Kev kho hniav ntawm cov hniav yog cov txheej txheem kho dua tshiab txhawm rau txhim kho qhov qub qub ntawm cov hniav hniav. Muaj ob peb txoj hauv kev niaj hnub no thiab txhua tus tuaj yeem xaiv qhov uas haum rau lawv raws li qhov zoo thiab tus nqi. Lub sij hawm kho cov hniav hauv kev kho hniav yog kev kho cov hniav anatomical ntawm cov hniav, nws cov xim thiab kev txuag ntawm nws cov functionality. Kev xaiv ntawm txoj kev yog tsim los ntawm kws kho hniav. Nws ua qhov kev ntsuam xyuas ua ntej thiab coj mus rau hauv tus account thaj tsam ntawm kev puas tsuaj, tom, kev ncaj ncees ntawm cov ntaub so ntswg, muaj kev tsis haum tshuaj thiab lwm yam nta. Yog tias tsis muaj kev kho mob ua ntej ntawm caries lossis tshem tawm lwm yam kev puas tsuaj, kev kho dua tshiab yuav tsis ua los ntawm leej twg.
hom tsiaj
Qhov kev faib loj yog los ntawm seb qhov haujlwm puas ua tiav hauv qhov ncauj lossis sab nraud. Nws yog qhov zoo tshaj plaws niaj hnub no, vim tias tsis muaj ib thaj tsam meej, ntau txoj hauv kev dhau mus rau ib leeg. Tab sis lub hom phiaj ntawm txhua txoj kev tseem zoo ib yam - txhawm rau tshem tawm qhov tsis txaus ntawm kev kho hniav. Lub ntsiab lus tseem ceeb ntawm kev kho dua tshiab yog kom ua tiav qhov siab tshaj plaws ntawm naturalness nyob rau hauv cov nqe lus ntawm ntuj ntxoov ntxoo ntawm enamel thiab cov duab ntawm cov hniav. Cov duab ua ntej thiab tom qab kho dua tshiabqhia hauv qab no.
Direct method
Txoj kev ncaj qha ntawm kev kho cov hniav yog yam uas tau siv los hu ua txhaws. Txhua txoj haujlwm yog ua tiav hauv qhov ncauj kab noj hniav. Cov hniav rov qab tsis txawv ntawm cov hniav zoo. Tshem tawm ib feem ntawm kev kho dua tshiab yog ua tsis tau txawm tias los ntawm kws kho hniav.
Indirect method
Txoj kev tsis ncaj ntawm kev kho hniav kho hniav yog kho los ntawm cam khwb cia. Kev ua haujlwm yog ua los ntawm tus kws kho hniav orthopedic. Cov cam khwb cia yog ua zoo tib yam rau tib cov hniav los ntawm lub puab tsaig noj qab nyob zoo. Yog tias qhov no tsis tuaj yeem ua tau, kev tsim qauv ntawm kev kho hniav tuaj yeem cawm tau. Tib lub sijhawm, cov khoom puas tsuaj yog, raws li nws tau, "tiav" - tus qauv 3D tau txais.
Nrog txoj kev tsis ncaj, tus neeg mob siv sijhawm tsawg dua hauv lub rooj zaum kho hniav. Inlays rau lub qhov ncauj kab noj hniav yog tsim nyob rau hauv lub laboratory. Cov khoom siv rov ua dua tau yooj yim tshem tawm hauv tsev kho mob yam tsis muaj kev puas tsuaj ntau.
Cov khoom siv dab tsi?
Thaum xaiv cov khoom siv rau kev kho dua tshiab, 4 tus yam ntxwv raug coj mus rau hauv tus account:
- kev sib haum xeeb;
- txoj kev kho;
- destination;
- qhov ntau thiab tsawg.
Kev kho dua tshiab tuaj yeem koom nrog cov hniav tom ntej thiab tom qab, thiab cov hau kev sib txawv. Rau pem hauv ntej nrog txoj kev ncaj nraim, siv lub teeb-kho cov khoom sib xyaw thiab amalgam.
Nrog kev kho tsis ncaj ntawm cov hniav, kev xaiv ntau dua: nws tuaj yeem yog cov khoom siv hluav taws xob, cov ceramics, zirconium, aluminium oxide, hlau ceramics. Cov yas tuaj yeem ua ib txwm ua los ntawm kub, lossis los ntawm cov hlau-ceramic, uas tam sim no nrov.
