Pulpitis: kev faib tawm, hom, chaw kuaj mob. Ib suam ntawm txoj kev kho mob ntawm pulpitis

Coj txawv txawv, tiam sis yeej muaj tseeb - ib tug kab mob raws li pulpitis, muaj ntau tshaj li 20 kev faib le caag. Cov kws kho hniav siv lawv tus kheej nyob rau hauv lub chav kawm ntawm lawv ua hauj lwm nyob rau hauv ntau txoj kev lub hom ntawm tus kab mob kev ntsuam xyuas, tab sis muab sau tias tej yam uas lawv muaj peev xwm 100% meej piav qhia txog tag nrho cov nta ntawm no insidious tus kab mob. Cov kws kho hniav hais tias lawv xav tau ntau yooj yim thiab succinct kev faib ntawm pulpitis, uas yuav cia rau tuab tus kab mob nrog rau tag nrho cov cai txaus.

Vim li cas kuv yuav tsum tau cais lub sam thiaj no?

Lub xub ntiag ntawm xws li ib tug loj heev systematization kho hniav kab mob txuam nrog sib txawv le caag los sim piav qhia txog daim duab ntawm tus kab mob. Ntau hom ntawm classifications pulpitises muaj xav txog lawv los ntawm ntau txoj kev xam pom: cov ua rau thiab txoj kev loj hlob, kev soj ntsuam kev vam meej, qhov kev tshwm sim ntawm qhov pib dab nyob rau hauv lub hauv paus kwj dej thiab lwm cov neeg.

Piav txog los ntawm tag nrho cov ces kaum sam thiaj no classifications tau tsis tau raug tsim. Yog li ntawd, cov kws kho hniav muaj teeb uas twb muaj lawm soj ntsuam daim duab ntawm tus neeg tus neeg mob tsis pub dhau lub moj khaum ntawm tus uas twb muaj txoj kev ntsuam xyuas. Ob peb kev faib schemes tau tsim xyoo dhau los, li cas los xij, thiab yog tam sim no siv nyob rau hauv txoj kev xyaum ntawm tus mob thiab kev kho mob ntawm pulpitis.

Tus thawj cov me nyuam mus systematize no kho hniav kab mob tau noj nyob rau hauv lub 20s ntawm lub xeem caug xyoo thiab tau raug hu ua tshaj plaws yog piav qhia ntawm lub pulp. cov classifications twb theej complex thiab cumbersome. Uas yog vim li cas cov kws txawj ua ib tug tas mus li ua hauj lwm rau kev txhim kho ntawm tus kab mob no piav qhia hom kev kawm. Thaum cov Team sib ntawm 5-10 xyoo npaj ib tug tshiab kev faib tawm, uas yog raws li nyob rau hauv ua ntej lawm schemes, tab sis muaj ib co tshiab yam ntxwv rau qhov kev piav qhia ntawm daim duab pulpits.

LEEJ TWG kev faib

Qhov kawg ntawm lub xyoo pua 20th, namely nyob rau hauv 1997, kev kho hniav twb cim los ntawm cov kev taw qhia ntawm cov International ib suam ntawm kab mob, 10 Kho nqi lus, uas yog lub npe hu los ntawm cov tsiaj ntawv ICD-10. Nws tau pom zoo los ntawm lub ntiaj teb Health Organization, thiab nyob rau hauv 1999 los ua siv lug nyob rau hauv cov kev kho hniav xyaum rau qhov mob thiab kev kho mob ntawm pulpitis. Qhov no system yog ib lub npe ntawm cov lis dej num thiab lawv decryption los piav tus soj ntsuam daim duab ntawm tus kab mob. Classification pulpitises ICD muaj xws li cov nram qab no cov khoom:

