Nyob rau hauv tsab xov xwm, peb yuav txiav txim siab seb lub luag hauj lwm devitalizing paste plays nyob rau hauv lub ntiaj teb no ntawm kev kho hniav.
Devitalization yog kev tua cov tub ntxhais nyob (pulp) ntawm cov hniav nrog nws tom qab tshem tawm. Qhov no inevitably ua rau kev tuag thiab kev puas tsuaj ntawm cov hniav, txij li thaum lub pulp tuag entails kev tuag ntawm cov hlab ntsha me tshaj plaws thiab cov hlab ntsha nyob rau hauv cov hniav kab noj hniav, uas muaj peev xwm teb rau cov kev hloov pauv.
Txawm li cas los xij, yog tias txhua yam tshwm sim li no hauv cov tsiaj qus, ces nyob rau hauv lub ntiaj teb niaj hnub no, qhov chaw uas cov hniav tig mus rau hauv cov khoom siv, kev siv cov txheej txheem kho hniav tshiab tso cai tsis tsuas yog ua kom cov hniav zoo xwb, tab sis kuj muab cov khoom siv kho hniav. xav duab. Thiab, txawm hais tias tsis muaj lub neej nyob rau hauv ib tug hniav uas tsis muaj ib tug pulp, nws lub cev muaj sia nyob mus ntxiv, tab sis tsuas yog nyob rau hauv cov xwm txheej ntawm kev saib xyuas thiab kev kho mob tas li, txawm tias qhov kev hloov tsis tseem ceeb tshaj plaws tshwm sim hauv nws.
Yog li, qhov downside ntawm cov txheej txheem tshem tawm cov ntaub so ntswg yog tias cov hniav sab laug tsis muaj kev saib xyuas yog qhov kev zam tsis tauyuav vau, thiab qhov zoo dua yog cov hniav tseem nyob hauv qhov chaw, khaws cia ob qho tib si rau zom thiab ua kom pom kev zoo nkauj.
Kev tawm dag zog
Cov lus qhia rau kev siv devitalization (depulpation) ntawm cov hniav yog cov xwm txheej thaum qhov kev tshem tawm ntawm cov tawv nqaij yog qhov tsim nyog, vim nws tsis tuaj yeem txuag nws vim qhov pib ntawm cov txheej txheem o. Cov no yog cov teeb meem ntawm kev loj hlob ntawm tus mob pulpitis, provoked los ntawm kev nkag mus ntawm tus kab mob los ntawm thinned hauv qab ntawm carious kab noj hniav, los ntawm lub qhov ncauj apical los yog los ntawm lub system ntawm microcracks nyob rau hauv mob los yog mob ntev.
Thaum twg qhov txheej txheem no xav tau?
Tsis tas li, cov txheej txheem tau ua thaum qhib lub tshuab nqus tsev nrog cov khoom siv kho hniav puas tsuaj los yog vim kev kho hniav tsis txaus. Tsis tas li ntawd, kev phais yuav tsum tau ua yog tias tsim nyog los npaj cov hniav rau prosthetics, thaum qhov tshwm sim ntawm o nyob rau hauv cov qauv tsim yuav tsum raug cais tag nrho.
Ntau yam pastes
Lub arsenal ntawm kev kho hniav devitalization khoom suav nrog:
- depulping pastes uas muaj arsenic tebchaw, nrog rau kev siv tshuaj lom neeg tsis muaj arsenic, tsim los ntawm formaldehyde;
- siv cov txheej txheem electrochemical pulp necrosis.
Txawm hais tias muaj kev cuam tshuam cov tshuaj lom ntawm arsenic, qhov xav tau kev noj tshuaj kom raug thiab ua raws li cov ntsiab lus ntawm kev nyob hauv cov kab noj hniav ntawm cov tshuaj uas muaj nws,nws siv rau pulp devitalization yog qhov tsim nyog thiab tsim nyog los ntawm ntau qhov kev sib cav. Arsenic-raws li devitalizing pastes tua cov tawv nqaij kom ntseeg tau, tsis mob thiab sai.
Tsev yam ntxwv ntawm kev thov muab tshuaj txhuam
Kev ua haujlwm rau devitalize cov kab noj hniav muaj nyob rau hauv kev siv cov tshuaj txhuam hniav uas muaj arsenic rau lub pob qhib ntawm cov tawv nqaij, sau rau ntawm qhov kawg ntawm kev sojntsuam. Qhov ntim no yog kwv yees li 40 npaug me dua li tus pinhead, raws li qhov ntau tshaj ib koob ntawm 3mg thiab qhov siab tshaj plaws txhua hnub ntawm 10mg.
