根管治療(「神経を取る」)とは?何回通う?|證據鏈
本頁是〈根管治療(「神経を取る」)とは?何回通う?〉的事實單元帳:每一條主張對應的來源、證據等級、地域與期間、原文引句與限制,逐條攤開。
根管治療(「神経を取る」)とは?何回通う?|證據鏈
F-Units(事実単位台帳)
- F1|選題根拠=14 診療所サイトの GSC 全量照合。「根管治療」等 5 語の合計露出 164,202、2 サイト。|Source #23|confidence=high|basis=internal_dataset|period=GSC 保持窓(2025-03-22 から)|geo: TW|caveat:露出はプロパティ単位で重複除去流量ではない。内部データで医学的主張ではなく公開可視層に出さない。
- F2|主適応は不可逆性歯髄炎と歯髄壊死。原因はう蝕進行、歯冠部亀裂・破折、歯の外傷。|Source #1|confidence=high|basis=peer_reviewed(Cochrane 系統的レビュー背景)|period=2022(検索終了 2022-04-25)|geo: universal|caveat:一般的適応の記述で個別診断基準ではない。
- F3|歯内療法の定義=歯髄除去と根管充填材による置換。|Source #12|confidence=high|basis=peer_reviewed|period=2015|geo: universal|caveat:定義的記述。
- F4|成功基準=疼痛等の症状、腫脹・瘻孔等の徴候がなく、歯周靱帯正常で画像上歯周組織関与なし。|Source #1|confidence=high|basis=peer_reviewed|period=2022|geo: universal|caveat:歯周靱帯・歯槽骨との連結という本カードの転述で、歯髄生理の専門論ではない。
- F5|単回=形成・洗浄後直ちに充填、複数回=2 回以上で完了し最終回に充填。|Source #1|confidence=high|basis=peer_reviewed|period=2022|geo: universal|caveat:定義であり操作指針ではない。
- F6|現代的ケアはラバーダム隔離と次亜塩素酸ナトリウム洗浄を含み、2022 版は不適合の旧研究 5 件を除外。|Source #1|confidence=high|basis=peer_reviewed|period=2022|geo: universal|caveat:著者による標準の定義で、各国法規要件ではない。
- F7|2022 Cochrane は 47 件、5805 人、5693 歯。単回・複数回の有効性差の根拠なし。画像失敗 RR 0.93(95% CI 0.81〜1.07;13 件、1505 歯;中等度確実性)。|Source #1|confidence=high|basis=peer_reviewed(現行 Cochrane SR/MA)|period=2022|geo: universal|caveat:画像追跡下限は治療後 1 年;バイアス低 10/高 17/不明 20。
- F8|1 週以内疼痛は単回群で高い:RR 1.55(95% CI 1.14〜2.09;I²=18%;5 件、638 歯);生活歯部分群 2.16(2 件、316 歯)。|Source #1|confidence=moderate|basis=peer_reviewed|period=2022|geo: universal|caveat:5 件、638 歯のみで F10 と完全一致せず、両方を併記。
- F9|現行は 2022 年 12 月更新 Cochrane(pub4)で 2016 版(pub3)を置換、旧 PubMed 記録も更新済みと表示。|Source #1、#2|confidence=high|basis=peer_reviewed|period=2026-08-06 検索|geo: universal|caveat:時効確認で医学的主張ではない。2026-08-06 に pub5 なし。
- F10|2026 アンブレラレビュー(2025-12 まで検索)は 12 件を含み、高確実性レビューで術後痛の一貫した臨床的重要差なし。複雑性、感染制御、希望、日程で選択。|Source #3|confidence=moderate|basis=peer_reviewed|period=2026|geo: universal|caveat:研究重複と結果定義不一致の限界を著者が記載。
- F11|2026 RCT:壊死歯髄・根尖病変 59 人(単回 28/2 回 31)、2 回群は水酸化カルシウム 10〜14 日、平均 2.8 年、42 人完了。差なく優越・非劣・同等を証明せず。|Source #4|confidence=low|basis=peer_reviewed|period=2026|geo: universal|caveat:2 回が良いとは推論不可。
- F12|疼痛有病率 81%(SD 28)、24 時間 40%(SD 24)、1 週 11%(SD 14);強度 0〜100 点で 54、24、5。「Supplemental injections were frequently required (60 [24%])」。|Source #5|confidence=moderate|basis=peer_reviewed|period=2011|geo: universal|caveat:括弧は SD、補充麻酔は定性的記述のみ使用。集団平均で個人差大。
- F13|6 か月以上持続痛 5.3%(95% CI 3.5%〜7.2%)、I²=80%;前向き 7.6%、後向き 0.9%。|Source #6|confidence=moderate|basis=peer_reviewed(SR/MA、26 件、追跡データ 2996 歯)|period=2010|geo: universal|caveat:異質性高、2026-08-06 に更新メタ解析なし。
- F14|病理所見なしの非歯原性痛 3.4%(95% CI 1.4%〜5.5%);9 件中 56%(44/78)が非歯原性。|Source #7|confidence=moderate|basis=peer_reviewed|period=2010|geo: universal|caveat:1125 歯のみ。持続痛の再診断用で個人リスク推定でない。
- F15|台湾健保 DB:2005〜2011 初回 517,234 歯、抜歯 29,219、存留 94.4%;平均 3.43 年でラバーダム 90.3%、なし 88.8%、調整抜歯 HR 0.81(95% CI 0.79〜0.84)。|Source #8|confidence=moderate|basis=peer_reviewed|period=2014(data 2005-2011)|geo: TW|caveat:請求 DB は自費・臨床詳細を含まない。存留=未抜歯。