• Kab mob ntawm sis plawv hniav thiab periapical nqaij muaj denoted los ntawm ib tug code K04.
• Ncaj qha sam thiaj no encrypted K04.0.
• Cov thawj zaug rau theem ntawm tus kab mob, yus muaj los ntawm hyperemia, denoted K04.00.
• Mob pulpitis muaj encrypt K04.01.
• Yog hais tias ib tug rwj yog pom, nws yog ib lo code K04.02.
• Cov mob hauv daim ntawv ntawm pulpitis yog xaiv K04.03, thiab yog hais tias qhov no thiaj paub hais tias yog ib lub rwj, nws yog npaj rau encrypt qhov mob ntawm K04.04.
• Yog hais tias ib tug neeg mob yog muaj nyob sis plawv hniav polyp nyob rau hauv lub mob hauv daim ntawv, nws xaiv K04.05.
• Thaum cov kab mob ntawm lub paj hlwb thiab leeg tshav cov ntaub so ntswg ntawm ib tug hniav lwm teev xwm Stamp K04.08.
• Yog hais tias qhov ua rau ntawm pulpitis yog tsis meej, nws hais tias code K04.09.
• Necrotic los yog gangrenous tshwm sim nyob rau lub slurry yog qhia nyob rau hauv code K04.1.
• Yog hais tias tus kws kho hniav cai degenerative dab xws li dentikli, sis plawv hniav pob zeb los yog calcification, nws qhia lawv code K04.2.
• Nyob rau hauv cov ntaub ntawv ntawm ib qho txawv txav tsim ntawm ib qho nyuaj cov ntaub so ntswg nyob rau hauv lub sis plawv hniav annotation K04.3. Thiab yog hais tias nws yog lus (secondary) dentin, nws yog qhia los ntawm cov code K4.3X. Nws yuav tsum tau muab sau tseg tias nyob rau hauv no qhov teeb meem yog cais calcification thiab pob zeb nyob rau hauv lub pulp.
• Nyob rau hauv apical periodontitis mob xwm, uas yog qhov ua rau ntawm cov kev hloov nyob rau hauv lub Neuro-leeg tshav ntaub so ntswg ntawm ib tug hniav, muab tso rau cipher K04.4.
• Yog hais tias tus kws kho hniav pom tias nyob rau hauv pem hauv ntej ntawm nws sis plawv hniav kab mob thiab periapical ntaub so ntswg uas tsis haum rau hauv lub saum toj no-hais cov ntsiab lus, nws yuav ua rau ib daim ntawv K04.9.

Qhov no kev faib pulpitises LEEJ TWG, raws li cov kws kho hniav, nws tsis yog yooj yim heev. Txawm li cas los, nws yog tseem siv tau raws li cov hauj lwm tswvyim rau cov kev npaj ntawm statistical ceeb toom ntawm cov kws txawj rau kev ua hauj lwm ua thaum lub sij hawm ib tug tej lub sij hawm lub sij hawm. Codes thiab ciphers ntawm no faib tus kws kho mob yog yuam ua hauj lwm kom muab tso cia rau ntawm daim card thiab tus neeg mob daim ntawv. Muaj ntau cov kws kho hniav tau pom hais tias lawv muaj feem ntau kho lawv rau inscribe tus kab mob no tsis pub dhau lub moj khaum ntawm lub tswvyim npaj los ntawm lub LEEJ TWG, txawm hais tias lawv muaj nyob rau hauv sib txawv kiag li txoj kev yooj yim yam ntxwv ntawm kev kho hniav pathology.

Yam ntxwv sam thiaj no ntawm nws keeb kwm

Qhov no kev faib yuav siv sij hawm mus rau hauv tus account pulpitis thiab periodontitis ua ntawm tus kab mob. Raws li qhov no txog kev paub, cov kws kho hniav yog 4 yam ntawm tus kab mob:

• Kab mob.
• Traumatic.
• Konkrementozny.
• Kev kho mob los yog tshuaj.