Tom qab daim ntawv thov, cov tshuaj txhuam hniav yog npog (tsis siv lub siab) nrog ib daim paj rwb soaked hauv tshuaj loog. Cov hniav kab noj hniav yog them nrog ib tug xoob hnav khaub ncaws ua los ntawm cov dej dentine, uas muaj ib tug ib ntus lub hom phiaj, tab sis xyuas kom meej meej nruj ntawm cov hniav kab noj hniav. Muab qhov luaj li cas ntawm lub pulp chamber (nyob ntawm seb tus naj npawb ntawm cov hauv paus hniav), cov muaj pes tsawg leeg raug tshem tawm ntawm kab noj hniav tom qab 36 los yog 24 teev, tab sis yog hais tias muaj tshuaj periodontitis tshwm sim, cov txheej txheem yog ua tam sim ntawd.
Yuav ua rau mob mob
Tus neeg mob tau ceeb toom ua ntej txog qhov yuav tshwm sim rau lub sijhawm luv (hauv 2 teev) qhov mob tshwm sim, thiab tau muab los txo lawv nrog Amidopyrine lossis bromine npaj.
Ntxiv rau qhov kev mob tshwm sim sai sai, kev siv cov tshuaj pastes nrog cov tshuaj arsenous acid cuam tshuam ua rau mob hnyav heev thaum ntxuav tawm lossis cov kab noj hniav tsis nruj txaus, mus txog rau necrosis.(osteomyelitis). Lwm qhov laj thawj ntawm kev siv arsenic pastes yog qhov pom ntawm cov kab mob toxic persistantitis, uas feem ntau pom nrog ntev thiab ntau dhau ntawm arsenic.
Yog li, txhawm rau zam kev puas tsuaj rau lub sijhawm nrog kev txhim kho ntawm necrosis foci thaum siv arsenic, thaum xam cov tshuaj thiab lub sijhawm raug, tus kws kho hniav yuav tsum xav txog yam xws li tus neeg mob lub hnub nyoog thiab cov hniav hnyav.
Ntau tus neeg xav tsis thoob yog dab tsi yog qhov cuam tshuam ntawm devitalizing muab tshuaj. Cov kev tshawb fawb tshawb fawb tau pom tias kev siv cov tshuaj txaus txaus ntawm arsenous acid, vim nws qhov kev sib kis mus rau hauv qhov chaw periapical, provokes tsis yog tsuas yog kev puas tsuaj ntawm cov ntaub so ntswg, tab sis kuj ua rau stimulation ntawm nws cov stump, thiab tseem ua rau rov tsim dua cov ntaub so ntswg..
Puas yog cov tshuaj no siv rau menyuam yaus?
Vim cov yam ntxwv ntawm cov menyuam yaus cov hniav uas tsis tsim thiab nqus tau cov hauv paus hniav, nrog rau cov menyuam tsis muaj peev xwm los ntsuas qhov kev xav uas tshwm sim, kev siv devitalizing pastes hauv kev kho hniav menyuam yaus yog contraindicated, phenol-muaj kev npaj siv ntawm no, uas muab qhov tsis mob thaum lub sij hawm pulectomy.
Cov nyiaj no
Arsenic acid (As2O3) yog tam sim no nyob rau hauv arsenic-based devitalizing pastes. arsenic-dawb pastes uas yog siv rau pulp devitalization muaj phenol, formaldehyde (formalin) thiab ua ke ntawm lawv cov derivatives. Hauv cov tshuaj tsis muaj arsenic, formalin hmoov yog tov nrog creosote, glycerin lossis roj av jelly. Lawv qhov cuam tshuam me ntsis tsis muaj zog thiab tsis tshua muaj kev ntseeg siab dua li cov pastes uas muaj arsenic, thiab nrog lub sijhawm tsis txaus, tsis yog necrosis ntawm cov ntaub so ntswg, tsuas yog nws cov mummification (sclerosis) tuaj yeem ua tiav. Txawm li cas los xij, lub hom phiaj ntawm qhov kev ua haujlwm zoo li no tsuas yog ib qho txiaj ntsig: nrog rau cov txheej txheem amputation, nyob rau hauv cov ntaub ntawv ntawm kev kho hniav nyob rau hauv cov me nyuam, cov ntaub so ntswg sclerotic, uas tshuav nyob rau hauv lub microtubules, yog aseptic thiab yuav tsis ua rau ib tug inflammatory txheej txheem..
Cov khoom noj khoom haus zoo li no suav nrog Paraform, Paraformaldehyde, Trioxymethylene, Formalin, Asphaline thiab Triopasta. Peb qhov kev npaj kawg yog ua raws li formalin, txawm li cas los xij, kev siv tom kawg yog qhov zoo dua rau kev sau cov txiaj ntsig ntawm cov txheej txheem kho hniav, vim tias thaum lub sij hawm kho nrog cov txheej txheem amputation, cov pob txha pob txha tiv thaiv kev sib kis ntawm formaldehyde mus rau hauv qhov chaw periapical.