Contraindications rau kev kho dua tshiab
Contraindications rau kho hniav yog:
- ua xua rau cov khoom sib xyaw lossis cov nplaum rau nws;
- tsis tuaj yeem cais cov hniav thiab nws cov kab noj hniav los ntawm kev ya raws;
- Nco cov hniav hnav ua ke nrog kev tom ncaj;
- bruxism;
- pronounced incisal overlap;
- tsis muaj qhov ncauj huv.
Lub neej ntawm cov khoom siv kho dua tshiab
Tsis yog tus kws kho hniav ib leeg yuav muab hnub tim ntawm kev khaws cia ntawm kev kho dua tshiab, vim txhua yam yog tus kheej. Kev huv huv ua lub luag haujlwm, muaj tus cwj pwm tsis zoo, noj zaub mov, thiab lwm yam. Thiab lub sijhawm tseem nyob ntawm tus kws kho hniav tsim nyog.
cov chav kawm kho dua tshiab
Raws li qib kev puas tsuaj, 3 chav kawm ntawm kev kho hniav tuaj yeem paub qhov txawv. Lawv kuj hu ua txoj hauv kev:
- 1 chav. Nws yog siv rau caries ntawm fissures, uas tshwm sim heev heev. Qhov teeb meem yog unpredictable vim hais tias thaum pib ntawm kev kho mob, qhov ntim ntawm qhov txhab yog feem ntau tob tshaj qhov xav tau. Qhov chaw zom zaub mov tsis tawg ntawm no. Restoration yog nqa tawm siv txoj kev occlusal key. Qhov no yog ib qho kev npaj los ntawm kev zom qhov chaw ntawm qhov kev xav, uas qhov tsim nyog ntawm cov khoom sib xyaw yog tom qab nyem tawm kom tau txais cov duab qub ntawm cov hniav. Bit-silicone yog siv los ua tus yuam sij. Lawv yog cov tawv heev, thiab tag nrho cov ntsiab lus me tshaj plaws ntawm qhov zom zom yog imprinted heev.
- 2 chav rhuav tshem thiab kho dua tshiab. Nws yog hais txog cov kab noj hniav sib sib zog nqus thiab insolventntim. Cov yam ntxwv tseem ceeb ntawm chav kawm 2 yog kev puas tsuaj txog li 50% ntawm qhov chaw zom zaub mov, tab sis kev khaws cia ntawm cov ntsiab lus tseem ceeb ntawm cov tubercles, ridges, ib feem ntawm cov ridges, thiab lwm yam. Yog li ntawd, tus kws kho hniav tuaj yeem yooj yim rov tsim cov duab sab nraud. thiab tau txais ib daim qauv zoo heev ntawm qhov zom zaws. Kev ua haujlwm yog ua los ntawm cov txheej txheem ntawm txheej txheej los ntawm txheej txheej.
- Txoj kev rov qab los ntawm kev puas tsuaj thib 3. Cov pawg no suav nrog qhov tsis xws luag loj, txhua yam pathologies nrog cov ntaub so ntswg tsis tuaj. Yog tias qhov kev puas tsuaj ntawm cov yas yog ntau tshaj 50% ntawm qhov ntim, txoj kev tsis ncaj ncees yuav raug siv. Cov chav kawm muaj teeb meem, vim tus kws kho mob muaj ob peb yam lus qhia. Nws yog tsis yooj yim sua kom hnov cov ntaub ntawv tsim nyog ntawm cov hniav, thiab kom nkag siab qhov tseeb spatial txoj hauj lwm ntawm cov khoom. Kev siv quav ciab ua ntej yog ua tiav hauv chav kuaj hniav uas siv lub tshuab kho hniav kom raug. Tus kws kho mob rov tsim cov morphology ntawm tus hniav ntawm nws tus kheej kev txiav txim siab, thiab tom qab ntawd kuaj xyuas qhov ua tau raws li qhov occlusion, thiab tshem tawm qhov ntau dhau nrog cov burr.
Composite restoration
Composite restoration yog sau ntawm sab nrauv ntawm cov hniav nrog ib tug tshwj xeeb muaj pes tsawg leeg (photopolymer nyob rau hauv ob peb txheej). Cov txheej txheem yog nce, nws yuav siv sij hawm 1 mus ntsib, nyob rau hauv lub sij hawm - 30-60 feeb. Nws tsis tas yuav tig thiab npaj.
Txoj kev sib xyaw yog zoo ib yam li cov veneers, vim tias cov filling kuj muab tso rau ntawm 1 sab ntawm tus hniav nkaus xwb. Txawm li cas los xij, enamel tsis cuam tshuam los ntawm txoj kev no. Tsuas yog 2 grooves yog drilled ntawm tus hniav nto raws li ciam teb rau cov resin. Tom qab ntawd ib qho tshwj xeeb compound yog siv los degrease cov enamel thiab rhuav tshem microbes.
