Kusigaba izimbotshana Black: incazelo, degree of ekilasini kanye nokwelashwa

Caries - nobulwelwe. Kodwa odokotela baye basungula indlela esebenza kahle ukubhekana nalesi sifo. Uyini Ukwahlukaniswa izimbotshana by Black? Cabanga ngalo mbuzo kabanzi.

izinyo kwamazinyo

"Izimbotshana" iyisiLatini ihumusha ngokuthi "bola". Le nqubo eyinkimbinkimbi sokugembula sluggishly ogeleza kwezicubu onzima izinyo. Ngokuvamile sibangelwa ngenxa umphumela elihlangene eziyingozi izimbangela zangaphakathi nezangaphandle.

Ngesikhathi besanda kuqala kwamazinyo kunqunywa ukubhujiswa matrix eziphilayo koqweqwe lwawo futhi demineralization ebalulekile isabelo saso wezinto ezingaphili. Okudala kanzima zamazinyo izicubu kwamazinyo, ngalo ingaphakathi ku dentin ukuvela. Uma isiguli ngeke ufune usizo lwabezokwelapha isikhathi eside, kungase kube yezinkinga we periodontal ukuvuvukala kanye uginindela.

Le nguqulo yokuqala

Uyini Ukwahlukaniswa Black? Lokhu behlukanisa zokwakheka carious phezu izinyo. Lokhu kwethulwa ngo-1896 ukunquma izindinganiso imithi esimweni ngasinye emtholampilo.

Lokhu kuhlukaniswa kuhlanganisa amakilasi ezinhlanu, ngayinye yaba eye yathuthuka yayo ukugcwaliswa isikimu kanye nokulungisa amazinyo. Ngemva nje kancane kwalokho, lesi simiso ingezwe ku-lesithupha. Namuhla, kubonakala sengathi lokhu:

• Ikilasi lokuqala - ukwa ZaseLaki caries, emgodini kanye izimbotshana zemvelo buccal, ukuhlafuna futhi LasePalatine izinyo evele (ZaseLaki caries).
• Okwesibili - kulimaze evele contact we molars futhi premolars.
• Eyesithathu - loxhumana ebusweni caries canines futhi amazinyo, ningathinti emaphethelweni ukusika.
• grade Okwesine - acebile abolile amazinyo futhi canines, ecasula izindinyana elidlula.
• caries wesibeletho - wesihlanu. Kulokhu, evele vestibular amaqembu namazinyo libhujiswa.
• lesithupha - umonakalo, ibekwe emaphethelweni ukusika we canines futhi amazinyo, premolars futhi molars amagquma.

Eyesibili version

Black Ukwahlukanisa caries kwasendaweni umelwe ezinguqulweni eziningana. Ukuguqulwa yesibili kanje:

• Ikilasi lokuqala lihlanganisa umonakalo eduze ZaseLaki (sulci zemvelo).
• Okwesibili - ukubola kwamazinyo, eyabonakala ku izindiza ezinkulu futhi molars encane.
• Eyesithathu - ukunwetshwa ubuso contact canines futhi amazinyo nge walondoloza emaphethelweni ukusika.
• Okwesine - caries yokuxhuma evele of amazinyo futhi canines nge ephukile emaphethelweni ukusika.
• Okwesihlanu kuhlanganisa umonakalo wesibeletho.

Le nguqulo wesithathu

Kusigaba Blake Yaziwa version yayo wesithathu. Namuhla, simi ngale ndlela:

• Ikilasi lokuqala lihlanganisa umonakalo kule ndawo emigodini yemvelo kanye emifantwini amazinyo.
• Esesibili - ukucindezeleka yabonakala ubuso contact we molars ezincane nezinkulu.
• Esesithathu ekilasini - ingaphakathi ubekwe evele contact we canines futhi amazinyo (Ukuqhamuka akuyona wathinta).
• Okwesine - notch avela ngesikhathi elihlangana izindiza canines futhi amazinyo (yaphakamisa Ukuqhamuka namakhona).
• Okwesihlanu - ngalo ingaphakathi kwakhiwa endaweni entanyeni yazo namazinyo zonke izigaba.
• Kamuva idaliwe lesithupha, eyayibonakala labizwa ngokuthi kokuquleka atypical emakamu: izindunduma zenhlabathi ukuhlafuna futhi ukusika imiphetho amazinyo angaphambili.

