Cov chav kawm nyob rau hauv Blake: qhov chaw muaj kab noj hniav, kev faib thiab kev kho mob ntawm kev kho hniav caries

Yog vim li cas cais kho hniav caries? Nws yog tsuas yog nyob rau thawj nuam ib tug yooj yim kab mob hu mus rau txhua leej txhua tus. Rau cov kws kho hniav, muaj yog ib qho uas txawv ntawm nws cov ntau yam ntaub ntawv, thiab txhua tus ntawm lawv yuav tsum tau nws tus kheej tshwj xeeb mus kom ze rau kev kho mob.

Caries yog txawv

Caries - lub feem ntau tus kab mob ntawm lub qhov ncauj kab noj hniav, tsim nyob txawv qhov chaw ntawm cov kaus hniav yuav ua tau txawv thiab cov kev soj ntsuam daim duab ntawm tus txheej txheem. Rau qhov yooj yim ntawm cov kev kho mob, qhov tseeb kev xaiv ntawm hniav kev npaj thiab siv tau rau kev sib khi cov ntaub ntawv uas hom cais kho hniav caries. Yog li ntawd faib chav kawm ntawv nyob rau hauv Blake, ntawm qhov tob ntawm lub yeej, cov neeg kawm ntawv ntawm kev ua si ntawm tus txheej txheem ntawm kev puas tsuaj, los ntawm lub xub ntiag ntawm teeb meem, tus soj ntsuam qhov thiab qhov chaw nyob ntawm lub lesion.

Cov feem nrov yog cov kev faib npaj nyob rau hauv 1986 ib tug American kws kho hniav George. Dub. Nws aim yog tus systematization ntawm lub hauv paus ntsiab lus ntawm kev kho mob rau ib tug ntau yam ntawm cov ua cim hom hniav caries.

Cov chav kawm nyob rau hauv Blake

Dub nrhiav tau tsib cov chav kawm los localize rau ntawm qhov chaw, uas yog, nyob ntawm seb qhov twg nws yog nyob carious kab noj hniav:

1. Localization fissures (tej kab nrib pleb thiab depressions nyob rau hauv tus txha hniav laus occlusal nto), qho to hniav puas thiab premolars (loj loj thiab me me hniav puas), canines thiab incisors.
2. Nws cuam tshuam ob los yog ntau tshaj ntawm cov chaw - yog yuav los ntawm lub nrub nrab thiab distal (pem hauv ntej caries ntawm cov hniav) los yog occlusion (zom thiab txiav chaw) hniav puas thiab premolars.
3. Kev vam meej ntawm tus kab mob nyob rau hauv lub nrub nrab thiab distal ib feem ntawm lub canines thiab incisors.
4. Localization yog tib yam li hais tias ntawm lub thib peb hauv chav kawm ntawv, ntxiv rau entrained kaum sab xis ntawm lub crown feem los yog txiav saum npoo av.
5. Kab noj hniav occupies ncauj tsev menyuam feem ntawm tej pab pawg ntawm cov hniav.

los ntawm dub Qib systematize tag nrho cov tau embodiments muaj kab noj hniav, txhua yam uas lawv muab ib tug nyias muaj nyias ib kev kho mob, ib txoj kev hniav kev npaj ntawm tus neeg mob thiab nruab ib lub foob.

Tus thawj chav kawm ntawv los ntawm dub

Nyob carious kab noj hniav li ua qhov uas yuav tawg lub tsiaj hiav txwv ntug ntawm lub high school siab rau nws thaum lub sij hawm zom. Thaum tus hniav kev npaj muaj xws li kev ntsuas kom tshem tawm xws li ib tug tau. Qhov no tshwm sim los ntawm kev txo lub bevel txha hniav laus thiab overlay ib thicker txheej ntawm sau cov ntaub ntawv uas. Thaum uas siv cov ib puas nrog ib tug tshuaj curing yog thov thaum uas tig mus rau hauv qab ntawm nws cov kab noj hniav, raws li shrinkage yuav tsum tau qhia rau lub pulp. Yog hais tias koj siv lub teeb-kho cov ntaub ntawv uas, nws yog pw slanting khaubncaws sab nraud povtseg. Shrinkage nyob rau hauv rooj plaub no yuav tsum tau qhia rau ib tug polymerization qhov chaw. Khaubncaws sab nraud povtseg yuav tsum dag los ntawm nruab nrab hauv qab mus rau ntawm cov npoo ntawm cov kab noj hniav, glare tshwm sim los ntawm lub sab phab ntsa, thiab tom qab - perpendicular mus rau lub zom nto. Raws li ib tug tshwm sim, ib tug nruj haum yog tiav nyob rau hauv lub tsiaj hiav txwv kab noj hniav.

