Periodontitis muaj ob hom kab mob ntawm cov kab mob thiab ob peb hom sib txawv ntawm lawv qhov tshwm sim thiab qhov tshwm sim. Nws yog ib qho tseem ceeb uas yuav tau kuaj xyuas nws raws sij hawm thiab raug, vim tias cov tsos mob zoo ib yam li lwm yam kab mob ntawm cov hniav, thiab qhov tshwm sim ntawm kev kho tsis raug tuaj yeem ua rau cov hniav poob.
Txoj kev mob
Cov ntaub so ntswg sib txuas ntawm cov hniav thiab cov alveolus hu ua periodontium. Periodontitis yog dab tsi? Qhov no yog ib qho mob ntawm cov ntaub so ntswg, uas muaj cov lymphatic, cov hlab ntsha, cov hlab ntsha. Periodontium muaj kev poob siab-absorbing - thaum zom zaub mov, nws txo qhov hnyav ntawm cov hniav, sib npaug faib rau cov pob txha. Periodontitis tshwm sim nyob rau hauv ob hom - mob thiab ntev. Mob hnyav yog qhov tshwm sim tsis tshua muaj, vim qhov mob feem ntau qeeb, kav ntev thiab tsis pom cov tsos mob ntev.
Ua rau kab mob
Qhov laj thawj tseem ceeb ntawm periodontitis yog kab mob hauv lub cev. Txoj kev ntawm nws txoj kev nkag mus yuav txawv, thiab raws li qhov no, tus kab mob tau muab faib ua hom:
- intradental(intradental), yog qhov tshwm sim ntawm qhov teeb meem ntawm pulpitis (mob ntawm cov ntaub so ntswg sab hauv);
- extradental (extrinsic), txhim kho vim kev hloov pauv ntawm tus kab mob mus rau lub sijhawm los ntawm cov ntaub so ntswg ib puag ncig nrog sinusitis, osteomyelitis.
Qhov ua rau mob plab tsis tuaj yeem yog vim kis kab mob. Kev txhim kho ntawm qhov mob qee zaum pib vim raug mob lossis raug tshuaj. Hauv qhov no, muaj ob hom kab mob ntxiv. Cov tshuaj yog tshwm sim los ntawm kev kho tsis zoo ntawm pulpitis, ingress ntawm irritating Cheebtsam mus rau lub periodontium. Dab tsi yog traumatic periodontitis yog qhov tseeb ntawm lub npe: nws tshwm sim vim kev puas tsuaj rau cov ntaub so ntswg ntawm cov hniav.
Cov tsos mob hnyav
Kev tshwm sim ntawm mob plab hnyuv:
- mob hniav thiab thaj chaw ncig nws;
- mob thaum kov tus hniav;
- hniav mob;
- qhov tshwm sim ntawm fistula - lub qhov ntawm cov pos hniav los ntawm cov kua paug ntws.
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Thawj theem ntawm tus kab mob yog qhov mob npub thiab nws qhov hnyav thaum nias ntawm tus hniav. Nrog rau kev txhim kho ntxiv ntawm kev mob thiab kev hloov mus rau ib daim ntawv purulent, cov kev xav ua kom ntse thiab ntev dua. Cov hniav puas tuaj yeem txav tau thaum nias nrog tus ntiv tes, ib qho flux tshwm ntawm cov pos hniav. Cov xwm txheej ntawm lub cev hnyav zuj zus, tus neeg mob qaug zog, tsis muaj zog, pw tsaug zog, kub taub hau tuaj yeem tshwm sim.
Kev tshwm sim ntevshapes
Tus mob periodontitis yog dab tsi ntawm cov tsos mob? Tus kab mob manifests nws tus kheej li cov tsos mob me me: ib qho kev xav ntawm hnyav thiab tag nrho, tsis xis nyob, tsis muaj zog qhov chaw ntawm cov hniav cuam tshuam thaum zom. Qee zaum daim ntawv ntawm periodontitis no tsuas yog kuaj pom tom qab x-ray. Daim ntawv mob ntev feem ntau ua rau cov hniav poob, vim nws qhov tshwm sim yuav luag tsis mob thiab feem ntau cov neeg tsis xav tias nws yuav tsum tau mus ntsib kws kho mob. Qhov tshwm sim ntawm kev tsis saib xyuas zoo li no tuaj yeem yog lub hauv paus cyst, uas yuav tsum tau muab cov hniav rho tawm. Cov kab mob ntev ntev tuaj yeem tshwm sim nrog cov teeb meem uas tshwm sim zoo ib yam li daim ntawv mob.