- F16|存留率は 2〜3 年 86%(95% CI 75%〜98%)、4〜5 年 93%(92%〜94%)、8〜10 年 87%(82%〜92%);高存留関連の首位は治療後クラウン。|Source #9|confidence=moderate|basis=peer_reviewed|period=2010(2007 まで採用)|geo: universal|caveat:14 件、多くが後向き。因子根拠弱く異質性大、更新版なし。
- F17|前向き研究:完全根尖治癒は初回 83%(95% CI 81%〜85%)、再治療 80%(78%〜82%);満足な歯冠修復は有利、穿孔・充填材逸出は不利。|Source #10|confidence=moderate|basis=peer_reviewed|period=2011|geo: universal|caveat:教育病院の大学院生治療、一般診療と異なり得る。
- F18|同研究の 4 年累積存留は初回 95.4%、再治療 95.3%;糖尿病歴、全身ステロイド、鋳造修復(仮充填比)が因子。|Source #11|confidence=moderate|basis=peer_reviewed|period=2011|geo: universal|caveat:F17 と同集団。存留と治癒は交換不可。
- F19|クラウン対通常充填は根拠不足(1 試験、117 人、小臼歯、3 年)。個別条件・希望で決定。|Source #12|confidence=high|basis=peer_reviewed|period=2015(現行版;2026-08-06 更新なし)|geo: universal|caveat:高バイアス、根拠極めて低い。
- F20|2026 SR/MA(33 件:臨床 6、in vitro 18、有限要素 9):ferrule と臨床存留が関連、RR 1.34(95% CI 1.12〜1.59);高さ 1.5〜2.0 mm、象牙質 ≥ 1 mm が良好な結果と関連。|Source #13|confidence=moderate|basis=peer_reviewed|period=2026|geo: universal|caveat:混合設計で多くが in vitro・有限要素。
- F21|根管治療歯は生活歯より破折しやすく、歯質喪失とアクセス、形成洗浄、充填、ポスト空間・選択、歯冠修復の応力に帰される。|Source #14|confidence=moderate|basis=peer_reviewed|period=2010|geo: universal|caveat:綜説で定量リスクなし。
- F22|ネットワークメタ解析(25 件):適応時のファイバーポストは無ポストより破折リスク低下、中等度確実性。|Source #15|confidence=moderate|basis=peer_reviewed|period=2025|geo: universal|caveat:適応時のみで常用推奨ではない。長期試験が必要。
- F23|下顎第一大臼歯根管の micro-CT 系統的レビュー(30 件)は高度な解剖多様性を示した。|Source #16|confidence=moderate|basis=peer_reviewed|period=2023|geo: universal|caveat:多くは中等度バイアス、ex vivo は臨床時間測定でない。
- F24|台湾医療法第 81 条:病状、方針、処置、用薬、予後、可能な有害反応を患者等に告知。|Source #17|confidence=high|basis=law|period=現行条文(2026-08-06 ブラウザ実測・逐語一致)|geo: TW|caveat:条文要約、法的見解ではない。
- F25|台湾全民健康保険法第 41 条:給付項目・基準は保険者等の代表が共同で策定し主管機関が認定・公布。|Source #18|confidence=high|basis=law|period=現行条文(2026-08-06 実測逐語)|geo: TW|caveat:現行公告への確認経路のみで個別判断なし。
- F26|台湾全民健康保険法第 51 条:義歯、義眼、眼鏡、補聴器、車椅子、松葉杖など非積極的治療性装具は給付外に列挙。|Source #19|confidence=high|basis=law|period=現行条文(2026-08-06 実測逐語)|geo: TW|caveat:#9/#17 の C2 と同じ。個別結論ではない。
- F27[一部要検証]|健保署の支払項目・基準ページは現行ファイルを提供(115.07.01 有効 archive、114.08.11 からオープンデータで取得可能と記載)。|Source #20|confidence=high|basis=official_statement|period=2026-08-06 ego-browser 実測可、標題・一覧逐語読取|geo: TW|caveat:歯科項目を個別照合していないため給付状態は要検証、判断なし。
- F28|自費料金は地方衛生主管機関の基準。検証例は dataset 121913「臺北市醫療收費標準」、提供者は臺北市政府衛生局。|Source #21|confidence=high|basis=official_statement|period=2026-08-06 実測可、標題・機関逐語一致|geo: TW|caveat:#3/#17 の C3 と同じ。他県市は個別検証。
- F29|健保署「醫材比價網」は歯科品目なし(自己負担差額 12 類、医材料金 8 類)。|Source #22|confidence=high|basis=official_statement|period=2026-08-05|geo: TW|caveat:VERIFIED-FACTS 準拠の負の発見。
- F30[要検証]|商業保険の給付は保険証券の条項による。|Source type:保険証券条項|confidence=low|basis=待補|geo: TW|caveat:保険金請求見解なし、「条項による」のみ。
- F31[構造整理]|用語→適応→手順→回数→術後→修復、および自己診断表を出さないことは編集構造で事実主張でない。|confidence=n/a|basis=editorial|geo: TW|caveat:要検証とは表示しない。
- F32[構造整理]|見積りの診断画像/根管/仮充填/最終修復の 4 分けは編集上の読解枠で、機関料金分類・金額ではない。|confidence=n/a|basis=editorial|geo: TW|caveat:同上。
