Nyob hauv kev xyaum kho hniav, cov cuab yeej kho hniav yeej ib txwm txhim kho. Txawm li cas los xij, qhov no tsis tiv thaiv cov neeg mob los ntawm cov teeb meem. Ib qho ntawm cov no yog cov hniav perforation. Pathology tshwm sim hauv tsuas yog 9% ntawm cov neeg mob, tab sis yuav tsum tau tshem tawm raws sijhawm. Txwv tsis pub, qhov tshwm sim tsis yog tsuas yog cov hniav ploj zuj zus xwb, tab sis kuj pom muaj teeb meem kev noj qab haus huv hnyav dua.
daim ntawv pov thawj kho mob
Tooth perforation feem ntau nkag siab tias yog kab mob uas tshwm sim los ntawm kev tsim lub qhov me me. Los ntawm nws, cov ntaub so ntswg noj qab haus huv thiab kev ua kom pom tseeb ntawm qhov mob yog sib txuas lus. Ib qho tawg tuaj yeem tshwm sim vim muaj kev kho mob yuam kev, cov txheej txheem carious, lossis raug rau cov teeb meem raug mob. Txhawm rau txuag koj cov hniav, koj yuav tsum mus ntsib kws kho hniav kom sai li sai tau. Txwv tsis pub, tus kab mob yuav kis mus rau cov ntaub so ntswg, ua rau sepsis lossis granuloma.
Raws li cov tshuaj noj ntawm qhov tshwm sim ntawm cov kab mob pathology, nws yog txoj cai los faib nws mus rau hauv tshiab thiab tsis tu ncua. Hauv thawj kis, qhov teeb meem raug kuaj pom tam sim ntawd thiab tam sim ntawd mus raunws tshem tawm. Daim ntawv qub tau tshwm sim tom qab lub sijhawm ntev.
Perforation tuaj yeem nyob hauv zos:
- hauv phab ntsa ntawm tus hniav;
- nyob rau thaj tsam ntawm cov hauv paus hniav.
Qhov laj thawj tseem ceeb
Tus etiology ntawm qhov teeb meem no yuav muaj qhov txawv hauv keeb kwm:
- Txhua tus yam ntxwv ntawm cov hniav, lawv cov hauv paus hniav thiab cov kwj dej. Nyob rau hauv rooj plaub no, nws yog ib qho nyuaj rau kwv yees cov kev taw qhia ntawm kev txav ntawm cov cuab yeej kho hniav, thiab yog li ntawd ib tug kab noj hniav yog tsim. Feem ntau, qhov xwm txheej no tau pom thaum nthuav cov kwj deg kho hniav lossis txhim kho tus pins.
- Kev puas tsuaj vim kev cuam tshuam, kev ua haujlwm tsis zoo nrog cov cuab yeej kho mob, kev siv zog ntau dhau. Outwardly, xws li ib tug perforation ntawm cov hniav zoo li ib tug tawg.
- Carious lossis lwm yam kis tau. Yog tias tsis kho raws sijhawm, tus kab mob ua rau maj mam softening ntawm phab ntsa ntawm cov hniav. Sij hawm dhau mus, kab noj hniav tsim hauv nws, uas tuaj yeem ncav cuag cov hauv paus hniav.
Tus kws kho hniav tsis yog ib txwm liam rau kev txhim kho ntawm qhov teeb meem no. Hauv qee tus neeg mob, muaj kev pheej hmoo rau nws qhov tsos. Peb tab tom tham txog cov xwm txheej ceev nrawm ntawm cov enamel, ib qho txawv txav ntawm cov hniav axis nrog rau offset rau ib sab.
Thawj tsos mob
Yog hais tias tus hniav perforation tshwm sim thaum lub sij hawm kho, tus neeg mob feem ntau tsis hnov txog kev hloov, vim nws nyob rau hauv cov tshuaj loog. Thaum tsis muaj kev kho hniav raws sijhawm thiab tom qab qhov kawg ntawm cov tshuaj loog, qhov mob tshwm sim. Los ntawmRaws li kev mob tshwm sim, cov tsos mob ntawm periodontitis lossis periostitis tshwm:
- nce qhov rhiab ntawm cov enamel;
- daim tawv nqaij o;
- pom ntawm neoplasm ntawm cov pos hniav;
- kev tsim ntawm lub fistula thiab tso cov kua paug tawm rau sab nraud, uas ua rau tus neeg mob zoo li qub;
- nce kub, zoo siab heev.