Type of periodontitis
Tus kab mob mob ntev, nyob ntawm qhov mob ntawm qhov mob, muab faib ua peb hom:
- Fibrous. Daim ntawv tsis zoo tshaj plaws, txhim kho vim muaj kev cuam tshuam ntev ntawm kev kis kab mob ntawm lub periodontium. Thaum tsis kho, nws kis mus rau lwm yam.
- Granulating. Nws yog tus cwj pwm los ntawm kev hloov pauv hauv cov qauv ntawm lub sijhawm ntev, kev loj hlob ntawm cov ntaub so ntswg granulation.
- Granulomatous. Granuloma tsim.
Yog tsis muaj kev kho mob rau cov kab mob periodontitis, tus kab mob maj mam zuj zus los ntawm ib daim ntawv me me mus rau ib qho nyuaj.
Kab mob ntev ntev tuaj yeem ua rau mob. Nws manifests nws tus kheej nrog ib tug tas li load ntawm cov hniav, nrog tsis zoo-zoo filling los yog nyob rau hauv kev twb kev txuas nrog lub peculiarity ntawm cov qauv. Feem ntau hom kab mob no hloov mus ua periodontitis, thaum qhov mob mus rau cov pos hniav thiab pob txha.
Raws li localization, marginal thiab apical hom periodontitis yog qhov txawv. Thawj yog txuam nrog kev puas tsuaj rau hauv paus daim nyias nyias thiab tob zuj zus ntawm o, qhov thib ob cuam tshuam rau ligaments uas tuav cov hniav hauv alveolus. Ib hom kab mob uas tsis tshua muaj tshwm sim yog retrograde, thaum tus kab mob nkag mus rau hauv cov lymphatic thiab cov hlab ntsha.
Types of acute periodontitis
Mob plab kab mob tshwm sim sai. Tsis pub dhau ob hnub, thawj daim ntawv ntawm tus kab mob ua purulent. Muaj plaub theem ntawm mob periodontitis:
- Periodontal. Purulent o tsis mus dhau qhov sib txawv ntawm lub cev.
- Endoosseous. Cov pob txha raug cuam tshuam.
- Subperiosteal. Cov kab mob loj hlob, mus rau hauv lub periosteum.
- Submucous. Pus nkag mus rau hauv cov ntaub so ntswg.
Diagnosis
Tus kab mob no tau kuaj pom los ntawm kev kho mob tshwm sim: mob, o. Hauv kev kuaj mob, tus kws kho mob tuaj yeem kuaj pom qhov o ntawm cov pos hniav, liab, xoob ntawm cov hniav, tsim ntawm qhov txhab nrog cov kua qaub. Qhov tseem ceeb ntawm kev txiav txim siab hauv kev kuaj mob yog kev kuaj x-ray. Daim duab qhia tau hais tias muaj zog tsaus nti nyob rau sab sauv ntawm cov hauv paus hniav - ib lub hnab purulent. Yog tias tus neeg mob xav tias muaj kab mob periodontitis, daim duab yuav raug txiav txim siab qhov kev kuaj mob thiab theem ntawm tus kab mob.
Differential Diagnosis
Thaum kuaj mob, nws tuaj yeem nyuaj rau kev paub qhov txawv ntawm ib tus kab mob los ntawm lwm tus, vim muaj ntau yam kab mob hauv kev kho hniav uas muaj cov tsos mob zoo ib yam. Kev kuaj mob sib txawv ntawm periodontitis yog los txiav txim seb hom kab mob twg thiab qhov txawv ntawm lwm tus. Yog li, pulpitis yog ib yam kab mob zoo sib xws, tab sis nws cuam tshuam rau cov nqaij mos - cov nqaij mos, thiab thaum nws raug rhuav tshem vim tsis muaj kev kho mob thiab kev loj hlob ntawm o, tus kab mob nkag mus ntxiv, ua rau muaj kab mob. Yuav kom kho cov kab mob periodontitis kom muaj txiaj ntsig, nws cov duab thiab hom yuav tsum raug txiav txim kom raug.