- F33|台湾医療法第 21 条は料金基準を県市が認定、第 22 条は項目・額入り領収書と基準違反・超過・勝手な項目の禁止を定める。|Source #17c、#17d|confidence=high|basis=law|period=現行条文(2026-08-06 ブラウザ実測・逐語一致)|geo: TW|caveat:条文要約、法的見解でなく金額なし。
- F32b|台湾医療法第 87 条第 2 項:勧誘を伴わない医学知識・研究報告、患者衛生教育、学術刊行物は医療広告とみなさない。|Source #17b|confidence=high|basis=law|period=現行条文(2026-08-06 実測逐語)|geo: TW|caveat:本カード位置付けの根拠。
出典一覧
- Mergoni G, Ganim M, Lodi G, Figini L, Gagliani M, Manfredi M. Single versus multiple visits for endodontic treatment of permanent teeth. Cochrane Database Syst Rev. 2022 Dec 13;12(12):CD005296. PMID 36512807. https://pubmed.ncbi.nlm.nih.gov/36512807/(取用 2026-08-06,efetch 摘要取回成功)。逐字 span:「The main indications for RoCT are irreversible pulpitis and necrosis of the dental pulp caused by carious processes, coronal crack or fracture, or dental trauma」「Successful RoCT is characterised by an absence of symptoms (i.e. pain) and clinical signs (i.e. swelling and sinus tract) in teeth without radiographic evidence of periodontal involvement (i.e. normal periodontal ligament)」「RoCT can be carried out with a single-visit approach, which involves root canal system obturation (filling and sealing) directly after instrumentation and irrigation, or with a multiple-visits approach, in which the treatment is completed in two or more sessions and obturation is performed in the last session」「We excluded five studies that were included in the previous version of the review because they did not meet the current standard of care (i.e. rubber dam isolation and irrigation with sodium hypochlorite)」「We included 47 studies with 5805 participants and 5693 teeth analysed」「We found no evidence of a difference between single-visit and multiple-visit treatment in terms of radiological failure (RR 0.93, 95% CI 0.81 to 1.07; I2 = 0%; 13 studies, 1505 teeth; moderate-certainty evidence)」「We found evidence of a higher proportion of participants reporting pain within one week in single-visit groups compared to multiple visit groups (RR 1.55, 95% CI 1.14 to 2.09; I2 = 18%; 5 studies, 638 teeth; moderate-certainty evidence)」「which was higher in the single-visit groups for vital teeth (RR 2.16, 95% CI 1.39 to 3.36; I2 = 0%; 2 studies, 316 teeth)」「there is currently no evidence to suggest that one treatment regimen (single-visit or multiple-visit RoCT) is more effective than the other」
- Manfredi M, Figini L, Gagliani M, Lodi G. Single versus multiple visits for endodontic treatment of permanent teeth. Cochrane Database Syst Rev. 2016 Dec 1;12(12):CD005296. PMID 27905673. https://pubmed.ncbi.nlm.nih.gov/27905673/(取用 2026-08-06)。已被 2022 年版取代,本卡僅用於版本沿革查核,不引用其數字。逐字 span:「There is no evidence to suggest that one treatment regimen (single-visit or multiple-visit root canal treatment) is better than the other」
