dd牙髓病和根尖周病治疗概述(P189).ppt
《dd牙髓病和根尖周病治疗概述(P189).ppt》由会员分享,可在线阅读,更多相关《dd牙髓病和根尖周病治疗概述(P189).ppt(48页珍藏版)》请在三一文库上搜索。
1、Therapy Introduction 牙髓病和根尖周病治疗概述(P.189),Principle and Planning 治疗原则和治疗计划,Treatment Principle 治疗原则,1、Preserving Vital Pulp 保存活髓 2、Preserving Offending Tooth 保存患牙,Treatment Planning 治疗计划,Emergency Endodontic Treatment 缓解疼痛,控制急性症状 Examination & Routine Treatment 全面检查,常规治疗,Case Analysis 病 例 选 择 Basis f
2、or Successful Endodontic,Medical History 患者状态 适用于任何年龄,无绝对的全身禁忌证 Dental History 患牙状态 尽可能保存患牙,Infection Control感染的控制 (Aseptic Technique无菌技术),Isolating the Operative Field 术区隔离 Sterilizing the Instrument 手机灭菌、器械消毒和灭菌,Absorbents 隔 湿,Cotton rolls,Rubber Dam 橡 皮 障,Suction 吸 唾 器,Saliva evacuator,Saliva eje
3、ctors,Pain Control 无痛技术,Local Anesthesia 局部麻醉法 2 LidocaineEpinephrine,Local Anesthesia Techniques,Local infiltration anesthesia 局部浸润麻醉(常用) Block anesthesia 阻滞麻醉(常用) Intraligamentary anesthesia 牙周膜内注射 Intrapulpal anesthesia 牙髓内注射,Treatment Methods 治疗方法 (P.203),保存活髓 保存全部生活牙髓Pulp Capping(盖髓术) 保存根部生活牙髓P
4、ulpotomy(牙髓切断术),盖髓术 Pulp Capping,Pulp capping is defined as “endodontic treatment designed to maintain the vitality of the endodontium”. 覆盖使牙髓病变转归的制剂以保护牙髓,消除病变,保存活髓,盖髓术 Pulp Capping,Direct Pulp Capping(直接盖髓术) 覆盖已暴露的牙髓 Indirect Pulp Capping (间接盖髓术) 覆盖接近牙髓的牙本质,Drugs in Pulp Capping and Pulpotomy 常用盖髓剂
5、,Calcium Hydroxide 氢氧化钙 (highly alkaline强碱性) 最具疗效的盖髓剂之一,Dycal:可硬性氢氧化钙制剂,可作为次基材料 Calvital:为非可硬性氢氧化钙制剂,Antibacterial activity中和炎症所产生的酸性产物 Activate AKP, promote dentin formation激活碱性磷酸酶,促进修复性牙本质形成,Remember!,These calcium ions present in the dentin bridge come from the systemic circulation,not from the c
6、alcium hydroxide you used. 修复过程中形成的牙本质桥中的钙离子是来自体循环,Other Drugs 其它盖髓剂,Zinc Oxide-eugenol 氧化锌丁香油糊剂(多用于间接盖髓) Glucocoticoids & Antibiotics 糖皮质激素及抗生素 Hydroxyapatite 羟基磷灰石、BMP骨形成蛋白 Mineral Trioxide Aggregate (MTA),Direct Pulp Capping 直接盖髓术,Pulp capping implies placing the dressing directly onto the pulp e
7、xposure.,原 理,用盖髓剂覆盖在露髓创面上,消除炎症和感染,保护牙髓组织,使其恢复健康。,Indications 适应证,考虑病人年龄 年轻恒牙根尖孔尚未形成 考虑病变程度 恒牙牙髓有无感染、牙髓病变早期阶段,Contraindication 禁忌证,有牙痛史的恒牙 有慢性牙髓炎或根尖周炎表现的患牙,Direct Pulp Capping,For a direct pulp capping procedure, a calcium hydroxide lining material is placed on the exposed pulpal tissue and a small a
8、mount of surrounding dentin. A sealing liner and/or a sealing restoration is then placed to seal out bacteria and their by-products.,Factors that affect outcome of pulp capping or pulpotomy 决定预后的因素,Local factors 局部因素 Systemic factors 全身因素 Ages and Status of the Pulp 年龄与牙髓的状态,Local Factors 局部因素,1)The
9、 size of the exposure 露髓孔大小直径大于1mm行活髓切断术保存活髓,Local Factors 局部因素,2)Location of the exposure 露髓孔的位置颈部龋预后差(轴壁牙本质钙化桥阻断冠髓血供),Local Factors 局部因素,3)Periods of exposure 牙髓暴露的时间越长,牙髓发生炎症的可能性越大,Local Factors 局部因素,4) Discouraged for carious pulp exposures 牙髓暴露的类型因龋病露髓的牙齿由于细菌感染不提倡盖髓 外伤性露髓炎症多局限在距牙髓表面2mm的范围内,Loca
- 配套讲稿:
如PPT文件的首页显示word图标,表示该PPT已包含配套word讲稿。双击word图标可打开word文档。
- 特殊限制:
部分文档作品中含有的国旗、国徽等图片,仅作为作品整体效果示例展示,禁止商用。设计者仅对作品中独创性部分享有著作权。
- 关 键 词:
- dd 牙髓 根尖 治疗 概述 P189
链接地址:https://www.31doc.com/p-2102268.html