Qee lub sij hawm qhov teeb meem nrog sluggish o, yog li daim duab kho mob yog qhov muag plooj. Outwardly, tus hniav yuav saib zoo tag nrho. Txawm li cas los xij, yog tias tsis kho, nws tig mus tsaus.
Yog tias muaj perforation tshwm sim thaum lub sij hawm kho hniav, tus kws kho mob tau ceeb toom tam sim ntawd. Nws manifests nws tus kheej nyob rau hauv daim ntawv ntawm los ntshav thiab ib tug zoo nkaus li ntawm ib tug kev hloov nyob rau hauv lub zog ntawm lub ntsuas nyob rau hauv lub hauv paus kwj dej. Tus kws tshaj lij lub luag haujlwm tam sim ntawd tshem tawm qhov tsis xws luag thiab kaw qhov perforation ntawm cov hniav nrog cov khoom ntim.
Qhov no yog qhov teeb meem ntau tshaj plaws. Nws tuaj yeem tshwm sim ob qho tib si hauv phab ntsa ntawm cov hniav thiab hauv cheeb tsam ntawm nws hauv qab. Cov laj thawj tseem ceeb yog cov yam ntxwv ntawm lub cev ntawm cov qauv ntawm cov hniav thiab kev kho tsis raug.
Daim duab kho mob nrog perforation ntawm hnub ntawm cov hniav los yog nws cov phab ntsa yog heev raug. Tus neeg mob mob hnyav heev. Nyob rau tib lub sijhawm, ntshav pib ooze los ntawm chav kho hniav. Ib daim ntawv qub ntawm pathology tsis tshwm sim nws tus kheej rau lub sijhawm ntev. Tus neeg mob tsuas yog txhawj xeeb txog qhov mob luv luv. Tsuas yog los ntawm kev tshuaj xyuas qhov muag pom tus kws kho hniav tuaj yeem txiav txim siab seb puas muaj teeb meem.
Feem ntau cov perforations no pomtam sim ntawd thiab tshem tawm los ntawm kev sau. Qhov kev kwv yees yuav luag ib txwm zoo. Txawm li cas los xij, qhov tshwm sim ntawm kev kho mob feem ntau txiav txim siab los ntawm qhov loj ntawm perforation. Yog tias tus nqi no ntau dua 2 hli, qhov filling tuaj yeem ua rau raug tshem tawm ntawm cov khoom nquag mus rau hauv lub cev thiab nws cov kab mob tom ntej.
Ntxhais hauv paus chaw
Root perforation kuj yog ib qho teeb meem ntawm kev kho mob endodontic. Nyob rau hauv cov ntaub ntawv ntawm kev kho tsis raug tactics, nws hem kom poob ib tug hniav.
Pathology tuaj yeem nyob hauv thaj tsam nruab nrab ntawm cov hauv paus hniav, nws apex lossis hauv thaj tsam ntawm bifurcation. Koj tuaj yeem xav tias nws txoj kev loj hlob los ntawm cov tsos mob hauv qab no:
- qaug zog tab sis los ntshav tas li;
- sudden tenderness ntawm cov ntaub so ntswg ze ntawm tus hniav;
- hloov kho mob stroke of the dental instrument.
Ib qho qub perforation nrog o thiab liab ntawm cov ntaub mos mos, tsis muaj zog thiab mob taub hau.
Kev kho mob ntawm cov hniav hauv paus hniav nyob ntawm qhov loj ntawm lub qhov, daim duab kho mob thiab qhov chaw ntawm qhov tsis xws luag. Nws tuaj yeem yog kev saib xyuas lossis phais. Cov ntsiab lus ntxiv txog txhua txoj hauv kev yuav piav qhia hauv qab no.
