Zvisiri-carious lesions mazino: marudzi, zvikonzero, kurapa

Zvisingatauriki zvinokonzera mazino zvinowanzoitika mune mazino maitiro. Iyi pfungwa inosanganisira zvirwere zvakasiyana-siyana ne etiology yakasiyana uye zviratidzo zvekurapa.

General concept

Zvisiri-carious lesions mazino - boka rakakura rezvirwere uye pathologies. Izvi zvinosanganisira zvose zvinokuvadza kuEamel, mazino emishonga, chirwere chekusina bhakitiriya. Mukuwanda, vanogara panzvimbo yechipiri mushure mekuora mazino. Izvo zvipembenene zvinogona kuva nezviratidzo zvakasiyana-siyana uye kliniki yemifananidzo, vane zvikonzero zvakasiyana uye zvinokonzera. Asi ivo vose vanozvarwa kana kuti vanowana.

Vanogona kunge vakapararira zvakasiyana - kurova rimwe kana mazino ose ari mumutsara, mumwe munhu anosungira mune imwe nzira. Zvizhinji zvezvirwere izvi zvakaoma kufungidzira, sezvo zviratidzo zvekusiyana kwezvirwere zvakafanana uye zvakaoma kusiyanisa kubva kune mumwe. Izvi zvingave zvakakonzerwa nehuwandu hwechirwere chechirwere, chinosanganisa kuonekwa kwayo uye kuwedzera ngozi yezvinetso. Mune mamiriro ezvinhu aya chete, makiriniki emakirini chete anogona kubatsira, kwaanozosarudza kurapa kwakakodzera (somuenzaniso, "SM-Clinic", iyo ine mapazi akawanda muMoscow, "Diamed" kana kuti "DentaLux-M").

Kuenzanisa kwezvipembenene zvisiri izvo

Pamusana pezvirwere zvakasiyana-siyana zvinoreva pfungwa ye "zvisingaoneki zvinokonzera mazino," maitiro avo haana rimwe rinogamuchirwa. Kana iwe uchidimburira data yose, unogona kuwana ruwandu rwemhando yemhando yezvionda.

1. Pathology yekufambira mberi nekutengesa:

• Anomaly yemaumbirwo, ukuru.
• Fluorosis (meno akavaraidza).
• Hypoplasia ye enamel (kukuremara kwekuremara).
• Kurapa kwechimiro chemazino evanhu vane nhaka (odontogenesis, amelodentinogenesis).
• Syphilis (congenital).
• Dzimwe hutano hunobudirira hunoenderana nekunze kwezvinhu (kutora antibiotics, rhesus conflict).

2. Kuchinja kwechirwere chetachiona mune mazino akaoma mazino:

• Zvose zvakakwana kurasikirwa.
• Erosion.
• Ruvara ruchishandurwa mushure mokuputika.
• Hypersensitivity yematumbu.

3. Kuchinja mukati megadziro mukati mezino :

• Kuputsa kwemukati.
• A kubudiswa kwemudzi.
• Kuputsana kwekorona rezino.
• Kuvhura kwemaspire.

Munyika yedu kakawanda shandisa rimwe rutivi, rwakarongwa muna 1968 naVK Patrikeev. Maererano nahwo kwete maziso emakumbo mazino akaparadzaniswa kuva mapoka maviri.

1. Matambudziko anoitika asati aputika:

• Kuipa kwekuputika uye kukura.
• Hypoplasia yemeno.
• Hyperplasia.
• Fluorosis.
• Hereditary pathologies.

2. Matambudziko anoitika mushure mokuputika:

• Erosion.
• Chiremara chakaita somuti.
• Necrosis yematundu akaoma.
• Hyperesthesia yemeno.
• Erasing.
• Kukuvadza kwemeno.
• Pigmentation.

Hypoplasia

Iri ndiro zita rehutano hwekuvandudzika kwemazino emazinyo panguva yekuumbwa kwayo, kureva kuti, muvana vasati vasvika. Ichi chirwere chinokonzerwa nokusakwana kwema minisitiri. Chinhu chinokosha ndechokusavapo zvachose kwechirongwa kana kukura kwechidiki zvishoma. Hypoplasia yemeno mazino inogona kunge yakabatana uye inokura mushure mokuzvarwa kwomwana. Pane zvikonzero zvakawanda zveizvi:

• Kurwisana neRh chinokanganisa amai nevana,
• Amai-vanotakura chirwere chinopararira panguva yekuzvitakura, chirwere mumwana mushure mokuberekwa,
• A strong toxicosis inobata pamuviri,
• Kuberekwa kusati kwaitika, kushungurudzika panguva yekuberekwa,
• Pathology yekukura kwevana mushure mokuberekwa,
• Dystrophy, zvirwere zvegumbo remimba,
• Matambudziko emagetsi,
• Uropi hunoita uropi,
• Misiki inoparadza murusha.