fibrous periodontitis
Cov txheej txheem inflammatory mus sij hawm ntev, nrog rau kev hloov pauv hauv kev tso tawm thiab exacerbations, muab lub hauv paus rau kev kuaj mob fibrous periodontitis. Feem ntau nws tsis tshwm sim nws tus kheej rau lub sijhawm ntev. Nws yog ib qho nyuaj rau kev kuaj mob, vim hais tias txawm tias cov tsos mob tshwm sim, lawv tuaj yeem yooj yim ntaus nqi rau lwm yam kab mob hniav. Cov cim qhia tau tshaj plaws ntawm fibrous periodontitis yog darkening ntawm cov hniav, mob thaum soj ntsuam cov kwj dej thiab nws tsis tuaj thaum raug kub thiab palpation. Qhov ua rau tus kab mob yog kis kab mob ntawm cov ntaub so ntswg ntawm cov hniav los ntawm microorganisms. Feem ntau mob periodontitis hloov mus ua mob fibrous nrog kev kho tsis raug lossis nws tsis tuaj. Tom qab ntawd tus neeg ntawd hnov mob thiab fading ntawm cov tsos mob, tab sis qhov no tsuas yog kev dag ntxias, vim hais tias cov txheej txheem inflammatory txuas ntxiv mus rau hauv daim ntawv hnyav dua. Tsis tas li ntawd, qhov ua rau tej zaum yuav tsis saib xyuas caries, mechanical trauma.
Kev kho raws li tus qauv no:
- mob nyem (yog tias tsis muaj kev tuag ntawm daim tawv nqaij);
- ntxuav qhov chaw ntawm cov hniav los ntawm cov quav hniav;
- tshem tawm cov ntaub so ntswg cuam tshuam uas hloov xim;
- kev tshem tawm;
- nthuav tawm hauv paus kwj dej, ntxuav nws nrog tshuaj tua kab mob;
- kwj filling.
Cov txheej txheem ntawm kev kho hauv paus kwj dej rau cov kab mob kab mob kuj tseem tuaj yeem siv txoj hauv kev tshiab, xws li diathermocoagulation (cauterization thiab sterilization siv cov zaus tam sim no) thiab ultrasound.
Granulating periodontitis
Dab tsi yog granulating periodontitis? Qhov no yog qhov kev loj hlob ntawm cov ntaub so ntswg granulation nyob rau sab sauv ntawm cov hniav hauv paus hniav, nrog rau kev puas tsuaj ntawm pob txha cov ntaub so ntswg thiab periosteum. Nws tshwm sim vim muaj kab mob, feem ntau muaj teeb meem ntawm caries, mob periodontitis, pulpitis. Nws kuj tuaj yeem yog qhov tshwm sim ntawm kev raug mob: pob txha, pob txha, cov hniav tawg, qhov chaw tsis raug cai, raug rau cov kab mob hauv paus kwj dej, malocclusion. Nrog granulating periodontitis, mob tshwm sim thaum zom, tapping, kub hloov, thiab kuj tsis muaj kev ua haujlwm.
Muaj cov hniav txav, purulent tawm, uas ua rau ua pa phem, liab ntawm cov pos hniav. Ib qho exacerbation tuaj yeem ua rau abscesses, tsim cov granulomas, cov kab mob nkag mus rau hauv cov ntshav, uas ua rau muaj kev fab tshuaj thiab ntau yam kab mob ntawm lub cev. Kev kho mob suav nrog hauv paus kwj dej ntxuav, huv si, sau ib ntus thiab cov kws tshaj lij tswj kev ua haujlwm ntawm cov txheej txheem inflammatory. Yog tias qhov kev loj hlob ntawm tus kab mob raug tso tseg,gutta-percha pins mus tas li raug teeb tsa thiab lub kaus mom ntawm cov hniav rov qab los. Nyob rau hauv rooj plaub thaum tus kws kho hniav tsis pom cov kev kho mob zoo, ib tug yuav tsum tau mus rau qhov tsawg kawg yog tshem tawm.