- Gupta R, Abraham D, Ahmad L, Puri A. Single-visit versus multiple-visit root canal therapy: Post-endodontic pain outcomes from an umbrella review. J Dent. 2026 Jun;169:106637. PMID 41856391. https://pubmed.ncbi.nlm.nih.gov/41856391/(取用 2026-08-06)。逐字 span:「Twelve systematic reviews met the inclusion criteria」「the higher-confidence reviews did not show a consistent or clinically important difference in post-operative pain between single-visit and multiple-visit treatment」「from inception to December 2025」「the choice of visit strategy can be guided by other factors such as case complexity, infection control, patient preference, and logistical considerations rather than the expectation of meaningful differences in post-operative pain」
- Sabeti M, Kim H, Abbaker S, Karimpourtalebi N, Azarpazhooh A. Healing Outcomes of Single-Visit and Two-Visit Endodontic Treatment for Necrotic Teeth with Apical Periodontitis: A Randomized Clinical Trial. J Endod. 2026 Jul 29 (online ahead of print). PMID 42526597. https://pubmed.ncbi.nlm.nih.gov/42526597/(取用 2026-08-06)。逐字 span:「Fifty-nine patients were randomized to single-visit (n= 28) or two-visit (n= 31) treatment, with calcium hydroxide placed for 10-14 days in the two-visit group」「At a mean follow-up of 2.8 years, 42 patients completed the study」「these findings do not demonstrate superiority, noninferiority, or equivalence」
- Pak JG, White SN. Pain prevalence and severity before, during, and after root canal treatment: a systematic review. J Endod. 2011 Apr;37(4):429-38. PMID 21419285. https://pubmed.ncbi.nlm.nih.gov/21419285/(取用 2026-08-06)。逐字 span:「Mean pretreatment, 24-hour posttreatment, and 1-week posttreatment pain prevalences with associated standard deviations were 81 (28%), 40 (24%), and 11 (14%), respectively」「Pretreatment, 24-hour posttreatment, and 1-week posttreatment pain severities, on a 100-point scale, were 54 (24%), 24 (12%), and 5 (5%), respectively」「Supplemental injections were frequently required (60 [24%])」
- Nixdorf DR, Moana-Filho EJ, Law AS, McGuire LA, Hodges JS, John MT. Frequency of persistent tooth pain after root canal therapy: a systematic review and meta-analysis. J Endod. 2010 Feb;36(2):224-30. PMID 20113779. https://pubmed.ncbi.nlm.nih.gov/20113779/(取用 2026-08-06)。逐字 span:「We identified 168 teeth with pain and derived a frequency of 5.3% (95% confidence interval, 3.5%-7.2%, p < 0.001) for persistent all-cause tooth pain」「In subgroup analysis, prospective studies had a higher pain frequency (7.6%) than retrospectives studies did (0.9%)」
- Nixdorf DR, Moana-Filho EJ, Law AS, McGuire LA, Hodges JS, John MT. Frequency of nonodontogenic pain after endodontic therapy: a systematic review and meta-analysis. J Endod. 2010 Sep;36(9):1494-8. PMID 20728716. https://pubmed.ncbi.nlm.nih.gov/20728716/(取用 2026-08-06)。逐字 span:「We identified 48 teeth with nonodontogenic pain and estimated a 3.4% (95% confidence interval, 1.4%-5.5%) frequency of occurrence」「56% (44/78) of all cases were thought to have a nonodontogenic cause」
- 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. https://pubmed.ncbi.nlm.nih.gov/25175849/(取用 2026-08-06)。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)」
