Kev mob ntawm cov hlab ntsha ntawm qhov chaw kho hniav, uas yog, lub pulp, hu ua pulpitis. Cov kab mob zoo sib xws tshwm sim vim kev puas tsuaj rau cov hniav ntawm cov hniav lossis kev kho mob yuam kev thaum lub sij hawm txhaws. Txawm li cas los xij, feem ntau ua rau pathology yog lub xeev tsis saib xyuas ntawm caries.
Dab tsi ntawm cov hlab ntsha zoo li yog qhov nthuav rau ntau tus. Txoj kev loj hlob ntawm pulpitis yog vim tus kab mob nkag mus rau hauv cov kab noj hniav (chamber). Cov kab mob phem (staphylococci, streptococci thiab lactobacilli) nyob hauv cov tawv nqaij, txav mus los ntawm kev ua kom pom tseeb ntawm caries.
Cov kab mob nkag mus los ntawm ntau txoj hauv kev: enamel tawg, dentinal tubules, thiab lwm yam.
Vim li cas lub pulp thiaj o?
Cov kab mob ntawm cov hlab ntsha ntawm cov hniav feem ntau tshwm sim los ntawm qhov nqaij tawv lossis pob txha ntawm cov hniav hniav, qhib qhov tsis raug ntawm cov hniav los ntawm tus kws kho hniav thaum kho. Nyob rau hauv rooj plaub no, traumatic pulpitis tshwm sim.
Lwm qhov ua rau pathology yog tus kab mob retrograde uas nkag mus rau hauv cov kwj dej hauv lub apicalqhov. Retrograde pulpitis, raws li txoj cai, tshwm sim tawm tsam keeb kwm ntawm otitis, periodontitis thiab lwm yam kab mob ntawm lub qhov ncauj kab noj hniav.
Ntau zaus, qhov mob ntawm qhov chaw kho hniav (pulpitis) tshwm sim vim kev kho mob yuam kev:
- tshuaj lom neeg cov tshuaj siv rau kev sau;
- siv cov tshuaj tua kab mob ntau dhau thaum kho cov kab noj hniav;
- Pulp overheating, piv txwv li, thaum lub sij hawm kev kho hniav rau ib tug prosthesis los yog photobleaching ntawm enamel.
YLub ntsiab lus thiab etiology ntawm pulpitis
Kev mob ntawm cov hlab ntsha hauv qhov chaw kho hniav, lossis pulpitis, tshwm nyob rau hauv kev cuam tshuam ntawm ntau yam stimuli: kub, tshuaj, txhua yam thiab kis tau.
- Kev kis mob. Nws tshwm sim thaum tus kab mob nkag mus rau hauv cov hlab hniav. Qhov no tuaj yeem tshwm sim rau ntau yam. Cov kab mob feem ntau nkag mus rau hauv cov tawv nqaij los ntawm dentin thinned los ntawm caries loj. Qhov no tuaj yeem zam tau yog tias koj mus ntsib tus kws kho mob tshwj xeeb raws sijhawm thiab kho caries. Lwm txoj kev retrograde ntawm tus kab mob nkag mus los ntawm cov hauv paus hniav nyob rau hauv periodontitis los yog periodontitis, thaum cov pos hniav tau loj heev los yog cov txheej txheem o tshwm sim nyob ze ntawm cov hniav (periodontitis, osteomyelitis, sinusitis, thiab lwm yam). Los ntawm cov lymphatic thiab cov hlab ntshav, tus kab mob tuaj yeem nkag mus rau hauv lub cev los ntawm lwm yam kabmob.
- Iatrogenic. Qhov no yog qhov tshwm sim ntawm qhov yuam kev los ntawm tus kws kho hniav hauv kev kho mob caries lossis nws cov teeb meem. Kev kho mob mus sij hawm ntev ntawm cov kab noj hniav caries nrog kev xyaum ua kom txias tsis txaus nrog dej provokesoverheating ntawm lub pulp nrog nws ntxiv o. Tib qhov yuam kev tuaj yeem ua nrog kev npaj kho hniav ntxhib rau lub kaus mom. Ntxiv nrog rau qhov cuam tshuam ntawm qhov kub thiab txias, cov txheej txheem o tuaj yeem txhim kho vim kev kho cov hauv paus kwj dej nrog cov tshuaj tua kab mob muaj zog, kev siv cov ntaub qhwv uas muaj cov alkali ntau, sau cov khoom tsis haum thiab cov khoom tsis suav nrog tib neeg kev tsis haum tshuaj.