UBANI

Ngakho, sathola ukuthi ngezigaba ezinjalo izimbotshana ngabantu abamnyama. UBANI linikeza izinhlobo lalo. ICD 10, kubukeka sengathi lokhu:

• ukubola izinyo koqweqwe lwawo;
• dentin zacekela;
• ukubhujiswa usimende;
• esibolile, wayeka ngenxa umthelela ukuthi ukuphepha kanye inhlanzeko amaseshini;
• odontoklaziya, lapho ukunyamalala lezihlahla namazinyo izimpande;
• omunye noqhekeko;
• bola engalungisiwe.

I we lesion ukujula

Eqinisweni, ngokuvumelana ngezigaba Black sika ithole isicelo yayo emhlabeni. Ngu degree of caries ekubhujisweni ihlukaniswe izinyathelo ezilandelayo:

• noqhekeko kokuqala;
• ukuvundulula ukuphazamiseka;
• caries nalasemkhatsini;
• kwamazinyo ezijulile.

Ngesikhathi besanda kuqala ukuthuthukiswa caries ku izinyo ukuvundulula ibala elimnyama noma amhlophe. Nokho, koqweqwe lwawo kuyinto surface bushelelezi, kusukela ekubhujisweni yokwakheka okwamanje. ibala Uvele isuswe ngu odokotela imishini yamazinyo. Bona remineralizing amazinyo, ukuzama ukuvimbela ukuthuthukiswa okwalandela lesi sifo.

In the isinyathelo esilandelayo izingqimba engenhla ayafa koqweqwe lwawo livela ephendula abukhali lokushisa ushintsho kuzo amanzi nokudla, futhi ukudla futhi esidi okubabayo. izinyo esengozini yokuba anolaka. Kuleli qophelo, odokotela ugaye endaweni ethintekile, bese remineralization yayo. Ngezinye izikhathi caries olukha phezulu ziphathwe nokulungiselela kanye ukugcwaliswa.

Vumelana Ukwahlukaniswa zamazinyo kanzima izicubu ukukhubazeka by Black iyithuluzi elihle for odokotela bamazinyo. Futhi lokho kuyinto caries phakathi? Esigabeni lesi, ungqimba koqweqwe lwawo we izinyo libhujiswa ukuze ubuhlungu ezithile unomphela noma ngakanye. Kulokhu, kakade inqubo noqhekeko ifinyelele ungqimba engenhla dentin.

Akumangalisi ukuthi amazinyo ezidinga ukuthi kungenelelwe yezokwelapha ayimpoqo, lapho udokotela kususa endaweni ethintekile futhi ulibuyise ngosizo material uphawu.

Futhi manje, bhekani caries ezijulile. Lesi sifo libhekene ekubhujisweni umxhwele kwezicubu yamazinyo, esilimaza kakhulu iningi dentin. Uma ngalesi sigaba ukuziba ukwelashwa, uginindela ungabhujiswa. Ngenxa yalokho, isiguli singase ukuthuthukisa pulpitis noma periodontitis.

Cavity nokulungiselela. ukuvezwa

Kusigaba Blake kwakheka isisekelo ukwelashwa kwamazinyo. Cavity ukulungiselela wenziwa ngezigaba ezinhlanu. Sifunda imithetho eyisisekelo ngesibonelo ekilasini lokuqala izimbobo emazinyweni, ezihlongozwayo udokotela odumile.

Ngesikhathi besanda kuqala ke Kwenziwa kuvulwa ingaphakathi. izinyo ukulungiselela iqala emaphethelweni ukususwa podrytymi koqweqwe lwawo ngaphandle ngaphansi, dentine enempilo obukhulu. Imiphumela iba yinhlanganisela yokukhandleka odongeni emaweni. Inombolo excised izicubu amiswa sokunquma dentin noqhekeko ekamelweni. Kulesi sigaba, udokotela kufanele ukunikeza ukufinyelela umbono ezinhle ngalo ingaphakathi nokucubungula wayo.

Odokotela ukuvezwa ukukhiqiza burs eyindilinga noma ZaseLaki eyenziwe idayimane noma Carbide waqinisa. Ithuluzi ubukhulu oluhambisana ubukhulu beso uvo ekhosombeni. Ochwepheshe zisebenzisa amathiphu ophephela ligijima ngesivinini, namanzi-komoya indlu.

isandiso

Ukwahlukanisa izimbotshana by Black isetshenziswa isikhathi eside futhi iwusizo kakhulu odokotela bamazinyo emsebenzini wabo. Kuyini isandiso zokuzivikela? Kulesi sigaba kuqhubeka ukuhlonza ingaphakathi carious. Nge lo msebenzi, udokotela uzama ukuvimbela yansukuzonke ukubola kwamazinyo. yangaphandle Specialist ucacisa ekupheleni ingaphakathi ukuma.

