Classification los ntawm dub kab noj hniav: qhov kev piav qhia, cov neeg kawm ntawv cov chav kawm ntawv thiab kev kho mob

Caries - ib tug txaus ntshai tus kab mob. Tab sis cov kws kho mob tau tsim ib tug npaum txoj kev mus nrog tus kab mob no. Yuav ua li cas yog lub cais ntawm kab noj hniav los ntawm dub? Xav txog lo lus nug no nyob rau hauv ntau yam.

hniav lwj

"Kab noj hniav" yog Latin translates li "rot". Qhov no intricate pathological kev sluggishly ntws nyob rau hauv ib qho nyuaj ntaub so ntswg ntawm tus hniav. Feem ntau nws muaj vim lub neej coj cov nyhuv ntawm cov teeb meem nrog thiab lwm ua.

Thaum thawj zaug rau theem ntawm lwj yog txiav txim los ntawm kev puas tsuaj ntawm cov organic matrix ntawm tus txha hniav laus thiab demineralization focal nws inorganic feem. Laus nyuaj kho hniav cov ntaub so ntswg lwj, cov kab noj hniav nyob rau hauv lub dentin tshwm sim. Yog hais tias tus neeg mob yuav tsis nrhiav kev pab kho mob rau ib tug ntev lub sij hawm, tej zaum yuav muaj teeb meem ntawm lub inflammatory ncig thiab sis plawv hniav.

Tus thawj version

Yuav ua li cas yog lub cais ntawm cov Dub? Qhov no grouping carious formations rau tus hniav nto. Nws twb hais nyob rau hauv 1896 los mus txiav txim cov qauv ntawm cov tshuaj nyob rau hauv txhua soj ntsuam cov ntaub ntawv.

Qhov no kev faib muaj tsib chav kawm, txhua tus uas tau tsim nws tus kheej filling tswvyim thiab kev npaj ntawm cov hniav. Ib me ntsis tom qab, qhov no muaj tau ntxiv mus rau lub thib qib. Niaj hnub no, nws zoo li no:

• Tus thawj cov hoob kawm - puas fissure caries, aub tsiv thiab tej yam ntuj tso kab noj hniav buccal, zom thiab Palatine hniav (fissure caries).
• Ob - puas cov txee uas chwv ntawm lub hniav puas thiab premolars.
• Qhov thib peb - qhov chaw hu caries canines thiab incisors, tsis txhob kov cov txiav npoo.
• Qib plaub - richer lwj incisors thiab canines, offending nqe vaj lug kub ntawm tej ntug.
• Fifth - lub tsev me nyuam caries. Nyob rau hauv cov ntaub ntawv no, lub vestibular chaw ntawm cov kaus hniav pab pawg puas lawm.
• Sixth qib - kev puas tsuaj, muab tso rau hauv tej lub npoo ntawm lub canines thiab incisors, premolars thiab hniav puas toj.

Qhov thib ob version

Dub suam ntawm caries localization yog sawv cev nyob rau hauv ob peb lub versions. Qhov thib ob hloov kho raws li nram no:

• Tus thawj cov hoob kawm muaj xws li kev puas tsuaj nyob ze ntawm lub fissure (natural sulci).
• Ob - hniav lwj, uas nyob rau hauv lub dav hlau loj loj thiab me me hniav puas.
• Qhov thib peb - cov expansion ntawm cov kev sib cuag ib sab ntawm canines thiab incisors nrog fwm txiav npoo.
• Plaub - caries txuas chaw ntawm incisors thiab canines nrog tawg txiav npoo.
• Fifth muaj xws li lub tsev me nyuam puas tsuaj.

Qhov thib peb version

Classification los ntawm Blake yog renowned rau nws thib peb version. Niaj hnub no, nws yog raws li nram no:

• Tus thawj cov hoob kawm muaj xws li kev puas tsuaj nyob rau hauv lub cheeb tsam ntawm tej yam ntuj tso qho to thiab fissures ntawm cov hniav.
• Qhov thib ob - tus kev nyuaj siab nyob rau hauv kev sib cuag ib sab ntawm cov me me thiab cov loj loj hniav puas.
• Qhov thib peb chav kawm ntawv - kab noj hniav muab tso rau hauv txee uas chwv ntawm lub canines thiab incisors (tej ntug yog tsis kov).
• Plaub - thais tshwm nyob rau coupling dav hlau canines thiab incisors (tsa tej ntug thiab ces kaum).
• Fifth - cov kab noj hniav tsim nyob rau hauv lub cheeb tsam ntawm lub caj dab ntawm cov hniav ntawm txhua pawg.
• Tom qab ntawd nws tau tsim lub qib, uas tau dej num raws li atypical qaug dab peg ntawm concentration: mounds ntawm zom thiab txiav sawv rau pem hauv ntej cov hniav.