Kev siv, piv txwv li, asph alt paste feem ntau ua rau kev txhim kho ntawm cov kab mob reactive periodontitis. Thaum lub sij hawm daim ntawv thov ntawm ib tug muab tshuaj txhuam uas muaj paraformaldehyde, lidocaine thiab phenol, nws cov nyhuv kav li ntawm 5 mus rau 8 hnub, tab sis nws muaj ib tug me me nyhuv, tsis muaj irritation thiab cuam tshuam ntawm periodontal qauv. Tsis muaj cov yam ntxwv tshwj xeeb thaum thov cov tshuaj paraformaldehyde - lawv zoo ib yam li cov arsenic.
Ntau lub tuam txhab tsim tawm ob qho tib si tsis muaj arsenic-dawb devitalizing pastes, thiab nrog arsenic nyob rau hauv muaj pes tsawg leeg, uas tso cai rau tsis tau tsuas yog ua kom tiav cov nyhuv, tab sis kujnpaj mus ntsib kws kho hniav rau tus neeg mob. Piv txwv li, kev siv Devit-A muab tshuaj txhuam, uas muaj cov nyhuv tshuaj loog, pab txo qhov mob hnyav thaum kho mob plab, Devit-P pab kom ua tiav mummification ntawm cov kua mis ntawm cov hniav thiab tiv thaiv nws cov extirpation, thiab Devit. -S pab siv txoj hauv kev ntawm kev tuag amputation lossis exirpation hauv kev kho cov tsos mob ntawm cov hauv paus pulpitis, ob qho tib si hauv cov hniav ib ntus thiab cov hniav mus tas li.
Devit Devitalizing muab tshuaj txhuam
Raws li tau sau tseg saum toj no, hom tshuaj pleev no yog peb hom thiab siv ntau yam kev kho hniav ntawm kev kho hniav. Nws yog siv rau cov nqaij mos devitalization nyob rau hauv kev kho mob ntawm pulpitis thaum lub sij hawm tuag amputation los yog extirpation, rau kev kho mob ntawm residual pulpitis, thiab kuj yog siv los ua tus neeg sawv cev ntxiv rau devitalization thaum rov ua cov txheej txheem tom qab siv devitalizing pastes uas muaj arsenic.
Dab tsi yog Arsenic Free Paste muaj?
No arsenic-dawb muab tshuaj txhuam muaj:
- paraformaldehyde, uas yog ib qho tshuaj tua kab mob uas coagulates albumins thiab muab cov pulp devitalization;
- Fibrous muab tub lim;
- paste qub;
- lidocaine hydrochloride, tshuaj loog uas txo qhov kev pheej hmoo ntawm cov tsos mob mob.
Kev siv Devit pastes muab lub sijhawm ntev ntawm cov pulp devitalization tsis muaj khaus thiab mob, tshem tawm qhov xav tau rov kho cov kwj dej hauvthiaj li yuav neutralize arsenic ntsev, zoo li thaum siv arsenic pastes. Pulp devitalization tshwm sim hauv 3-5 hnub, qee zaum hauv 7 hnub. Yog tias tus neeg mob tsis hnov mob, kev sib khi tuaj yeem ua tiav 48 teev tom qab siv cov tshuaj devitalizing no. Qhov ua tau zoo ntawm cov tshuaj no tam sim no yog qhov siab tshaj plaws, tshwj xeeb tshaj yog thaum piv nrog cov tshuaj arsenic-based pastes.
Kev tshuaj xyuas txog cov pastes no
Muaj qee qhov kev tshuaj xyuas ntawm devitalizing pastes ntawm cov vev xaib kho mob, thiab lawv tau tso tseg los ntawm cov kws kho hniav tshwj xeeb uas siv cov tshuaj no hauv kev kho mob txhua hnub. Cov kws kho hniav hais tias arsenic pastes muaj kev ntseeg siab dua, tab sis lawv muaj kev phom sij heev rau kev noj qab haus huv thiab tsis siv rau kev kho cov menyuam cov hniav. Kev npaj tsis muaj arsenic xws li Devit yog cov neeg nyiam tshaj plaws, txawm tias lawv tsis muaj lub zog zoo li no. Txawm li cas los xij, raws li kws kho hniav, lawv ua haujlwm zoo heev nrog lawv txoj haujlwm tseem ceeb, thiab, ntxiv rau, lawv pab txo qhov mob, uas tseem ceeb heev hauv kev kho hniav. Txog niaj hnub no, lawv feem ntau siv hauv kev kho hniav.