Kune marudzi maviri e hypoplasia - systemic uye munzvimbo. Yokutanga inoratidzika nekukundwa kwemazino ose, kuderera kweeamel kana kusipo kwayo. Inotarisa nzvimbo dzemajena. Inzvimbo imwe inokanganiswa nhengo imwe kana mbiri. Pano pane kushayikwa kweeamel (kusarura kana kukwana), kukanganiswa kwemaitiro emeno - vanogona kuora mwoyo. Kukanganisa kwakadaro kunokonzera kurwadziwa. Hypoplasia muhutano hwakaipa inokonzera kuwedzera kubvisa kwemazino, kuparadzwa kwemasukisi kana kurasikirwa kwakakwana kwechirongwa, kukura kwekumwa kusina kururama. Kurapa kwe hypoplasia kunosanganisira mazino ekuchenesa (panguva yekutanga) kana kuzadza uye prosthetics (ane chirwere chakaoma). Panguva imwecheteyo, kugadziriswa kweeamel nemagadziro emishonga (semuenzaniso, calcium gluconate solution). Nekudzivirira kutanga kwe hypoplasia muvana, vakadzi vane pamuviri vanokurudzirwa kudya kwakakwana kune vitamins kune meno (D, C, A, B), calcium uye fluoride, pamwe nekuchenesa kwakachena kwemukati.

Hyperplasia

Hyperplasia - kwete-carious mazino emeno anobatanidzwa nekunyanya kugadzirwa kwamazino mazino. Chimiro chavo chinokonzerwa nemunhu asina kukanganisa mukugadzirwa kwe epithelial cells, enamel uye dentin. Inowanikwa nenzira ye "madonhwe", ayo anonziwo "enamel maparera". Inogona kusvika 5 mm muhupamhi. Nzvimbo huru yekuwana nzvimbo ndeyemutsipa wezino. Donho rakadaro rinosanganisira mazino enamel, mukati maro rinogona kuva dentin kana kuti zvinyoronyoro zvinokonzera mavara zvakadai seppp. Kune marudzi mashanu emhando dzakadaro maererano nemaitiro avo:

• Chokwadi-enamel - inosanganisira chete enamel,
• Enamel-dentinal - sheam enamel ine mukati meDentin,
• Enamel-dentinal madonhwe ane maspp - mukati mumiririri unobatana,
• Dorosi Rodriguez-Ponty - enamel maitiro mu periodontium pakati pemudziro uye alveolus,
• Intradentinal - iri muhutu hwe dentin.

Hyperplasia ye mazino mazino haazviratidzi wega kuchipatara, haisi kukonzera marwadzo, kuvhiringidzika kana chero kusagadzikana. Iwe unogona kungosimbisa chete maitiro ekutenderera kana iyo anomaly inobata mazino apamberi.

Muchiitiko ichi kukera uye kuenzana kwepasi kunoitwa. Mune zvimwe zviitiko, kana murwere asina hanya, kurapwa hakuiti. Matanho ekudzivirira anosanganisira mukudzivirira meno emazino kubva kune caries, sezvo kuparadzwa kwavo kunogona kukonzera kukanganisa mukugadzirwa kwamazino anogara.

Fluorosis

Fluorosis inowanikwa panguva yekuumbwa kwemazino emazino nekuda kwekuwedzera kwema fluoride mumuviri. Inoshandura chimiro chakanaka cheeamel uye chinokonzera kukanganisa kwayo kwekunze - kuonekwa kwemavara, streaks, mafoshoro, rima inclusions. Mukuvandudzika kwehutano hwakadaro, iyo inobatwa kwete kwete chete nehuwandu hwe fluoride, asiwo nekushaikwa kwe calcium. Mumuviri wevana, fluoride inowedzera uye inokurumidza kupfuura vanhu vakuru, ine zvokudya nemvura. Kune marudzi akadaro e fluorosis:

• Dashed - inoratidzwa nekuonekwa kwemapoka machena pasina tsvina yakajeka;
• Inoshandiswa - inoratidzwa nekuvapo kwemavara matsvuku neinobwinya pasi;
• Melovid-mahwanda-matte kana shina mavara, ane mavara machena, machena kana machizha (anogona kunetsa mazino ose);
• Kusviba - kukanganiswa kwakawanda kwehutambo hweeamel;
• Kuparadza (zino rakaputsika kana rakaputsika zvachose) - zvinokuvadza zvinosanganiswa ne fluorosis.

Nzira dzekurapwa kwe fluorosis dzinosiyana zvichienderana nehuwandu hwechirwere. Saka, ine mavara akaonekwa, kuchenesa nekudzokorora kunoitwa, kana zvichidikanwa - kubika kwepamusoro kweeamel. Asi chimiro chinokonzera hachikwanisi kurapwa nenzira dzakadaro, zvakakosha kudzorera mazino nemavhena kana korona. Nzira dzakajairika dzekurapa dzinosanganisira yekudzokorora, kudzorerwa kwechimiro uye mararamiro echirongwa, mamiriro emunharaunda mumuviri, kutarirwa kwefluoride kudya.