Kawgtheem - txheej txheej los ntawm txheej txheej ntawm photopolymer. Txhua txheej yog qhuav nrog lub teeb tshwj xeeb. Tus naj npawb ntawm cov khaubncaws sab nraud povtseg yog xaiv los ntawm kws kho hniav raws li qhov mob ntawm tus hniav.
Cov duab ua ntej thiab tom qab kho cov hniav hauv qhov no yog nthuav tawm hauv qab no. Yuav luag tsis muaj qhov mob thaum lub sijhawm ua haujlwm, tab sis kev tshuaj loog hauv zos tseem ua. Kev sib xyaw ua ke tuaj yeem siv tau thaum muaj cov chips, tawg, chips, me ntsis ntawm cov enamel. Siv rau ntawm cov hniav pem hauv ntej xwb.
Lwm cov npe rau kev kho kom zoo nkauj yog kev kos duab lossis zoo nkauj vim tias tag nrho cov txheej txheem muaj tswv yim zoo.
Composite method details
Kev kho kom zoo nkauj ntawm cov hniav nrog cov khoom siv kho kom zoo nkauj yog ua raws li qhov seem thiab cov polymer tau sib xyaw ua ke rau hauv ib qho tag nrho vim muaj kev sib koom ua ke. Qhov zoo ntawm cov ntaub ntawv sib xyaw yog tias lawv tuaj yeem tiv taus kev nyuaj siab vim lawv cov yas.
Lwm qhov ntxiv yog qhov muaj peev xwm ua kom tiav kev kho dua tshiab hauv ib qho kev mus ntsib, tsis muaj kev xav thiab tsim cov yas. Qhov no kuj txo cov nqi kho mob. Txawm hais tias ib feem ntawm qhov txhaws tau poob, nws tuaj yeem rov qab tau hauv ib teev. Tsis tas li ntawd, cov khoom sib xyaw tsis zom cov ntaub so ntswg ntawm cov hniav antagonist.
Qhov tsis zoo ntawm txoj kev sib xyaw
Muaj qee qhov tsis zoo rau txoj hauv kev ntawm kev kho tus hniav ncaj qha nrog cov khoom sib xyaw. Ua ntej, xws li filling muab qee qhov shrinkage. Rau txhua yam khoom nws yog tus kheej. Thib ob, nyob rau hauv cov nqe lus ntawm cov xim ceev, cov khoom sib xyaw ua haujlwm tsis zoo rau lwm cov ntaub ntawv, piv txwv li, ceramics lossisveneers.
Thib peb, nws feem ntau tshwm sim tias cov khoom tsis ua raws li cov phab ntsa ntawm cov hniav thaum lub sij hawm, uas tuaj yeem ua rau cov kab mob caries rov qab. Plaub, cov ntaub ntawv sib xyaw yog cov rhiab heev rau cov dej noo, uas cuam tshuam rau lawv cov polymerization kom zoo, thiab cov filling yuav poob.
Cov khoom sib xyaw tsaus dhau sijhawm. Raws li kev tshawb fawb, nyob rau hauv 5 xyoo, 15% ntawm cov filling yuav tsum tau ib co kev kho kom zoo nkauj "kho" los yog polishing.
Cov khoom ntim niaj hnub rau kev kho cov hniav tso cai rau koj rov qab cov qauv ploj yam tsis muaj cov ntaub so ntswg noj qab haus huv. Cov txheej txheem thiab cov ntaub ntawv raug xaiv los ntawm kws kho hniav, nws nyob ntawm nws qhov kev paub, kev paub.
Pros and Cons of Direct Restoration
Direct Dental Benefits:
- nrawm ua haujlwm (1-3 teev);
- zoo thiab tus nqi pheej yig;
- ib mus ntsib tuaj yeem kho tau ntau cov hniav;
- yuav tshem tawm qhov tsis xws luag los ntawm kev puas tsuaj.