- Ng YL, Mann V, Gulabivala K. Tooth survival following non-surgical root canal treatment: a systematic review of the literature. Int Endod J. 2010 Mar;43(3):171-89. PMID 20158529. https://pubmed.ncbi.nlm.nih.gov/20158529/(取用 2026-08-06)。逐字 span:「The pooled percentages of reported tooth survival over 2-3, 4-5 and 8-10 years following RCTx were 86% (95% CI: 75%, 98%), 93% (95% CI: 92%, 94%) and 87% (95% CI: 82%, 92%), respectively」「Evidence for the effect of prognostic factors on tooth survival was weak」「the conditions increasing observed proportion of survival were as follows: (i) a crown restoration after RCTx」
- Ng YL, Mann V, Gulabivala K. A prospective study of the factors affecting outcomes of nonsurgical root canal treatment: part 1: periapical health. Int Endod J. 2011 Jul;44(7):583-609. PMID 21366626. https://pubmed.ncbi.nlm.nih.gov/21366626/(取用 2026-08-06)。逐字 span:「proportion of roots with complete periapical healing after 1°RCTx (83%; 95% CI: 81%, 85%) or 2°RCTx (80%; 95% CI: 78%, 82%) were similar」「presence of a satisfactory coronal restoration」
- Ng YL, Mann V, Gulabivala K. A prospective study of the factors affecting outcomes of non-surgical root canal treatment: part 2: tooth survival. Int Endod J. 2011 Jul;44(7):610-25. PMID 21366627. https://pubmed.ncbi.nlm.nih.gov/21366627/(取用 2026-08-06)。逐字 span:「The 4-year cumulative tooth survival following 1°RCTx [95.4% (93.6%, 96.8%)] or 2°RCTx [95.3% (93.6%, 96.5%)] was similar」「Significant patient factors included history of diabetes and systemic steroid therapy」「Significant post-operative restorative factors included presence of cast restoration versus temporary restoration」
- Sequeira-Byron P, Fedorowicz Z, Carter B, Nasser M, Alrowaili EF. Single crowns versus conventional fillings for the restoration of root-filled teeth. Cochrane Database Syst Rev. 2015 Sep 25;2015(9):CD009109. PMID 26403154. https://pubmed.ncbi.nlm.nih.gov/26403154/(取用 2026-08-06;2026-08-06 於 PubMed 檢索未見更新版)。逐字 span:「Endodontic treatment involves removal of the dental pulp and its replacement by a root canal filling」「There is insufficient evidence to assess the effects of crowns compared to conventional fillings for the restoration of root-filled teeth」「clinicians should continue to base decisions about how to restore root-filled teeth on their own clinical experience, whilst taking into consideration the individual circumstances and preferences of their patients」
- Hajeer O, Hasan A, Kanout C, Morad ML. Ferrule dimensions and restoration outcomes in endodontically treated teeth: A systematic review and meta-analysis. J Prosthodont. 2026 Apr;35(4):450-459. PMID 41601347. https://pubmed.ncbi.nlm.nih.gov/41601347/(取用 2026-08-06)。逐字 span:「Thirty-three primary studies (6 clinical, 18 in vitro, 9 finite-element) were included」「Ferrule presence increased clinical survival (RR 1.34; 95% CI: 1.12-1.59)」「A ferrule height of 1.5-2.0 mm and dentin thickness ≥ 1 mm are associated with improved biomechanical and clinical outcomes」