- Taumatic. Kev ua kis las, kev lag luam thiab kev raug mob hauv tsev tuaj yeem ua rau muaj kev loj hlob ntawm pulpitis thiab, txawm tias phem dua, pulp necrosis. Cov kab nrib pleb me me thiab cov chips tsis qhib lub pulp tuaj yeem tso cov kab mob mus rau hauv cov hniav. Hauv qhov xwm txheej zoo li no, tshwm sim tshwm sim ntawm pulpitis.
Pulp qhib
Txawm qhov teeb meem loj dua ntawm qhov qhib ntawm daim tawv nqaij. Dislocation ntawm tus hniav, pob txha ntawm cov hauv paus hniav los yog crown, raug cov ntaub so ntswg thaum sib tsoo cov hniav ua ntej txhim kho lub crown los yog nyob rau hauv kev kho mob ntawm caries feem ntau ua rau mob tom qab mob necrosis los yog mob o. Hauv qhov xwm txheej hnyav tshaj plaws, tus neeg mob tau kuaj pom tias muaj necrosis tiav hauv ib lub lis piam.
Yuav ua li cas cov hlab ntsha zoo li muaj nyob rau hauv daim duab.
Ntau dhau ntawm cov hniav vim yog qhov tsis zoo tom los yog bruxism yog fraught nrog rau tom ntej ntawm lub cev nqaij daim tawv. Qee zaum, pulpitis yog qhov tshwm sim ntawm qhov txhaws loj heev, nrog rau lub siab ntawm petrificates lossis denticles (dentine-zoo li formations nyob rau hauv cov hniav hauv paus hniav los yog crown). Lawv pab txhawb kev cuam tshuam ntawm microcirculation thiab compress cov hlab ntsha thiab cov hlab ntsha.
Pulpitis cov tsos mob
Cov tsos mob tseem ceeb ntawm kev mob ntawm cov hlab ntsha hauv qhov chaw kho hniav yog mob spontaneous mob, mob heev thaum hmo ntuj.
Thaum xub thawj, qhov mob mob tshwm sim ntau zaus hauv ib hnub thiab kav ntev li nees nkaum vib nas this. Txawm li cas los xij, dhau sij hawm, kev hnov lus tsis txaus siab tau dhau los ua ntu zus, lawv qhov xwm txheej yog tawg, uas yog, qhov mob tuaj yeem muab rau lub puab tsaig, lub tuam tsev lossis pob ntseg. Qee zaum, zoo li ib tug neeg uas ib nrab ntawm nws lub puab tsaig mob. Cov tsos mob ntawm qhov mob ntawm qhov chaw kho hniav yuav tsum tsis txhob ignored.
Nws yooj yim heev kom pom qhov txawv ntawm caries thiab pulpitis. Yog tias muaj kev mob siab rau, qhov tsis xis nyob tsuas yog tshwm sim los ntawm kev cuam tshuam sab nraud (thaum zom zaub mov lossis txhuam koj cov hniav). Nrog pulpitis, qhov mob feem ntau tsis yog nyob ntawm ntau yam ntawm cov neeg kho tshuab stimuli, nws tshwm sim poob nthav.
Forms of pulpitis
Pulpitis raws li qhov xwm txheej ntawm cov txheej txheem o tuaj yeem ua raws li hauv qab no:
- Acute - thawj theem inflammatory, kav li ntawm peb mus rau tsib hnub. Kev mob tshwm sim ntawm theem no tsuas yog cuam tshuam rau thaj chaw coronal ntawm lub pulp.
- Chronic - yog mob plab tsis kho raws sij hawm, nws loj hlob mus rau hauv daim ntawv ntev. Cov hlab ntsha ntawm cov hniav pib tuag maj mam, cov ntaub so ntswg tuag nyob hauv cov hniav kab noj hniav, thaum qhov mob tsis tuaj los yog mob me. Tej zaum yuav tshwm sim ib ntus.