Kev Tiv Thaiv Kev Tiv Thaiv
Yog tias kuaj pom tus hniav perforation, kho tam sim ntawd. Ua ntej, tus kws kho mob yuav tsum tso tseg cov ntshav, tom qab ntawd tua cov kab noj hniav. Tom qab ntawd, nws yog qhuav nrog daim ntawv pins. Qhov tsis xws luag yog kaw nrog cov khoom siv cement tshwj xeeb. Cov kev cai loj heev raug siv rau lawv: raugbiocompatibility nrog cov ntaub so ntswg thiab muaj peev xwm harden txawm nyob rau hauv high humidity tej yam kev mob.
Tus neeg mob yuav tsum tau muab tshuaj tua kab mob thiab tshuaj tua kab mob rau tag nrho lub sijhawm rov zoo. Cov tshuaj tua kab mob raug xaiv nrog ntau qhov kev ua haujlwm thiab zoo heev permeability rau cov pob txha. Thaum mus ntsib tom ntej, cov hauv paus kwj dej raug kaw, thiab cov yas rov qab los. Tom qab qhov kawg ntawm kev kho mob, tus neeg mob tau nyob rau hauv kev saib xyuas ntawm kws kho hniav txog rau lub hlis.
Kev tshem tawm tus kheej lossis kev kho mob perforation nrog kev pab ntawm cov tshuaj ib txwm txwv nruj heev. Cov txheej txheem zoo li no tsis muaj txiaj ntsig thiab tsuas tuaj yeem ua rau cov txheej txheem pathological ua rau hnyav dua.
kev kho mob phais
Kho cov hauv paus perforation nrog cov teeb meem loj yuav cuam tshuam nrog kev phais (resection ntawm lub hauv paus apex, reimplantation ntawm cov hniav). Replantation feem ntau yog to taub raws li ib tug complex txheej txheem. Ua ntej, tus kws kho hniav tshem tawm cov hniav uas puas lawm, tom qab ntawd rov ua dua hauv chav kuaj, thiab tsuas yog tom qab ntawd muab tso rau hauv nws qhov chaw. Tom qab implantation, nws muaj kev tiv thaiv nrog ib tug tshwj xeeb splint.
Yog tias tsis muaj qhov mob hauv cov ntaub so ntswg, tab sis qhov loj ntawm qhov tawg yog los ntawm 2 hli, tus kws kho mob yuav pom zoo kom tshem tawm chav tsev.
Qhia rau cov hniav rho tawm
Tus kws kho hniav tsis tas yuav muaj lub sijhawm los tiv thaiv qhov teeb meem. Tshwj xeeb tshaj yog thaum nws los txog rau qub perforation. Nyob rau hauv cov ntaub ntawv no, resection ntawm chav kho hniav yog pom zoo.
Thaum tus hniav yog perforated, rho tawm yog qhia hauv qab nocase:
- kev puas tsuaj tseem ceeb hauv paus;
- mob mob plab qib 3-4;
- tshwm sim ntawm purulent o;
- tsis muaj peev xwm tshem tawm qhov tsis xws luag vim yog cov yam ntxwv ntawm tus hniav.
Tom qab tshem tawm, tus neeg mob tau muab tshuaj tua kab mob thiab tshuaj tiv thaiv kab mob. Rov qab saib xyuas dua 6 lub hlis tom ntej.
Kev ntsuas kom rov zoo
Yog tias koj nrhiav kev pab los ntawm kws kho hniav kom raws sijhawm lossis kuaj pom muaj teeb meem tam sim ntawd thaum kho, qhov kev cia siab rau kev rov zoo yog qhov zoo. Txawm li cas los xij, nws feem ntau txiav txim siab los ntawm localization ntawm qhov txhab. Piv txwv li, thaum cov phab ntsa lossis cov hauv paus hniav raug perforated, cov hniav tsis tshua muaj kev cawmdim. Yog hais tias tus kws kho mob tswj kom tsis txhob resection ntawm chav tsev, nws yuav tsis muaj peev xwm ua tau tag nrho cov dej num. Tom qab ntawd, cov txheej txheem inflammatory yuav tshwm sim ntawm qhov chaw no. Tsis tas li ntawd, cov hniav hauv paus tsis tuaj yeem siv los ua ib qho abutment nyob rau hauv rooj plaub ntawm pins.