Flaws:
- nrog cov thev naus laus zis thiab kev ua haujlwm zoo, lub sijhawm tsis pub dhau 10-15 xyoo;
- kev vam meej nyob ntawm kev tshaj lij ntawm kws kho hniav;
- tom qab kev kho dua tshiab, cov txheej txheem tu cev yuav tsum tau saib xyuas tshwj xeeb - kev siv cov khoom zoo thiab cov txhuam hniav;
- ib ntus lawv yuav tsum tau polished;
- xim ntawm cov hniav hloov lub sijhawm, tab sis tsis muaj cov polymers, yog li qhov sib txawv yuav pom tau.
theem tseem ceeb ntawm kev kho dua tshiab
Kev kho dua tshiabCov hniav sib xyaw suav nrog cov kauj ruam hauv qab no:
- Kev npaj rau kev kho dua tshiab - ua tiav kev tu cov hniav ntawm tartar thiab cov quav hniav. Kev txiav txim siab ntawm cov xim tshwj xeeb, thiab xaiv qhov tsim nyog ntxoov ntxoo ntawm cov khoom sib xyaw.
- Kev tswj hwm tshuaj loog hauv zos.
- xiav carious kab noj hniav.
- Kev cais cov hniav los ntawm cov pa ntub thiab qaub ncaug, thaum lub sij hawm siv lub pas dej da dej.
- Yog tias lub kaus mom raug rhuav tshem ntau dua 50%, cov hniav yog depulped, yuav tsum muab tus pin. Qhov no txhim kho lub zog ntawm lub foob thaum thauj khoom.
- Cov hniav zoo li yuav tsum tau rov qab ua kom zoo li qub. Hauv qhov no, cov txheej txheem ntawm txheej txheej rov qab siv dua. Cov khaubncaws sab nraud povtseg sib txawv ntawm cov xim thiab pob tshab, tab sis ua ke lawv yuav tsum sib koom ua ib qho kev tsim ntuj tsim.
- Toothing. Cov txheej txheem no suav nrog qhov kawg burr qauv, sib tsoo thiab polishing ntawm qhov txhaws.
Tab
Nov yog ib txoj hauv kev los kho cov hniav zom, lawv sab hauv. Nws yog ib qho kev xaiv rau pins. Tabs yog ib ntus thiab mus tas li. Nyob rau hauv rooj plaub tom kawg, lawv yog ua los ntawm hlau los yog ceramics. Qee zaum ib lub tab tuaj yeem sau rau hauv qhov ploj lawm. Tab sis nws yuav tsum hloov tsis pub dhau ib nrab ntawm cov hniav nto.
Txawm hais tias qhov inlays yog kev kho cov hniav ncaj qha, yuav tsum muaj kev xav rau lawv cov khoom siv thiab kev teeb tsa. Lawv yuav txawv me me. Lub stump tab ua lub hauv paus rau lub crown. Rau hom kev kho dua tshiab no, yuav tsum tau mus ntsib kws kho mob ntau. Nyob rau thawj zaug, cov hlab ntsha raug tshem tawm, tom qab ntawd "hollow" thiab cov channelsfoob. Thiab tsuas yog tom qab ntawd, los ntawm cov hniav huv si, qhov kev xav tau tshwm sim.
Thaum lub sijhawm mus ntsib zaum ob, lub tab ib ntus raug tshem tawm thiab kev teeb tsa ntawm kev sau mus tas li pib. Nws yog tsau rau ntawm ib tug tshwj xeeb compound.
Nws tsis tuaj yeem pom cov hniav yog tias qhov txhaws tsis ua los ntawm hlau. Nyob rau hauv cov nqe lus ntawm kev ntseeg siab, kev pab cuam lub neej, inlays yog superior rau restorations, thiab yog hais tias lawv yog ua los ntawm ceramics, ces lawv yuav tshaj li artistic restoration.
Pins
Pins yog siv rau kev puas tsuaj loj. Txawm hais tias tsuas yog ib lub pob zeb tseem nyob ntawm cov pos hniav es tsis txhob siv cov hniav, xws li kev tsim yuav rov qab los. Tus pin nws tus kheej zoo li tus pin hlau uas tau muab tso rau hauv lub hauv paus kwj dej. Nws sab sauv, protruding saum cov pos hniav, dhau los ua lub hauv paus rau cov hniav rov qab.
Rau incisors thiab canines, 1 tus pin yog yuav tsum tau, rau cov molars - 2. Kev teeb tsa ntawm cov qauv no yog ib theem npaj rau kev tsim lub hauv paus rau lub kaus mom. Tus hniav puas rau tus pin tsis raug tshem tawm. Nws tsuas yog ntxuav kom ntau li ntau tau, cov kab yog drilled, thiab kho cov tshuaj yog poured rau hauv lawv nyob rau hauv lub filling, rau hauv uas tus pas nrig yog ntxig.
Tom qab cov tshuaj dries, qhov uas ploj lawm ntawm cov hniav yog tsim rau ntawm tus pin. Lub downside ntawm txoj kev no yog qhov kev pheej hmoo ntawm kev sib cais, cov hlau puag yog tsis ntseeg heev.