Wb sib tham txog txhua sis plawv hniav uas faib piav nws ua.

ua kab mob pulpitis

Qhov no hom ntawm tus kab mob yog tshwm sim los ntawm cov kev ua ntawm cov kab mob uas tsim cov co toxins thiab ntxias o thiab leeg tshav paj nras hniav. Nyob rau hauv 9 mob tawm ntawm 10 ntawm lub kab mob poob rau cov kab noj hniav ntawm dentine canals los yog muaj feem xyuam rau cov raug nto ntawm lub paj. Tsis tshua muaj heev retrograde pulpitis, thaum cov kab mob nkag mus rau cov hniav los ntawm ib lub qhov nyob rau hauv lub saum toj ntawm lub hauv paus. Qhov no tshwm sim thaum kab mob xws li mob ua pa kab mob, rubella, osteomyelitis, sinusitis los yog periodontitis. Nyob rau hauv tsawg tus neeg mob, kab mob yuav hnav hematogenous cim. Cov txaus ntseeg kawg nkaus nam kom paub txog lub sam thiaj no - etiology. Cov kev faib ntawm txoj ntsiab cai no feem ntau yog siv los ntawm cov kws kho mob.

puas pulpitis

Nws yuav tsum tau muab sau tseg tias kev raug mob yog qhov ua rau ntawm ib tug pathological txheej txheem uas tej zaum yuav raug nyob rau hauv pulpitis. Nyob rau hauv cov ntaub ntawv no, sterility yog tawg hniav kab noj hniav thiab lawv kab mob tshwm sim nrog lub ntxiv kev loj hlob ntawm o paj nras. Tej zaum nws tsis tau ua txhaum lub meej mom ntawm tus hniav thiab nws yog qhov chaw (luxation los yog subluxation). Nyob rau hauv cov ntaub ntawv no, lub sam thiaj no yog pub leej twg paub thiab yog progressing tsis muaj kev koom tes ntawm microorganisms.

Cov kev raug mob yuav tau hnav txhua hnub xwm, yuav tau raws li ib tug tshwm sim ntawm cov kev huam yuaj los yog raug mob, tab sis tej zaum yuav tshwm sim los ntawm tsis kho mob kev pab. Piv txwv li, thaum sib tsoo lub hniav "ib tug crown" pulpitis feem ntau tshwm sim raws li ib tug rau txim ntawm perforating cov ntaub so ntswg. Qhov no tshwm sim yuav tsum tau tam sim ntawd kho. Nws yog ib qho tseem ceeb heev rau hwm rau hauv Circuit Court tus kws kho mob: sam thiaj no - Classification - lub tsev kho mob - kev kho mob. Rau cov series lag luam tus kws zoo ib yam, txawm lub feem ntau nyuab cov ntaub ntawv, koj yuav tau kho thiab tsis txhob ib tug ntau ntawm tsis kaj siab mob.

Konkrementozny sam thiaj no

Qhov no hom ntawm pulpitis tshwm sim vim hais tias ib co chaw nyob rau hauv lub hauv paus kwj dej - dentikley los yog petrifikatov. Lawv loj hlob nyob rau hauv lub raws thiab muaj kab noj hniav hlob cov hlab ntsha. Raws li ib tug tshwm sim mikrotsirkullyatsiya lawm, tsim o. Qhov tsim nyog yog ib sis plawv hniav.

Kev kho mob los yog tshuaj sis plawv hniav

Qhov no sam thiaj no faib feem ntau tsis piav qhia txog, tab sis nyob rau hauv qhov tseeb nws yog heev heev thiab yog tshwm sim los ntawm ib tug kws kho kev ua yuam kev. Qhov no tshwm sim thaum tus kws kho hniav siv thaum npaj qhov ncauj caries los yog ncig lub hnab tshos neeg sawv cev ntawm lub hwj chim xwm (alcohols los yog esters) los yog kev yuam kev tau ua ntawm kev sib khi.