Los ntawm qhov chaw mob:
- pulpitis hauv qab qhov txhaws yog cov kab mob thib ob uas ua rau hauv qab;
- dub cag pulpitis -Kev kis tus kab mob tshwm sim nyob rau tag nrho qhov ntev ntawm lub hauv paus kwj dej thiab muaj peev xwm tawm ntawm qhov txwv los ntawm qhov qhib apical (apex);
- ob-channel thiab peb-channel pulpitis - cov txheej txheem ntawm o tshwm sim nyob rau hauv premolars thiab molars, ntes hauv paus kwj dej, vim hais tias cov kev kho hniav ua hauj lwm nyuaj.
Pulpitis ntawm cov hniav ib ntus kuj yog ib qho tshwm sim tsis tu ncua. Cov me nyuam cov mis nyuj cov hniav muaj ib tug dav pulp chamber thiab tsis muaj zog enamel, yog li cov txheej txheem inflammatory ntawm cov hlab ntsha ntawm cov hniav yog tus cwj pwm los ntawm kev loj hlob sai. Qhov txaus ntshai nyob rau hauv qhov tseeb tias tus kab mob tuaj yeem nkag mus rau cov ntaub so ntswg ze ntawm cov hniav, thiab tseem ua rau cov hniav ntawm cov hniav mus tas li.
Types of acute pulpitis
- Diffuse - cuam tshuam rau tag nrho cov hauv paus hniav thiab coronal ntawm cov tawv nqaij. Kev hnov lus tsis txaus siab dhau 10-15 feeb, tshwm sim txhua ob peb teev. Cov tsos mob tsis zoo yuav hnyav dua thaum tus neeg mob pw.
- Focal. Kev mob tshwm sim tsuas yog sab sauv ntawm cov hniav. Daim ntawv no yog tus cwj pwm los ntawm qhov mob hnyav paroxysmal, kis raws cov ceg ntawm cov hlab ntsha trigeminal. Qee zaum, gingival o thiab o ntawm submandibular cov qog ntshav hauv zos tshwm sim.
- Serous. Mob pulpitis nyob rau hauv daim ntawv siab heev tsim los ntawm 3-4 hnub. Pulsating spontaneous pains txuas ntxiv yuav luag txhua lub sijhawm.
- Purulent. Ib qho purulent tsom pom nyob rau hauv cov kab noj hniav. Thaum tshav kub kub yog siv, tsis xis nyob yog intensified, thaum txias, tsis xis nyob raug tshem tawm. Lub cev kub tuaj yeem nce mus rau38 degrees, kev noj qab haus huv tsis zoo.
Ntau yam ntawm cov kab mob ntsws ntev
- Hypertrophic, uas yog nrog los ntawm kev nthuav dav ntawm polyp (granulation ntaub so ntswg), qee zaum dhau ntawm kab noj hniav. Muaj los ntshav los ntawm cov hniav thaum noj. Nyob rau hauv cov ntaub ntawv no, lub crown raug rhuav tshem, tsis mob thaum tapping, tsis hnov mob rau txias.
- Fibrous. Feem ntau hom pathology. Qhov mob syndrome feem ntau tsis thab tus neeg, txawm li cas los xij, qhov tshwm sim ntawm qhov kub lossis txias yuav tshwm sim. Lub pulp los ntshav ntawm palpation. Cov theem no kav li 2-3 lub hlis.
- Nkauj hmoob. Pulpitis nyob rau hauv daim ntawv loj, tus yam ntxwv los ntawm lwj (necrosis) ntawm lub pulp. Cov enamel ntawm cov hniav uas mob ua rau tsaus nti, ua pa tsis zoo tshwm sim, thiab tus neeg cov tshuaj tiv thaiv rau kub intensifies. Muaj peev xwm txhim kho nyob rau hauv ob qho tib si kaw thiab qhib cov kab noj hniav.
Yuav tshwm sim ntawm cov hlab ntsha hauv cov hniav txhab hniav mob.
Pathology ntawm lub tswv yim hniav
Zoo li lwm cov hniav, "yim" kuj raug cuam tshuam rau qhov tsis zoo, tsuas yog ntau zaus. Txij li cov molars thib peb yog qhov nyuaj rau ncav cuag, kev tu kom zoo tsis tuaj yeem ua tiav. Cov kab mob plaque sai sai tshwm rau ntawm lawv, caries thiab nws cov txiaj ntsig tshwm sim, uas yog, pulpitis.