Cov qib sau cov kab noj hniav ntawm cov thawj chav kawm ntawv ntawm

Tej yam ua yuav tsum tau coj tus kws kho hniav los kho ib tug Qib 1 rau Blake:

• anesthetize (siv tshuaj loog gel los yog tsuag lidocaine) ,
• npaj cov hniav (kev npaj yuav drilling sib sib zog nqus carious feem ntawm ib qho nyuaj ntaub so ntswg)
• yog tias tsim nyog mus kom ib tug insulating gasket (tiv thaiv kom txhob raug tus kab mob ntawm tus qhab rau lub sis plawv hniav thiab nws voos)
• acid dib qaub thiab yaug, qhuav cov kab noj hniav,
• cais los ntawm cov qaub ncaug,
• tas thov primer (rau dentin)
• Thov nplaum (tsevneeg ntawm tus qhab neeg thiab hniav daim ntaub los yog primer)
• txheej los ntawm txheej cam khwb cia cov ntaub ntawv uas los tuav nws ruaj khov,
• muab kho rau lub Desired zoo, los ua xov thiab polishing,
• ua glare (kawg curing).

Qhov thib ob chav kawm ntawv los ntawm dub

Muaj nws tus kheej teeb meem Qib 2 by Dub qhia nyob rau hauv nws kev kho mob ntawm ob lub ntsiab hom phiaj - los tsim ib tug muaj zog tiv tauj ntawm cov hniav thiab muab ib tug snug haum ntawm tus qhab rau ntawm ntug ntawm lub ntsiab kab noj hniav. Feem ntau cov kev sib khi yog nyuab los ntawm cov tsos ntawm cov overhanging ntug cov ntsaws ruaj ruaj, cov tsis muaj ntawm kev sib cuag ntawm cov hniav los yog ib tug cov ntaub ntawv uas nrog kab noj hniav. Yuav kom tiv thaiv no, siv ib tug nyias matrix yog nqa hniav offset (rau cov neeg tau) siv ntoo wedges. Nyob rau hauv plaug interdental chaw matrix thiab tsau npoo, ces moistened nrog dej. Npoo swells thiab pushes tus hniav. Qhov no txoj kev thaum sau kom tsis txhob overhanging npoo ntawm cov ntsaws, uas nyob rau hauv lem yuav ua rau o ntawm cov pos hniav. Tuab cov ntaub ntawv uas haum rau cov kab noj hniav muab kev siv ntawm ib tug nplaum - phau ntawv nws tus kheej vim hais tias tus qhab yuav tsum nrees kev cob cog rua nrog enamel, tab sis lub dentin.

Cov qib sau muaj kab noj hniav thib ob chav kawm

los ntawm dub chav kawm nyob rau hauv cov kev kho mob tau zoo sib xws, tab sis txhua tus ntawm lawv yuav tsum tau tshwj xeeb nuances ntawm filling. Ntawm no yog cov kauj ruam rau lub thib ob chav kawm ntawv:

• tshuaj loog,
• kev npaj,
• Yog hais tias tsim nyog, kho ntawm cov pos hniav,
• Installation ntawm lub matrix nrog cov kev taw qhia ntawm ib tug ntoo npoo los yog yas dhos,
• yog tias tsim nyog tsiv sib nrug cov hniav,
• lub imposition ntawm ib tug insulating lub tog raj (Yog hais tias tsim nyog)
• nqa tawm etching txoj kev, acid ntxuav thiab so qhuav
  kab noj hniav
• rho tawm cov hniav los ntawm cov qaub ncaug,
• thov primer thiab nplaum,
• Yog hais tias tsim nyog - restore tus txha hniav laus npoo (yog tias muaj),
• lub imposition ntawm tus qhab khaubncaws sab nraud povtseg,
• Tshem cov matrix thiab cov npoo,
• tswj interproximal sib cuag,
• kho, polishing,
• glare finish.