Kufanele kuqashelwe ukuthi, ngokuhambisana indlela "rationality begazi" I. G. Lukomskogo, kude ngesikhathi silungiselela lesi sinyathelo hhayi lwenziwa.

Uma udokotela iholwa ubuchwepheshe, ukuphepha reaming Black, ke kuveza excision ezinkulu ezindaweni ekuthonyweni ukubola, ezindaweni mzimba. ngaleyo ndlela Ukwanda caries ushona kwenziwe noma tapered ZaseLaki burs (Carbide noma idayimane). Kanyekanye yayisebenzisa amanzi emoyeni indlu.

namazinyo ngezigaba Blake inikeza ukugcwaliswa ukukhalima, ngayo nefunda ngayo kunciphise ukulahlekelwa isakhiwo izinyo enempilo indiza occlusal. Uma endaweni ingaphakathi carious isuswe, zonke izicubu sesibolile excised le ZaseLaki kuphela ngaphakathi koqweqwe lwawo. Phansi ekhosombeni kule kufaniswe nonclassic - babanjwa noma wangenela.

Ngo ukudalula ZaseLaki udokotela akususi semali izicubu: kwanele ezokhipha inkatho 1-1.5 mm ububanzi 0.7-0.8 mm ukujula, ngaphandle kokuhamba umngcele koqweqwe lwawo. Iphinde ugwema ukudalwa imiphetho ebukhali.

Ezweni lethu, njengoba umthetho, ngokuba excision ka emifantwini (fissurotomii) zisebenzisa ewumngcingo cylindrical burs. Ngezinye izikhathi lo msebenzi wenziwa umkhonto namabhola plamevidnymi.

necrosectomy

Isigaba esilandelayo ukususwa caries - necrectomy. Udokotela kususa othambile futhi esikhunjeni dentin caries ka ekhosombeni. Zone ekubhujisweni demineralization iphoyinti morphological buka, lesi sinyathelo siqedwa. Imingcele kude zidalwe endaweni lilimale dentin okusobala.

kumiswa

Ngokulandelayo, udokotela unika ngalo ingaphakathi umumo okuyinto enomthelela nokuqiniseka onokwethenjelwa uphawu. Kufanele ekwazi ukumelana esanele izinyo waphulukiswa futhi amandla ngezinye imithwalo sokusebenza. Kulesi sigaba, lokugcina kwakhiwa wabuka kwangaphakathi kanye elingaphandle ingaphakathi.

Ekhosombeni kudala ZaseLaki, plamevidnymi, oyindilinga ipheya emise burs (Carbide futhi idayimane) nge ozikhethela amanzi emoyeni indlu. Lo chwepheshe kwenza ophephela handpiece ukujikisa ngesivinini. Ukuma ofiselekayo ka ekhosombeni etholwe ekubukeni ukumelana kanye nokugcinwa.

Finishing

Emva ekucubunguleni Carbide noma idayimane burs koqweqwe lwawo onqenqemeni ikhefu ozuza ijika ukuma, iba buthakathaka, ke contact nezibhebhe alahlekile indwangu aphansi. Ngokuzayo kungase kusize ukushintsha kokungathembeki uphawu kanye nokuthuthukiswa izinqubo putrefactive. Lezi umehluko wemisindo nemiqondo yamagama kudinge Finishing - yokugcina machining imiphetho ngaphakathi komgodi, ngenxa okuyinto kumelwe iqedwe ezilimele izindawo koqweqwe lwawo.

Ngenxa yalokho, udokotela ukuze kuzuzwe ukuxhumana umhlabeleli ngokomlando fit phakathi isakhiwo izinyo futhi ukugcwaliswa. Lo msebenzi wenziwa 16 no-32, Granite yokuqedela burs noma okuncane idayimane amakhanda.

Odokotela sokuzivivinya usebenze ngesivinini ongaphakeme ngaphandle kwengcindezi edingekayo amanzi emoyeni indlu. Babuye ziphathwe ikhefu onqenqemeni trimmers wekhasi gingival kanye koqweqwe lwawo imimese, kokukhipha ungqimba elincanyana elingaphandle izinyo futhi ngaphandle ngemiphumela omubi ke okweqile, vibration nezinye izinto.

Njengoba ubona, ukwelashwa kwamazinyo impela inqubo ezinzima, kodwa uma ngesikhathi ukuze ubone udokotela usizo, singahlala ukumamatheka Hollywood iminyaka eminingi ezayo.