LEEJ TWG

Yog li ntawd, peb pom hais tias xws li ib tug kev faib muaj kab noj hniav los ntawm dub. LEEJ TWG muaj nws tus kheej tsi. ICD 10, nws zoo li no:

• lwj ntawm txha hniav laus;
• puas dentin;
• kev puas tsuaj ntawm MAAs;
• decomposition, nres raws li ib tug tshwm sim ntawm tej yam uas muaj kev ruaj ntseg thiab kev tu cev zaug;
• odontoklaziya, nyob rau lub disappearance ntawm deciduous hniav hauv paus hniav;
• lwm decomposition;
• unadjusted rot.

Lub qhov tob ntawm lub lesion

Nyob rau hauv qhov tseeb, raws li Dub tus faib tau pom nws daim ntawv thov nyob rau hauv lub ntiaj teb no. Los ntawm degree ntawm caries kev puas tsuaj faib mus rau hauv lub nram qab no cov kauj ruam:

• thawj zaug decomposition;
• nto cuam tshuam;
• caries nruab nrab;
• sib sib zog nqus lwj.

Thaum thawj zaug rau theem ntawm txoj kev loj hlob ntawm caries rau tus hniav nto ib tug maub los yog dawb stain. Txawm li cas los, enamel yog ib tug du nto, txij thaum lub anatomical kev puas tsuaj tau. Nyob stain muab tshem tawm los ntawm cov kws kho mob kho hniav cov khoom. Lawv remineralizing hniav, sim kom tsis txhob tom ntej txoj kev loj hlob ntawm tus kab mob.

Nyob rau hauv lub kauj ruam tom ntej rau sab qaum khaubncaws sab nraud povtseg yuav raug rhuav tshem txha hniav laus tshwm lo lus teb rau ib tug ntse kub kev hloov ntawm cov dej thiab khoom noj khoom haus, thiab kuj acidic thiab ntsim zaub mov. hniav verge ntawm kab ntxhib. Thaum no tus taw tes, cov kws kho mob zom cheeb tsam thiab ces nws remineralization. Tej zaum ces dag caries kho nrog cov kev npaj thiab filling.

Pom zoo kev faib kho hniav nyuaj cov ntaub so ntswg tsis xws luag by Dub yog ib qho zoo heev lub cuab tam rau cov kws kho hniav. Thiab yog dab tsi yog ib tug nruab nrab caries? Nyob rau hauv no theem, tus txha hniav laus txheej ntawm tus hniav puas lawm yog li ntawd tej yam tas mus li los yog sib quas ntus mob. Nyob rau hauv cov ntaub ntawv no, lub decomposition txheej txheem twb mus txog sab sauv txheej ntawm dentin.

Kuj ceeb tias tsis, cov hniav yuav tsum tau yuav tsum kho mob kev pab, nyob rau hauv uas tus kws kho mob tshem tawm cov cheeb tsam thiab restore nws nrog kev pab los ntawm ib tug sealing cov ntaub ntawv uas.

Thiab tam sim no saib sib sib zog nqus caries. Tus kab mob no yog yus impressive kev puas tsuaj ntawm kev kho hniav ntaub so ntswg, uas tau cuam tshuam feem ntau ntawm cov dentin. Yog hais tias nyob rau ntawm no theem yuav las mees kho mob, sis plawv hniav yuav raug rhuav tshem. Raws li ib tug tshwm sim, tus neeg mob tej zaum yuav tsim pulpitis los yog periodontitis.

Kab noj hniav kev npaj. qhia tawm

Classification los ntawm Blake tsim lub hauv paus ntawm kev kho hniav. Kab noj hniav npaj yog nqa tawm nyob rau hauv tsib theem. Peb kawm cov kev cai rau cov piv txwv ntawm cov thawj chav kawm ntawv muaj kab noj hniav, npaj tus naas ej tus kws kho mob.

Thaum thawj zaug rau theem nws yog nqa tawm ntawm cov kab noj hniav qhib. hniav npaj yuav pib nrog qhov kev tshem tawm podrytymi txha hniav laus npoo tsis muaj nyob rau hauv ib tug noj qab nyob zoo, tuab dentine. Cov no ib tug ntxhab phab ntsa. Number excised cov ntaub so ntswg yog tsim los ntawm kev txiav txim decomposition chamber dentin. Rau ntawm no theem, tus kws kho mob yuav tsum muab kev nkag tau mus rau ib tug zoo saib ntawm cov kab noj hniav thiab nws ntxiv ua.

Cov kws kho mob qhia tawm ua kheej kheej los yog fissure burs ua los ntawm cov pob zeb diamond los yog cemented carbide. Tool txoj kab uas hla sau raws nkaus Ii qhov loj ntawm lub tswv yim aperture ntawm lub si nraum zoov. Kws txawj siv ib tug turbine tswv yim rotating thaum muaj kev kub ceev, thiab dej-cua txias.

extension

Ib suam ntawm kab noj hniav los ntawm dub yog siv rau ib ntev lub sij hawm thiab yog heev pab tau rau cov kws kho hniav nyob rau hauv lawv cov chaw ua hauj lwm. Yuav ua li cas yog qhov yuav ncua ntxiv ntawm tiv thaiv? Rau ntawm no theem nws tseem qhia tau tias carious kab noj hniav. Nrog rau qhov no lub lag luam, tus kws kho mob yuav tau tiv thaiv kom txhob recurrent hniav lwj. Specialist txheej qhia txog tiav kab noj hniav zoo.