Daim duab kho mob yog tus qauv - qhov mob tsis txaus ntseeg, ua npaws, thiab lwm yam. Cov hniav ntse yog kho nrog arsenic, uas tua cov kab mob ntsws. Txawm li cas los xij, qhov kev kho no tsis tshua tau sau tseg, "yim" feem ntau tsuas yog tshem tawm.
Kev nyuaj siab
Pulpitis xav tau kev kho tam sim. Yog tias nws tsis tuaj, cov teeb meem tseem ceeb yuav tshwm sim. Cov kab mob thaum kawg tawm hauv cov kwj dej, cov ntaub so ntswg sib sib zog nqus ua rau mob.
Qhov tshwm sim ntawm cov kab mob no nce:
- periosteal o (flux);
- purulent hom kab mob ntawm lub puab tsaig - osteomyelitis;
- purulent abscess nyob rau hauv qhov ncauj kab noj hniav - abscess;
- qhov txaus ntshai tshaj plaws pathology uas purulent exudate cuam tshuam rau cov ntaub so ntswg ntawm lub ntsej muag - phlegmon.
Yuav ua li cas tua cov hlab ntsha? Cia peb kawm saib.
Yav dhau los, pulpitis tau kho tsuas yog tshem tawm cov hniav cuam tshuam, tab sis tam sim no cov cuab yeej siv tshiab feem ntau tso cai rau koj txuag nws txawm tias muaj tus kab mob zoo li no. Qee qhov xwm txheej, thaum tus neeg mob tuaj rau tus kws kho mob nrog qhov mob me ntsis, cov tawv nqaij tuaj yeem khaws cia tag nrho lossis tsawg kawg ib feem ntawm nws yam tsis muaj kev ua haujlwm tsis zoo.
Raws li qhov tshwm sim ntawm kev kho mob ntawm cov hlab ntsha ntawm cov hniav, cov ntaub so ntswg yog khaws cia los yog ib nrab lossis tshem tawm tag nrho. Nyob ntawm theem ntawm tus kab mob, tus kws kho hniav siv cov kev phais lossis kev kho mob lom neeg.
Kev phais mob. Nws yog siv thaum khaws cia pulp tsuas yog ua tsis tau. Cov hlab ntsha raug tshem tawm thiab ua tiav
Lub pulp hauv qhov xwm txheej no raug tshem tawm ib nrab lossis tag nrho. Txawm li cas los xij, qhov kev xaiv zoo tshaj yog khaws cia tsawg kawg ib feem me me ntawm cov hlab ntsha, txij li cov hniav "tuag" feem ntau yognkig thiab tawg sai dua.
Ua tiav lossis ib nrab, cov ntaub so ntswg raug tshem tawm siv cov txheej txheem devital thiab tseem ceeb. Hauv thawj kis, nws raug tshem tawm yam tsis muaj kev kho mob ua ntej nrog tshuaj lossis tshuaj lom. Rau devitalization, ib qho tshuaj tshwj xeeb tau muab tso rau hauv uas tua cov tawv nqaij, thiab tsuas yog tom qab ntawd nws raug tshem tawm.
Yuav ua li cas tua cov hlab ntsha? Cov theem ntawm kev tshem tawm ib nrab lossis ua tiav:
- txhaj tshuaj loog hauv zos;
- kev npaj kho hniav nrog tshem tawm cov ntaub so ntswg cuam tshuam;
- ua tiav lossis ib nrab tshem tawm ntawm cov tawv nqaij;
- kho nrog cov tshuaj tiv thaiv kab mob thiab kev siv tshuaj rau lub hauv paus ntawm cov kwj dej thiab cov ntaub so ntswg, kev teeb tsa ntawm ib ntus sau;
- kwj dej hauv paus raug kaw;
- ib photopolymer ruaj khov filling yog ntsia.
ntsuas kev tiv thaiv
Thaum muaj kab mob pulpitis, kev tiv thaiv muaj kev tu cev zoo ntawm lub qhov ncauj thiab kho cov kab mob raws sij hawm.
Txhawm rau txiav txim siab qhov mob carious hauv lub sijhawm, koj yuav tsum tau hu rau tus kws kho hniav ob zaug hauv ib xyoos thiab ua cov tshuaj tiv thaiv. Ntxiv nrog rau kev tu tsev, nws tseem pom zoo kom muaj kev tshem tawm tartar tsawg kawg ib zaug txhua rau lub hlis.