- Tang W, Wu Y, Smales RJ. Identifying and reducing risks for potential fractures in endodontically treated teeth. J Endod. 2010 Apr;36(4):609-17. PMID 20307732. https://pubmed.ncbi.nlm.nih.gov/20307732/(取用 2026-08-06)。逐字 span:「they are generally more susceptible to fracture than teeth with vital pulps」「Postendodontic tooth fractures might occur because of the loss of tooth structure and induced stresses caused by endodontic and restorative procedures such as access cavity preparation, instrumentation and irrigation of the root canal, obturation of the instrumented root canal, post-space preparation, post selection, and coronal restoration」
- Giok KC, Veettil SK, Menon RK. Comparative effectiveness of fiber and metal posts in the restoration of endodontically treated teeth: A systematic review with network meta-analysis. J Prosthet Dent. 2025 Sep;134(3):597-615. PMID 37827970. https://pubmed.ncbi.nlm.nih.gov/37827970/(取用 2026-08-06)。逐字 span:「The use of a fiber post when indicated results in reduced risk of tooth fracture as compared with no post」「Twenty-five articles were included in the quantitative analysis」
- 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. https://pubmed.ncbi.nlm.nih.gov/37248469/(取用 2026-08-06)。逐字 span:「the selected studies showed high anatomical variability in mandibular first molars」「thirty met the inclusion criteria」
- 《醫療法》第 81 條,全國法規資料庫。https://law.moj.gov.tw/LawClass/LawSingle.aspx?pcode=L0020021&flno=81(2026-08-06 以 ego-browser 實載,標題「醫療法§81-全國法規資料庫」,條文逐字對得上)
17b. 《醫療法》第 87 條,全國法規資料庫。https://law.moj.gov.tw/LawClass/LawSingle.aspx?pcode=L0020021&flno=87(2026-08-06 以 ego-browser 實載,兩項條文逐字取得) 17c. 《醫療法》第 21 條,全國法規資料庫。https://law.moj.gov.tw/LawClass/LawSingle.aspx?pcode=L0020021&flno=21(2026-08-06 以 ego-browser 實載,條文逐字對得上) 17d. 《醫療法》第 22 條,全國法規資料庫。https://law.moj.gov.tw/LawClass/LawSingle.aspx?pcode=L0020021&flno=22(2026-08-06 以 ego-browser 實載,兩項條文逐字取得)
- 《全民健康保險法》第 41 條,全國法規資料庫。https://law.moj.gov.tw/LawClass/LawSingle.aspx?pcode=L0060001&flno=41(2026-08-06 以 ego-browser 實載,條文逐字對得上)
- 《全民健康保險法》第 51 條,全國法規資料庫。https://law.moj.gov.tw/LawClass/LawSingle.aspx?pcode=L0060001&flno=51(2026-08-06 以 ego-browser 實載,十二款逐字取得;同 VERIFIED-FACTS 已驗錨)
- 衛生福利部中央健康保險署「全民健康保險醫療服務給付項目及支付標準」公告頁。https://www.nhi.gov.tw/ch/lp-3778-1.html(2026-08-06 以 ego-browser 實載,頁面標題與四筆檔案清單逐字讀取;本卡未下載檔案逐項比對)
- 政府資料開放平臺,資料集 121913「臺北市醫療收費標準」,提供機關臺北市政府衛生局。https://data.gov.tw/dataset/121913(2026-08-06 以 ego-browser 實載,標題與提供機關逐字對得上)
- 衛生福利部中央健康保險署「醫材比價網」不含牙科品項之實測紀錄,見 `km-compliance/VERIFIED-FACTS.md`(OP 2026-08-05 以 ego-browser 逐項讀取兩軌類別下拉選單,頁面全文無「牙」字)
- km 牙醫線選題底帳:`analysis/reports/km-dental-backlog.md` #18 附錄(5 詞項逐筆、合計 164,202、跨 2 站),資料源=14 診所資產 GSC 全量對帳。
内部引用チェーン
- 蛀牙什麼時候需要補、什麼時候已經補不回來(本卡「什麼情況會被建議做根管」的前一段路):蛀牙了一定要補嗎?補牙怎麼補?(KM-DENTAL-12)
- 蛀到牙齦下、牙齒露出的高度不夠而做不了牙冠時會被提到的手術,以及費用組成與保險段的同款處理方式:牙冠增長術是什麼?費用、保險、會不會痛(KM-DENTAL-17)(本卡 F26/F28 與該卡 F25/F26 為同源錨)
發布閘門提醒:本卡為 draft。F27(本題各項目之健保給付狀態)、F30(商業保險)待驗未清前不得標 published;四語(zh-Hans/en/ja)未產前不得進 km_entries。
FAQ
- 根管治療は何回なら普通ですか?