Nws yuav tsum tau muab sau tseg tias, nyob rau hauv raws li cov qauv ntawm cov "lom rationality" I. G. Lukomskogo, ua si nraum zoov ntawm kev npaj cov kauj ruam no yog tsis tau.

Yog hais tias tus kws kho mob yog ua los ntawm technology, kev ruaj ntseg reaming Dub, nws ua ib tug tshaj dhau excision ntawm qhov chaw raug mus rau rot, rau kev tiv thaiv kab chaw. Qhov kev nthuav ntawm caries deepening li ua los yog tapered fissure burs (carbide los yog pob zeb diamond). Ib txhij siv dej-cua txias.

hniav kev faib Blake pab tiv thaiv kev filling, los ntawm txoj kev uas txo tsis tau kev noj qab nyob zoo hniav qauv nyob rau hauv lub occlusal dav hlau. Yog hais tias lub cheeb tsam ntawm lub carious kab noj hniav yog muab tshem tawm, tag nrho cov decayed cov ntaub so ntswg excised lub fissure xwb nyob rau hauv lub enamel. Lub hauv qab ntawm lub caij so nyob rau hauv no precedent yog nonclassic - npawv los yog tshaj.

Nyob rau hauv raws lub fissure tus kws kho mob tsis tshem tawm ib tug loj npaum li cas ntawm cov ntaub so ntswg: nws yog txaus rau txim tuag lub zawj tob ntawm 1-1.5 hli thiab ib tug dav ntawm 0.7-0.8 hli, tsis muaj departing los ntawm tus txha hniav laus ciam teb. Nws kuj txhob creation ntawm ntse hau.

Nyob rau hauv peb lub teb chaws, raws li ib tug txoj cai, rau excision ntawm fissures (fissurotomii) siv nqaim cylindrical burs. Tej zaum qhov no lag luam yog nqa tawm rab hmuv thiab plamevidnymi xyaum.

necrosectomy

Cov theem tom ntej yog qhov kev tshem tawm ntawm caries - necrectomy. Tus kws kho mob tshem tawm cov softened thiab pigmented dentin caries ntawm lub si nraum zoov. Zone kev puas tsuaj thiab demineralization nrog ib tug morphological taw tes ntawm view, cov kauj ruam no yog tshem tawm. Ib thaj tsam ntawm lub ua si nraum zoov yog tsim nyob rau hauv lub cheeb tsam ntawm cov kaus pob tshab dentin.

tsim

Tom ntej no, tus kws kho mob muab cov kab noj hniav ib tug duab uas muaj txhawb rau txhim khu kev qha phiaj ntawm lub tsiaj hiav txwv. Nws yuav tsum tau muab txaus kam mus rau lub hniav kho thiab lub dag lub zog ntawm kev haumxeeb loads. Rau ntawm no theem, qhov kawg tsim puab thiab txheej nkhaus ntawm cov kab noj hniav.

Lub caij so kawm ntawv tsim ib tug fissure, plamevidnymi, pear-zoo li tus conical thiab burs (carbide thiab pob zeb diamond) nrog yeem dej-cua txias. Tus kws khomob tshwjxeeb ua turbine handpiece tig thaum muaj kev kub ceev. Cov yam zoo ntawm lub caij so yog tau nyob rau hauv view ntawm kuj thiab tuav tseg.

Xov

Tom qab ua carbide los yog pob zeb diamond burs txha hniav laus so ntug acquires nkhaus zoo, nws yog tsis muaj zog txaus, nws plaub poob kev sib cuag nrog rau sab ntaub. Nyob rau hauv lub neej yav tom ntej tej zaum nws yuav pab tau kom hloov tus foob kho thiab cov kev loj hlob ntawm putrefactive dab. Cov nuances necessitate xov - kawg machining npoo ntawm cov kab noj hniav, raws li ib tug tshwm sim ntawm uas yuav tsum tau tshem tawm puas qhov chaw ntawm enamel.

Raws li ib tug tshwm sim, tus kws kho mob kom ua tau qhov zoo tshaj plaws thiab txhim khu kev qha kev sis raug zoo ntawm haum ntawm tus hniav qauv thiab filling. Qhov no lub lag luam yog nqa tawm 16 thiab 32 Granite finishing burs los yog zoo-grained pob zeb diamond hau.

Cov kws kho mob xyaum khiav lag luam ntawm tsawg ceev tsis siab yuav tsum tau dej-cua txias. Lawv kuj kho gingival ntug ntawm lub caij so ntug trimmers thiab txha hniav laus riam, tshem tawm cov nyias txheej txheej ntawm tus hniav thiab suav tau tsis zoo los rau nws overheating, kev co thiab lwm yam.

Raws li koj tau pom, kev kho hniav yog ib tug heev yooj yim txoj kev, tab sis, yog hais tias nyob rau hauv lub sij hawm mus ntsib ib tug kws kho mob rau kev pab, peb yuav muaj ib tug Hollywood luag rau lub xyoo yuav tuaj.