及「买到什么 vs 证据多强」两层读法，见 F2、F3。
• S29b 卫生福利部中央健康保险署「醫材比價網」两查询轨之品项分类（跨卡已验事实，同锚）。info.nhi.gov.tw INAE2000/INAE2010S01（2026-08-05 由 OP 以 ego-browser 实测并复验，纪录见 km-compliance/VERIFIED-FACTS.md；本卡未重复实测）

内部引用链

• 同族术式卡（必读）：根管治疗（抽神经）是什么？要跑几次？（KM-DENTAL-18，草稿）。两卡的 canonical 边界：归该卡的是——适应症、疗程步骤、单次与多次就诊的证据、术后疼痛的分布、成功率与存活率的完整读法；归本卡的是——费用由哪些段落组成、显微与特殊器械材料的加价项目各自的证据、台湾制度下的查证管道。两卡共用 F15（下颚第一大臼齿解剖）与 F16（台湾健保资料库橡皮障研究）两条文献锚，以及健保法 41／51 条、医疗法 21／22／81／87 条同一组制度锚，英文 span 与法条逐字一致。
• 后续费用卡：做一颗牙冠（假牙牙套）要多少钱？（KM-DENTAL-11，草稿）。本卡费用组成第 5 段所说的「治疗后的正式修复」，其项目拆解、环箍条件与材质存活率数据在该卡，本卡不重复铺陈。
• 决策前一段路：蛀牙了一定要补吗？补牙怎么补？（KM-DENTAL-12，草稿）。若你的情境还在「这颗牙要不要做到根管」的阶段，修复层级的判准在该卡。

发布闸门提醒：本卡为 draft。F26（本题各项目之健保给付状态）、F30（商业保险）待验未清前不得标 published；四语（zh-Hans／en／ja）未产前不得进 km_entries。