Classification los ntawm Platonov

Txawm tias muaj tseeb hais tias qhov no zoo ntawm kev soj ntsuam ntawm tus kab mob twb npaj siab los ntawm cov xibfwb Platonov kom deb li deb rov qab raws li xyoo 1968, nws yog hnub no siv los ntawm cov kws kho hniav nyob rau hauv txoj kev xyaum. Qhov no kev faib ntawm pulpitis thiab periodontitis muaj nws cov flaws, tab sis zoo nyob rau hauv nws cov simplicity thiab yooj yim. Cov xib fwb nyob rau hauv nws cov txheej txheem ua ke peb le caag: kev soj ntsuam ntawm lub pathological dab nyob rau hauv lub sis plawv hniav, qhov xwm ntawm tus kab mob no, raws li zoo raws li localization ntawm lub tsis xis nyob. Qhov no yog ib tug yooj yim, tab sis capacious system kab mob kev ntsuam xyuas yog mus rau lub los ntawm cov kws txawj uas piav txog nws tam sim no qhov tseeb. Nyob rau hauv no systematization tham txog cov ntsiab yam ntawm no tshwm sim, raws li lub sam thiaj no - etiology, pathogenesis. Suam ntawm cov kab mob ntawm Platonov yog raws li nram no:

• Mob pulpitis hom: lobular daim ntawv (mob, uas yog ib qhov tseeb localization neeg mob) thiab diffuse hom (undefined localization, extending raws trigeminal paj ntawm lub ntsej muag).
• Pulpitis mob cim hypertrophic (o ntawm sis plawv hniav kab noj hniav sau caries), gangrenous (necrosis ntawm cov hlab cov ntaub so ntswg thiab leeg tshav nras) thiab fibrotic (kev kho hniav daim ntawv so ntswg lwm).
• Pulpitis exacerbation ntawm tus kab mob cov ntaub ntawv.

Qhov no kev faib thiab pulpits Clinic heev piv cov ua hauj lwm ntawm cov kws kho hniav, tshwj xeeb tshaj yog nyob rau hauv budgetary tsev kho mob. Feem ntau, nyob rau hauv tej yam, cov kws kho mob tsis muaj lub sij hawm mus soj ntsuam cov ua hniav kab mob. Nyob rau hauv thiaj li yuav tsim kom muaj lub hom ntawm tus kab mob, yog txaus los mus hais kom tus neeg mob ib co lus nug.

Classification Gofungu

Qhov no txoj kev yog heev nrov nrog cov kws kho hniav, vim hais tias nws qhia txog cov feem ntau tseem ceeb sib nrauj ntawm no pathology raws li ib tug sam thiaj no - kev faib tawm, soj ntsuam daim duab, kev kho mob. Nws muab ib lub tswv yim hais txog cov theem ntawm tus kab mob pub rau ntau yam kev soj ntsuam tsis thiab morphology hloov nyob rau hauv lub sis plawv hniav thaum lub sij hawm lub inflammatory txheej txheem. Raws li qhov no system, cov ntaub ntawv ntawm tus kab mob yog cov nram qab no:

• Cov mob hauv daim ntawv ntawm pulpitis: ib nrab (reversible, yuav kho los ntawm ceev lom paj), tag nrho cov (diffuse, yuav tsum vov lub tag nrho sis plawv hniav, thiab yog kho los ntawm extirpation), tag nrho purulent (uas nws kim heev thiab irreversible kev puas tsuaj sis plawv hniav kho extirpation tseem ceeb heev rau kev tiv thaiv ntawm tshwm sim ntawm periodontitis).
• Cov mob hauv daim ntawv ntawm pulpitis: yooj yim, hypertrophic (cov ob hom ntawm txig kho tau nrog cov muaj peev xwm txuag lub hauv paus), gangrenous (puas hom extirpation kho nyob rau hauv ob peb mus ntsib mus rau tus kws kho mob).