- 標準回数はありません。単回・複数回の優劣を示す根拠はなく、複雑性、感染制御、希望、日程で決めます [F7][F10]。
- 根管治療は何回なら普通ですか? — 標準回数はありません。単回・複数回の優劣を示す根拠はなく、複雑性、感染制御、希望、日程で決めます [F7][F10]。
- How many visits are normal for root canal treatment? — The literature gives no standard number. The current Cochrane review finds no evidence that either single- or multiple-visit treatment is more effective [F7]. The 2026 umbrella review says visit strategy can depend on case complexity, infection-control needs, patient preference, and timing [F10]. Ask your own dentist how many visits and why [F10].
- 1 回で終える方が痛いですか?
- 1 週間以内の疼痛報告は単回群で高かった一方、2026 年レビューは一貫した臨床的重要差を示しませんでした。根拠は収束途上です [F8][F10]。
- 1 回で終える方が痛いですか? — 1 週間以内の疼痛報告は単回群で高かった一方、2026 年レビューは一貫した臨床的重要差を示しませんでした。根拠は収束途上です [F8][F10]。
- Is finishing it in one visit more painful? — The current Cochrane review reports a higher proportion with pain within one week in the single-visit group, risk ratio 1.55 (moderate-certainty evidence), with a clearer subgroup difference in vital teeth [F8]. Yet the 2026 umbrella review of 12 systematic reviews found that higher-certainty reviews did not show a consistent or clinically important difference [F10]. Read together, these findings mean the evidence is still converging [F8][F10].
- 治療は痛いですか。どのくらい続きますか?
- 群体値は 81%、24 時間後 40%、1 週後 11% で、強度は 54、24、5 です。6 か月以上続く痛みは約 5.3% で、再診断を受けます [F12][F13][F14]。
- 治療は痛いですか。どのくらい続きますか? — 群体値は 81%、24 時間後 40%、1 週後 11% で、強度は 54、24、5 です。6 か月以上続く痛みは約 5.3% で、再診断を受けます [F12][F13][F14]。
- Does “nerve removal” hurt, and how long does pain last afterward? — In the systematic review’s group figures, pain prevalence was 81% before treatment, 40% at 24 hours, and 11% at one week; intensity on a 0-to-100 scale fell from 54 to 24 to 5 [F12]. Supplemental anaesthesia was frequently required, so say so during treatment if it hurts [F12]. If pain persists six months after treatment, estimated prevalence is about 5.3%, and a substantial proportion of causes are outside that tooth; return for re-diagnosis [F13][F14].