Nkauj
Lub kaus mom yog ib yam ntawm cov pob qij txha, zoo li lub hau npog, uas yog muab tso rau ntawm qhov hnyav hnyav, cuam tshuam cov hniav lossis tus pin. Rau nws installation, 3-5 mus ntsib kws kho hniav yuav tsum tau. Lub crown yog tsim los ntawm ib tug cam khwb cia los yog ib tug virtual qauv. Yog li ntawd, nws rov ua cov duab zoo heev.cov hniav noj qab haus huv. Ib txoj hauv kev zoo sib xws yog qhia rau cov kab mob loj thiab thaum lwm txoj kev ua tsis tiav.
Txawm tias cov hniav puas ntau dua 70%, nws tuaj yeem rov qab los nrog lub kaus mom. Qhov xav tau tshaj plaws yog cov qauv tsim los ntawm ceramics thiab cermets. Lawv muaj xim ntuj thiab lub zog siab.
Tsim kom muaj lub kaus mom tsis tas yuav tshem tawm cov hniav, tab sis kev kho thiab ntxuav cov kwj dej yog cov txheej txheem yuav tsum tau ua. Tom qab ntawd, qhov kev xav ntawm tus kheej yog ua. Rau ib tug crown, tus hniav yog av mus rau qhov tsawg kawg nkaus loj. Thiab nws yuav zoo li ib tug nyias nyias stump. Yog tsis muaj tus hniav ntuj, muab tus pin.
Thaum pib, ib ntus yas yas tau muab tso rau, vim tias nws siv sijhawm los tsim cov qauv ruaj khov los ntawm kev xav. Cov qauv ua los ntawm zirconium dioxide ua haujlwm ntev dua li lwm tus (ntau tshaj 20 xyoo). Yog li, cov khoom no feem ntau pom zoo los ntawm cov kws kho hniav rau kev kho cov hniav nrog lub hau.
Kev hloov kho anterior kho dua tshiab
Veneers lossis Lumineers yog lwm txoj hauv kev txhaws. Qhov tseeb, qhov no yog tib yam: ib lub phaj nyias nyias txuas nrog cov hniav. Lawv txawv tsuas yog nyob rau hauv lawv thickness. Depulpation tsis xav tau ntawm no.
Thaum txhim kho veneers thiab lumineers, cov hniav yog me me, tab sis cov enamel yuav luag tag, mus rau qhov tob ntawm qhov loj ntawm cov qauv. Qhov no yog qhov tsim nyog rau qhov sib npaug ntawm kab. Veneers ua rau cov hniav sib zog los ntawm 2-3 tones, thiab lawv raug pom zoo kom muab ntsia yog tias nws tsis tuaj yeem siv tshuaj dawb. Ntxiv mus, cov qauv zoo li no tuaj yeem ua tautsim kom muaj kev luag nyav zoo tag nrho, txawm tias tus neeg mob muaj mob ntau dhau, tawg lossis tawg, lossis ploj ob peb cov hniav tag nrho.
Monolithic veneers muaj zog ntau dua li kev sau. Vim li no, lawv yog cov kav ntev. Qhov nrov tshaj plaws yog cov ceramics, vim lawv yog cov feem ntau ntom ntom nrog cov hniav ntawm cov hniav. Nyob rau hauv tag nrho lawv cov khoom, lawv yog ze li sai tau rau ntuj enamel. Veneer duab raug txog li 1 micron.
Lumineers yog nyias thiab sib dua. Thaum txhim kho lawv, tig lub enamel tsis tsim nyog. Cov qauv yog txuas nrog kho gel, uas suav nrog fluorine. Yog li ntawd, lub installation ntawm lumineers kuj muaj txiaj ntsig zoo rau cov hniav. Lub gel yog tsau sai dua nyob rau hauv lub teeb.
Veneers thiab lumineers yog yuav luag cov qauv kim tshaj plaws uas tau tsim los ntawm cov cuab yeej tshwj xeeb. Lwm qhov teeb meem yog tias, ua cov khoom siv nyuaj, lawv sai sai lov tes taw cov cuab yeej no. Yog li ntawd, tus nqi ntawm cov qauv kuj suav nrog tus nqi kho thiab hloov.
Veneers thiab Lumineers tau xaj kom tag nrho. Kev ua tiav ntawm cov qauv no tuaj yeem ua tiav hauv 2-3 mus ntsib kws kho mob. Veneers kav ntev txog 10 xyoo, Lumineers kav ntev dua - mus txog 20 xyoo.