YGranulomatous periodontitis
hom kab mob no yog tus cwj pwm los ntawm kev hloov pauv ntawm cov ntaub so ntswg thiab kev loj hlob ntawm ib qho tshiab - granuloma. Nyob rau hauv thawj theem, lub foob yog tsim, uas, nyob rau hauv tus txheej txheem ntawm kev loj hlob ntawm o, yog sau nrog microbes, lub cev tsis muaj zog, fibrous thiab granuloma hlwb. Thaum kawg, yog tias tsis kho, tus kab mob ua rau lub cyst uas rhuav tshem cov pob txha.
Cov kab mob granulomatous periodontitis tshwm sim rau tib yam li lwm yam - kab mob vim muaj teeb meem ntawm caries lossis pulpitis, kev kho mob tsis zoo. Manifested los ntawm tsis xis nyob thaum noj mov, darkening ntawm coronal ib feem. Pom tau los ntawm x-ray. Qhov exacerbation yog qhov mob hnyav, o ntawm cov pos hniav, thiab cov qog nqaij hlav o.
Yog tias tsis kho, cyst tsim, cov hniav yuav tsum tau muab tshem tawm. Kev kho mob tuaj yeem ua tau los ntawm txoj kev kho mob, uas suav nrog kev nthuav dav ntawm cov channel, nws cov kev huv huv, kev qhia txog tshuaj los rhuav tshem granuloma thiab rov tsim cov ntaub so ntswg. Txoj kev phais yog txiav cov pos hniav thiab tshem tawm ib feem ntawm cov hauv paus hniav nrog granuloma. Tom qab sau thiab suturing yog nqa tawm.
Non- kis kab mob periodontitis
Taumatic periodontitis tshwm sim nyob rau hauv ob hom - mob thiab ntev. Thawj tshwm sim yog tias qhov mob yog txuam nrog kev raug mob vim kev cuam tshuam. Muaj tshwm sim thaum tus hniav hloov chawnws kev txav mus los, rupture ntawm cov ntaub so ntswg mos thiab, vim li ntawd, kev hloov pauv ntawm cov xim ntawm lub crown, tawg ntawm cov hauv paus hniav. Qhov thib ob yog txuam nrog ib qho kev cuam tshuam tsis tu ncua ntawm cov hniav thiab kev thauj khoom loj, ua rau raug mob (piv txwv li, vim qhov txawv txav los yog tsis zoo filling). Traumatic periodontitis txoj kev kho mob feem ntau cuam tshuam nrog kev tshem tawm cov hniav puas.
Medicated periodontitis tshwm sim nyob rau hauv tus ntawm cov tshuaj uas yog siv nyob rau hauv filling thiab lwm yam kev kho mob. Hom kab mob no kuj yog tshwm sim los ntawm kev ua xua rau tshuaj.
Rehab
Tom qab kev kho mob ntawm cov kab mob hauv lub cev, qhov tsis xis nyob thiab qhov kev xav ntawm lub siab tuaj yeem tshwm sim, uas cuam tshuam nrog lub cev siv rau cov khoom ntim. Feem ntau cov kev tshwm sim no ploj mus ob peb hnub, tab sis yog tias qhov no tsis tshwm sim, koj yuav tsum mus ntsib kws kho hniav. Tsis pub dhau ob mus rau peb teev tom qab ua haujlwm, koj yuav tsum tso tseg kev noj haus thiab haus dej haus, thiab yav tom ntej, xyuas kom cov hniav cuam tshuam - tsis txhob zom rau ntawm nws sab. Koj yuav tsum ceev faj thaum txhuam hniav, tsis txhob haus luam yeeb thiab haus cawv, vim tias cov tshuaj no tuaj yeem ua rau los ntshav.
Rau lub hlis tom qab kev kho mob, koj yuav tsum tau mus ntsib kws kho mob thiab rov ua x-ray los saib xyuas cov pob txha rov qab. Kev ua haujlwm tau zoo nres qhov mob, txhawb kev tsim cov ntaub so ntswg, tsis ua rau muaj teeb meem thiab rov qab los ntawm tus kab mob, dhau sijhawmkev zom zaub mov ntawm cov hniav yog rov ua kom tiav. Yog hais tias, tom qab kev kho mob, qhov mob tsis ploj mus, tab sis tsuas yog intensifies, o ntawm cov pos hniav tshwm sim, qhov kub thiab txias nce, ces kev kho mob yog nqa tawm tsis zoo thiab tsis muab qhov xav tau. Hauv qhov no, nws yuav tsum tau mus ntsib kws kho mob kom rov kho dua.