Suam ntawm cov MMSI

Cov kev morphology kab mob neurovascular nras yog ib tug ncaj continuation Gofunga hom kev kawm. Classification sam thiaj no MMSI yam khoom muaj xws li exacerbation ntawm tus kab mob ntaub ntawv ntawm pulpitis thiab yuav siv sij hawm mus rau hauv tus account lub feature ntawm o nyob rau hauv tus hniav, ua ntej kho. Raws li qhov no morphology, tus kab mob no yog muab faib mus rau hauv:

• Mob ntaub ntawv ntawm pulpitis: focal los yog diffuse purulent, serous.
• Mob ntaub ntawv ntawm pulpitis: gangrenous, fibrotic los yog hypertrophic.
• Exacerbation ntawm tus kab mob ntaub ntawv ntawm pulpitis: fibrous los yog gangrenous.

Exacerbation ntawm gangrenous hom pulpitis yuav ua teeb meem ntawm ncig, raws li nws yog nquag tsim co microflora. Yog hais tias ib nrab kev tshem tawm ntawm lub paj tsis daws tau qhov teeb meem ntawm mob, ib tug ua tiav hysterectomy los yog pheej rov qab ua mummification raws feem ntau daws qhov teeb meem.

Classification los ntawm Vinogradova

Ib suam ntawm pulpits nyob rau hauv cov me nyuam ua los ntawm cov xibfwb Vinogradova system uas muaj ib tug kom meej meej cais cov kab mob ntawm deciduous hniav los ntawm qhov. Tus kws kho mob piav txog tias mob nyob rau hauv lub mammary thiab hniav puas tshwm sim nyob rau hauv ntau txoj kev. Xibfwb xav kom cov kev kho tseem saum nrog ib ntus hniav thiab txoj kev kho mob insists rau cov rejection tag kis channel. Qhov no yuav ua tau nyob rau hauv kev puas tsuaj rau tus me nyuam tus mus tas li hniav cos.

Ib suam ntawm pulpits nyob rau hauv cov me nyuam muaj xws li cov nram qab no cov khoom:

• Mis hniav pulpitis mob: serous (nyaij sai heev, lobular Daim ntawv no yuav diffuse), purulent (sai sai npog tag nrho sis plawv hniav thiab yuav ua mob).
• Mob pulpitis ruaj khov cim tooj ntawm cov hniav: mob serous tag nrho los yog ib nrab, mob purulent tag nrho los yog ib nrab.
• Mob pulpitis ib ntus thiab lawm set ntawm cov hniav: yooj yim, proliferative los yog hypertrophic, gangrenous.
• Exacerbation ntawm tus kab mob ntaub ntawv ntawm pulpitis ntawm ib ntus thiab lawm cov hniav, feem ntau tshwm sim tiv thaiv ib tug tom qab mob yooj yim pulpitis.

Lub peculiarity ntawm lub inflammatory txheej txheem nyob rau hauv lub ib ntus hniav yog hais tias lub txheej txheem kis mus rau mezhkornevyh qhov chaw uas muaj ntau yam. Qhov no yog vim hais tias cov dentin nyob rau hauv no tsam muaj ib tug high degree ntawm permeability. Qhov no tshwm sim yog txaus ntshai vim hais tias nws yuav ua rau cuam tshuam nyob rau hauv lub tsim ntawm ib tug hniav puas hniav cos, hloov cov hnub ntawm nws uas, txo nws kuj.

Mob pulpitis ib ntus hniav yog yus nyob rau hauv hais tias lawv tej zaum yuav tshwm sim raws li thawj ntaub ntawv bypassing mob theem. Tej zaum lawv yuav asymptomatic, tab sis insidious los ntawm qhov tseeb hais tias heev sai sai kis mus rau lub ncig ntaub so ntswg. Yog li ntawd nws yog tsim nyog los soj ntsuam qhov kev mob ntawm lub qhov ncauj kab noj hniav ntawm cov me nyuam thiab yuav tsum tsis txhob tsis saib tsis xyuas cov kev kho mob ntawm thawj cov hniav.