Muaj Teeb Meem
Ib qho teeb meem feem ntau ntawm perforation ntawm cov hniav kab noj hniav yog tsim ntawm granulomas, cysts. Cov chav kawm asymptomatic ntawm pathology yog suav tias yog qhov txaus ntshai tshwj xeeb. Qhov mob me tsis yog vim li cas thiaj mus ntsib kws kho mob. Ntau tus neeg mob qhia qhov tsis xis nyob rau qhov cuam tshuam ntawm kev kho mob. Nyob rau tib lub sijhawm, cov txheej txheem pathological hauv cov ntaub so ntswg sab hauv yog nquag tsim. Lawv ua rau cov teeb meem hauv qab no:
- Granuloma. Pob txha kab mob ua rautsim ntawm purulent vesicles. Qhov no yog granuloma. Yog tias tus kab mob no tsis nres, nws tuaj yeem kis mus rau cov ntaub so ntswg nyob ze.
- Cyst. Sab laug tsis kho, granuloma ua rau cyst tsim. Qhov teeb meem no ua rau muaj kev sib kis ntawm cov txheej txheem inflammatory sab nraum lub qhov ncauj kab noj hniav thiab puas rau lwm yam kabmob. Lub cyst feem ntau ua rau cov hniav poob.
- Root tawg tawm. Nrog rau qhov muaj zog perforation hauv qab ntawm cov hniav kab noj hniav, nws tuaj yeem yooj yim tawg. Qhov teeb meem no tuaj yeem raug cais lossis lees paub los ntawm kev kuaj X-ray. Nws yeej ib txwm nrog cov teeb meem articulation thiab txawm lub puab tsaig misalignment.
- Fragments ntawm cag hauv cov pos hniav. Tom qab tshem tawm cov hniav, nws cov khoom yuav nyob twj ywm hauv cov ntaub so ntswg, uas tus kws kho hniav tsis pom. Maj mam, lawv mus tob rau hauv cov pos hniav thiab overgrow. Rau ib ntev lub sij hawm, lub pathology tsis manifest nws tus kheej. Txawm li cas los xij, tsis ntev los sis tom qab, cov pos hniav pib mob, o thiab mob tshwm sim. Extraction ntawm cov hauv paus tawg yuav tsum tau phais loj nyob rau hauv cov tshuaj loog.
Txoj Kev Tiv Thaiv
Kev mob feem ntau tshwm sim vim kev kho mob yuam kev. Yog li ntawd, tus kws kho hniav yuav tsum tau ceev faj hauv qab no:
- Ua ntej pib kho, nws yuav tsum tau kuaj X-ray ntawm tus hniav txhawm rau txheeb xyuas qhov curvature ntawm cov kwj dej thiab lwm yam anatomical nta.
- Xaiv cov cuab yeej kho hniav raws li qhov loj me, cov duab thiab nkhaus ntawm cov hauv paus hniav.
- Nws yog ib qho tseem ceeb los tsimpom kev zoo ntawm thaj chaw ua haujlwm.
- Nyob hauv kev ua haujlwm, koj yuav tsum tswj lub zog ntawm nias, txav ntawm lub cuab yeej.
- Thaum muaj qhov xav tias muaj kev cuam tshuam, nws yog ib qho tseem ceeb kom tsis txhob ua haujlwm lossis txo qhov siab ntawm thaj chaw.
Ntawm qhov tod tes, txhua tus neeg mob yuav tsum ua raws li qee txoj cai ntawm kev tiv thaiv. Piv txwv li, yog tias koj muaj mob lossis tsis xis nyob thaum zom, koj yuav tsum hu rau koj tus kws kho hniav tam sim ntawd. Tom qab kev kuaj mob thiab, yog tias tsim nyog, nws yuav tsum tau kho. Txhawm rau saib xyuas lub qhov ncauj kab noj hniav, koj yuav tsum siv cov khoom pov thawj thiab nyab xeeb nkaus xwb. Ntawm qhov teeb meem no, koj tuaj yeem sab laj nrog kws kho hniav. Nws raug pom zoo kom ua kom huv huv thiab lwm yam kev tu cev.
Perforation tuaj yeem ua rau kis kab mob ntawm qhov ncauj thiab lwm yam kabmob. Yog li ntawd, yuav tsum tau mus ntsib kws kho hniav txhua xyoo, thiab yog tias pom muaj teeb meem, nws yuav tsum tau muab tshem tawm tam sim ntawd.
