可以看出根尖部阴影明显
但各个层面未见折裂影像
 

    可以见到左右上6和上7均有MB2，而且mb2均钙化明显
    事实上这张图是近根尖的图层
    越往根上段整个根管系统钙化越明显
    去腐清理髓腔后发现几个根均钙化
    这是就面临选择了
    是继续显微镜下通根还是直接拔除种植呢？
    经患者沟通，患者认为治疗时间太久要求拔牙后种植
    那我就在想如果我本人遇到这种情况呢？
    我多半会找个技术很牛的牙体牙髓病专家先保守治疗吧
    大家对此病例有什么建议？欢迎讨论
    刚才随便搜索了一下，其实这种讨论由来已久，只是国内尚未展开
    一个学者在他的“The endodontic implant algorithm”中总结到“The future may appear murky， but the clouds will lift and the sky will clear”（未来仍旧可能是模糊的，但是乌云会散去，天空将变得澄澈"
    不知道是因为本人的语言文字功底不好还是啥原因
    让大家觉得我想去争论牙体牙髓和种植孰好孰坏，这实在是杯具。
    难道大家在临床上就没有这样的疑惑或拿不定主意的时候吗？
    那这时候应该怎么办呢？
    我只是想提供个思考空间，
    让大家能对现实的临床问题通过查资料，阅读文献，必要的各专业的交流来做个讨论分析
    根本不存在谁压谁的问题。
    看看老外的文献
Comparative outcome analysis of endodontic treatment and single implant restoration
J. CARTER， D. JONES， E. SOLOMON， and J. HE， Baylor College of Dentistry， Dallas， TX， USA
Endodontic treatment and implant-supported restoration are both viable treatment options to restore the functionality and esthetics of the dentition. Both treatment modalities have high success rate and
predictability. Clinical decision making is often influenced by many factors in addition to success rate such as cost， time， function， and esthetics. Patient perception and preference play an important role in
the ultimate clinical decision making.
    首先老外肯定了牙体牙髓和种植的疗效。
    然后认为这两者的临床选择是受多种因素影响的，包括费用、时间、功能恢复的好坏以及美观等。病人的理解和偏好往往决定了临床的选择。于是老外就此问题专门进行了实验。下面是整个实验报告的摘要
Objective: the purpose of this study was to compare endodontic treatment（Endo） and single implant  restoration （Implant） regarding time to function，
cost， and patient  satisfaction. 
    目的：本实验的目的是从时间、功能恢复、费用及患者满意度几方面对牙髓治疗及单个种植修复（single implant restortion该如何翻译？）进行比较
Materials and methods: 254 patient satisfaction surveys  were sent to patients who received single implant
restoration or  endodontic treatment in the posterior mandible at Baylor College of Dentistry. Survey questions included patient satisfaction towards
the cost， duration of the treatment， appearance and the ability to eat after the treatment. 53 responses from Endo patients and 36 responses from Implant patients were received. Treatment records of responded patients
were reviewed to record the duration of the treatment， number of visits，treatment protocol， post-op intervention， and cost. Patient survey results were evaluated using Pearson chi square analysis to determine difference in the response to each question between the groups. Overall satisfaction was analyzed by Student\‘s t-test using a derived summative
score. 
    材料和方法：研究者发了254份调查表给患者，调查表调查的内容包括治疗的时间、费用、外观及功能恢复等的满意度情况。收到了53份牙髓治疗患者及36份种植患者的调查表。然后研究者对这些调查项目进行了统计学分析
Results: Time to function was significantly longer in Implant patients compared to Endo. Implant also required more post-opinterventions. Endo patients were significantly more likely to report satisfaction with treatment cost （p<0.05） and less likely to report
dissatisfaction regarding treatment duration， as compared to Implant patients （p<0.05）. However， there is no statistical difference in overall satisfaction between the two groups.
    结果：研究者的结果其实很简单就是种植时间长、费用高、不过满意度相比两者无统计学差别。也就是患者均认可这两种方案。
Conclusion: Implant treatment requires more time and intervention to achieve function  compared to Endo treatment. This delay causes significant
dissatisfaction among patients. However， Endo and Implant treatments have similar overall patient satisfaction.
    结论：最后研究者给予个结论就是相对于牙髓治疗来说种植需要更多的时间和复诊次数来获得咀嚼功能的恢复，这往往造成患者的不满意。但是患者对牙髓治疗和种植治疗的满意度是相似的。
    其实这个研究不用研究我们就能知道结果，这是很明显的
    老外为什么要做这个实验呢？难道老外比我们傻？
    我想正是他们的严谨态度才使他们站的更高看的更远
    有人说我博人气，我想好吧，如果我的博能有更多的人气，能让更多的人对临床的一个小问题都有锲而不舍的钻研精神，那我们的口腔事业将达到新的高度。

不明白这些文献里会有什么严厉禁止的词语，尽然不给发布没辙了。只能截图发了