出典アンカー
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- Gupta R, Abraham D, Ahmad L, Puri A. Single-visit versus multiple-visit root canal therapy: Post-endodontic pain outcomes from an umbrella review. J Dent.… · https://pubmed.ncbi.nlm.nih.gov/41856391/
- Sabeti M, Kim H, Abbaker S, Karimpourtalebi N, Azarpazhooh A. Healing Outcomes of Single-Visit and Two-Visit Endodontic Treatment for Necrotic Teeth with… · https://pubmed.ncbi.nlm.nih.gov/42526597/
- Pak JG, White SN. Pain prevalence and severity before, during, and after root canal treatment: a systematic review. J Endod. 2011 Apr;37(4):429-38. PMID… · https://pubmed.ncbi.nlm.nih.gov/21419285/
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- Nixdorf DR, Moana-Filho EJ, Law AS, McGuire LA, Hodges JS, John MT. Frequency of nonodontogenic pain after endodontic therapy: a systematic review and… · https://pubmed.ncbi.nlm.nih.gov/20728716/
- 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… · https://pubmed.ncbi.nlm.nih.gov/25175849/
- Ng YL, Mann V, Gulabivala K. Tooth survival following non-surgical root canal treatment: a systematic review of the literature. Int Endod J. 2010… · https://pubmed.ncbi.nlm.nih.gov/20158529/
- Ng YL, Mann V, Gulabivala K. A prospective study of the factors affecting outcomes of nonsurgical root canal treatment: part 1: periapical health. Int Endod… · https://pubmed.ncbi.nlm.nih.gov/21366626/
- Ng YL, Mann V, Gulabivala K. A prospective study of the factors affecting outcomes of non-surgical root canal treatment: part 2: tooth survival. Int Endod J.… · https://pubmed.ncbi.nlm.nih.gov/21366627/
- Sequeira-Byron P, Fedorowicz Z, Carter B, Nasser M, Alrowaili EF. Single crowns versus conventional fillings for the restoration of root-filled teeth.… · https://pubmed.ncbi.nlm.nih.gov/26403154/
- Hajeer O, Hasan A, Kanout C, Morad ML. Ferrule dimensions and restoration outcomes in endodontically treated teeth: A systematic review and meta-analysis. J… · https://pubmed.ncbi.nlm.nih.gov/41601347/
- Tang W, Wu Y, Smales RJ. Identifying and reducing risks for potential fractures in endodontically treated teeth. J Endod. 2010 Apr;36(4):609-17. PMID… · https://pubmed.ncbi.nlm.nih.gov/20307732/
- Giok KC, Veettil SK, Menon RK. Comparative effectiveness of fiber and metal posts in the restoration of endodontically treated teeth: A systematic review… · https://pubmed.ncbi.nlm.nih.gov/37827970/
- 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… · https://pubmed.ncbi.nlm.nih.gov/37248469/
- 《醫療法》第 81 條,全國法規資料庫。[ 以 ego-browser 實載,標題「醫療法§81-全國法規資料庫」,條文逐字對得上 · https://law.moj.gov.tw/LawClass/LawSingle.aspx?pcode=L0020021&flno=81
- b. 《醫療法》第 87 條,全國法規資料庫。[ 以 ego-browser 實載,兩項條文逐字取得 · https://law.moj.gov.tw/LawClass/LawSingle.aspx?pcode=L0020021&flno=87
- c. 《醫療法》第 21 條,全國法規資料庫。[ 以 ego-browser 實載,條文逐字對得上 · https://law.moj.gov.tw/LawClass/LawSingle.aspx?pcode=L0020021&flno=21
- d. 《醫療法》第 22 條,全國法規資料庫。[ 以 ego-browser 實載,兩項條文逐字取得 · https://law.moj.gov.tw/LawClass/LawSingle.aspx?pcode=L0020021&flno=22
- 《全民健康保險法》第 41 條,全國法規資料庫。[ 以 ego-browser 實載,條文逐字對得上 · https://law.moj.gov.tw/LawClass/LawSingle.aspx?pcode=L0060001&flno=41
- 《全民健康保險法》第 51 條,全國法規資料庫。[ 以 ego-browser 實載,十二款逐字取得;同 VERIFIED-FACTS 已驗錨 · https://law.moj.gov.tw/LawClass/LawSingle.aspx?pcode=L0060001&flno=51
- 衛生福利部中央健康保險署「全民健康保險醫療服務給付項目及支付標準」公告頁。[ 以 ego-browser 實載,頁面標題與四筆檔案清單逐字讀取;本卡未下載檔案逐項比對 · https://www.nhi.gov.tw/ch/lp-3778-1.html
- 政府資料開放平臺,資料集 121913「臺北市醫療收費標準」,提供機關臺北市政府衛生局。[ 以 ego-browser 實載,標題與提供機關逐字對得上 · https://data.gov.tw/dataset/121913
この記事を引用
km 編輯部・《根管治療(「神経を取る」)とは?何回通う?|證據鏈》・IDAEO 知識庫・2026-08-13・https://km.idaeo.ai/reports/dental-root-canal-basics-evidence