Peb thiab thib plaub kawm ntawv

Ntawm no, lub ntsiab luag hauj lwm no yog ua si los ntawm cov kev xaiv ntawm cov xim ntawm cov filling cov ntaub ntawv uas, vim hais tias nyob rau hauv rooj plaub no tus hniav lwj yog laus nyob rau hauv cov hniav. Vim qhov sib txawv coefficient ntawm transparency dentin thiab enamel, cov kev kho mob yog tsim nyog los siv ib puas ntawm ob tug sib txawv xim. Xav Tau yog rau ib tug hniav ciali homogeneous, thiab foob tsis zoo li ib thaj. Yuav kom tsim lub feem ntau natural nyhuv, siv lub dawb ntawm cov khoom xyaum lub dentin, thiab yuav luag pob tshab - mus recreate lub enamel. Cov kev hloov yog tsis pom, Bevel tus txha hniav laus yog them los ntawm 2-3 hli. Nws yog ib qho tseem ceeb hais tias xws li ib tug zoo txoj hauj lwm ua ib tug zoo kws kho hniav uas yuav txiav txim raug cov transparency ntawm tus hniav. Muaj peb degrees ntawm nws: opaque (feem ntau yog yellowish, opaque txawm tej ntug), pob tshab (daj-grey ntxoov, pob tshab tej ntug), yog heev pob tshab (grayish, pob tshab cheeb tsam ibyam peb ntawm tus hniav.

Cov qib sau muaj kab noj hniav 3 thiab 4 chav kawm

Yuav kom muab lub thib peb thiab thib plaub kawm ntawv muaj kab noj hniav los ntawm dub, ib tug kws kho hniav yuav tsum ua kom tiav cov nram qab no cov kauj ruam:

• ntxuav lub saum npoo ntawm cov quav hniav,
• txiav txim tus hniav ntxoov ntxoo,
• anesthetize,
• los npaj cov hniav kom tso los ntawm tus kab mob cov ntaub so ntswg
• teem lub retraction threads los yog matrix, thaum nws yog tsim nyog (cuam tshuam gingival ntug)
• thov insulating hauv ob sab phlu,
• Yog hais tias tsim nyog, los qhov nkhaus ntawm cov hniav,
• acid yaug thiab qhuav cov kab noj hniav,
• cais tawm cov qaub ncaug,
• Thov ib primer (yeem) thiab ib tug nplaum
• plobiruyuschy kom khaubncaws sab nraud povtseg ntawm cov ntaub ntawv uas,
• tshem tawm ntawm matrix thiab filaments, yog tias muaj,
• kho ntug, shape tus hniav,
• sib tsoo thiab polishing,
• glare finish.

Fifth kawm qib ib los Dub

Nyob rau hauv cov ntaub ntawv no, lub ntsiab tseem ceeb yog cov kev sib raug zoo ntawm cov pos hniav thiab kab noj hniav. Nrog tob txhab nrog lub kaw ntawm lub qis ntug ntawm cov pos hniav, los ntshav nws, ib tug zoo kws kho hniav tam sim ntawd txiav txim siab tias ib tug kho lus ntawm lub gingival npoo. Tom qab tsim nyog manipulation ntawm cov pos hniav rau ib tug ob peb hnub, kom ib tug ib ntus filling mus tshem tawm ntxiv teeb meem thaum txhim kho qhov. Qib tsib yuav siv cov composite cov ntaub ntawv thiab compomers (puas-ionomer muaj pes tsawg leeg). Cov yav tas yog siv rau sab nraum txhab nrog ib tug tseem ceeb feem ntawm cov loj tshaj plaws localization. Nyob rau hauv tus neeg mob qhov twg aesthetic zoo li yog ib qho tseem ceeb (los yog tsis ua hauj lwm muaj feem xyuam rau xwb tus txha hniav laus), siv lub teeb-curing composites qhia tshwj xeeb uas xaiv xim.

Cov kauj ruam rau sau muaj kab noj hniav ntawm lub thib tsib hauv chav kawm ntawv

Yuav ua li cas thaum tus kws kho caries qib tsib:

• ntxuav cov hniav nto los ntawm cov quav hniav,
• txiav txim qhov ntxoov ntxoo,
• siv tshuaj loog
• ua phais, tshem lub softened cov ntaub so ntswg
• muaj tseeb gingival paj tau paj, yog tias tsim nyog,
• nkag mus rau retraction qaum,
• kom ib tug gasket rau rwb thaiv tsev, yog tias tsim nyog,
• acid yaug, qhuav,
• cais los ntawm cov qaub ncaug,
• Thov primer thiab nplaum,
• packing khoom, glare,
• sib tsoo thiab polishing,
• glare finish.

thib rau qib

Cov naas ej American kws kho hniav, uas nws lub npe yog lub cais yog npe hu ua, Nws muaj tsib cov chav kawm ntawv muaj kab noj hniav. Rau ib ntev lub sij hawm, nws system twb siv nyob rau hauv nws cov thawj daim ntawv no. Tab sis tom qab ntawd rau cov teg num ntawm Health cov chav kawm los ntawm dub lub ntiaj teb no lub koom haum tau undergone me kev hloov - nws twb ntxiv mus rau lub thib. Nws qhia txog cov localization ntawm caries ntawm tus ntse ntug ntawm lub incisors thiab nyob rau hauv lub toj ntawm posterior hniav.