Nta ntawm kev kho mob ntawm pulpitis

Ib suam ntawm txoj kev kho mob ntawm pulpitis yog ncaj qha txog tus mob. Nws yog tus keej txiav txim seb lub degree ntawm complexity ntawm tus kab mob yuav nyob ntawm seb qhov kev vam meej ntawm txoj kev kho.

Yog hais tias kev hu mus rau tus kws kho hniav tau nqa tawm thaum pib ntawm txoj kev loj hlob ntawm pulpitis, tus kws kho mob yuav ua rau nws txoj kev mus rau lub lom kho mob. Nws muaj nyob rau hauv cov nram no: lub paj ntawm tus hniav yog tsis muab tshem tawm, siv ib tug tshwj xeeb calcium-protivogistaminnye tshuaj. Raws li ib tug ntawm xws li kev kho mob ib tus mob o ntawm lub sis plawv hniav dhau mus, yog tsim substitutive dentin. Thov mus rau ntxuav foob kab noj hniav.

Yog hais tias raws sij hawm kev kho mob rau cov kws kho mob tsis tshwm sim, ces tau ib tug lom kho mob tau raug tu. Rau ntawm no theem, cov kws kho hniav yuav tsum tau to taub dab tsi tus neeg mob sis plawv hniav. Lub tswvyim, kev faib thiab diagnostic txoj kev ua nws raws li muaj tseeb li sai tau.

Heev feem ntau siv txoj kev rau ib nrab kev tshem tawm ntawm sis plawv hniav. Nyob rau hauv tus ntawm tshuaj loog ua tus ntsoos ntsoos ntawm lub paj nyob rau theem ntawm lub crown, lub hauv paus cheeb tsam tseem zaum. Tom qab ntawd muab formulation uas muaj calcium, thiab tus hniav yog ntim. Yog hais tias xav tau yuav, nqa tawm physiotherapy, muab anti-inflammatory kev kho. Xws li ib tug qauv no yog pom zoo rau cov me nyuam uas nws cov hniav saum tseem tsis tsim.

Nws qhia tau hais tias kev kho hniav xyaum, nyob rau hauv Feem ntau, siv tag nrho tshem tawm ntawm lub paj. Qhov no yuav ua tau nyob rau hauv tshuaj loog los yog overlay txoj kev devitaliziruyuschey muab tshuaj txhuam muaj arsenic. Qhov no cov ntaub ntawv uas yog heev tshuaj lom, thiab cov ntaub qhwv yuav tsum tau muab tshem tawm thaum raws nraim lub sij hawm raws li tus kws kho mob. Tom qab hais tias, lub endodontic kev kho mob, thaum lub sij hawm uas tus filling raws hniav gutta percha.

Tom qab xws li ib tug kev kho mob yog nqa tawm X-ray mus xyuas lub zoo tshaj ua nyob rau hauv lub manipulation raws. Yog hais tias lawv tau sau mus txog rau lub sab saum toj, superimposed foob.

Nyob rau hauv cov ntaub ntawv ntawm yuav luag tiav kev puas tsuaj ntawm tus hniav kws kho mob siv ib tus pin -copings, uas yog ua los ntawm cov hniav restoration. Txhua tshwj xeeb yuav qhia rau koj tias yog guaranteed los pab txiav txim seb tus faib ntawm lub sam thiaj no. Kev kho mob yog ib zajlus kom extension meej mob ntawm tus neeg mob cov hniav.

Thov kom tus kws kho hniav nyob rau hauv thaum ntxov ua sawv ntawm pulpitis yog pab rau tus neeg mob. Kev kho mob nyob rau ntawm no theem yog yuav luag tsis mob thiab pheej yig. Yog hais tias koj khiav ib tug kab mob uas tej zaum yuav tsim periodontitis, uas yog nyuaj npaum li cas los kho thiab tshaj.