Erosion

Zvisizvo zvisingaoneki zvinokonzera mazino zvinosanganisira kukanganisa kwakadaro kuonameri sekukura. Kuumbwa kwaro kunotungamirira ku-discoloration, kushaya maitiro kunokanganisa dzino, pamwe nekuwedzera kwekunzwa. Inoratidzwa panguva yekuonekwa. Kuora kwezino kunoratidzirwa nekuparara kwekuwedzera kweeamel uye dentin, iyo chirwere chechirwere chisingaperi, chinogona kutora nguva yakareba. Chikonzero chehutachiona chinogona kuva chemajini, semuenzaniso, paunenge uchishandisa mabhurani akaoma kana mapepa ane mabrasive particles. Uyezve, kudengenyeka kunogona kukonzerwa nemakemikari anowanikwa kune enamel kana achipedza kudya nekumwa neup acidity (pickles, marinades, juisi dzemucrosi nevamwe). Vashandi vekugadzirwa, vanobatanidzwa nekugara kwekudzivirirwa kwezvinhu zvinokuvadza, kazhinji vanotambura kukuvara kwakadaro kumeno. Kushandiswa kwemimwe mishonga kunogona kuita kuti kutanga kwechirwere (somuenzaniso, yakawanda ye ascorbic acid inokanganisa inamel).

Chinokonzera kudengenyeka kwemazino kunogonawo kuva kusakanganiswa mubasa remuviri (kuwedzerwa acidity yemamiriro ayo ezvinhu) kana chirwere chetachiona. Tsvaga chirwere chiri mukutanga kwekutanga chakaoma, sezvo ichizviratidza chete nekurasikirwa kwekuvhenekera pane rimwe divi rega rega rakasiyana. Imwe nzira inowedzera yechirwere inoita kuti kuderera zvishoma nezvishoma kweeamel uye dentin. Inoratidzika semeno akacheneswa, kazhinji pane pasi. Mishonga inobva pakugadzirisa kuparadzwa kwemavara mazino. Inosanganisira kushandiswa kwezvidzidzo nehuwandu hwe fluorine uye calcium kwemazuva anenge makumi maviri, ipapo nzvimbo inobatwa yakazara ne fluorine. Zvinokwanisika kushandisa veneers kana korona kuti udzore maonero ekuona. Chirwere ichi chakaoma chinosanganisira calcium uye phosphorus mazano, uyewo mavitamini mazino. Kana iwe usingabati kudengenyeka, zvinogona kukonzera hyperesthesia yemeno.

Hyperesthesia

Hyperesthesia yemeno inoratidzwa nekuwedzera kwekunzwa kweeamel uye mumatambudziko akawanda chiratidzo chinogadzirisa chemwe zvirwere zvisingaoneki. Kuwanda kwehutachiona uku kwakanaka: inenge 70% yevanhu vanobatwa ne hyperesthesia, vakadzi vanowanzosangana nematambudziko. Kuoneswa kunorwadza kwakanyanya, kunorwadza kusingagumi kwemashure makumi matatu uye kunooneka apo kunze kwezvinhu zvinoshanda pane enamel. Hyperesthesia inogoverwa kuva zvipenyu maererano nemitemo yakawanda:

1. Kuparadzirwa:

• Chimiro chakakosha - chinokanganisa rimwe kana mamwe mazino;
• Generalized - inozivikanwa nekunzwisisika kwezvikamu zvose.

2. Nheyo:

• Fomu ye hyperesthesia inobatanidza nekurasikirwa kwemavara mazino;
• Hazvibatanidzi nekurashikirwa, kunokonzerwa nemamiriro ezvinhu emuviri.

3. Clinical picture:

• Zvinorwadza zvinomuka sezvinoitika kune kutonhora kwekunze kwekunze (mvura inotonhora);
• Manzwi anobata kumakemikari anotsamwisa (zvokudya zvinotapira kana zvechidimbu);
• Kuita kwezvose zvinokonzera, kusanganisira tactile.

Kurapa kwe hyperesthesia kunosarudzwa nenyanzvi, zvichienderana nechikonzero chekuitika kwayo, kuoma kwechinetso uye chimiro chechirwere. Mune zvimwe zviitiko, kupindira kwekuvhiya kunokosha (somuenzaniso, pakuderera kwechirwere chepamu uye kudonhedzwa kwemucheto wezino renzino), uye dzimwe nguva nzira dzokurapa, dzakadai sekushandisa shandisa fluoride-ine zvivako kune zvakakanganisika, inogona kudziviswa. Orthodontic therapy inogona kudiwa nokuda kwe hyperesthesia nemhaka yekuwedzera kuderedza mazino. Matanho ekudzivirira anosanganisira kushandiswa kwemaminerari ose anodiwa uye mavhitamisi kusimbisa maitiro emishonga, kushandiswa nguva dzose uye kwakakodzera kwemishonga yehutano hwemuromo, uye kuongorora gore negore nechiremba wemazino.

Chiremara chakaita somuti

Chiremera chakafanana nemakumbo ishoko rezino, umo maitiro aro akaparadzwa. Kunze kwekunoratidzika kukanganisa kumutsipa wezino mukati mekuita kwebhanhire. Mafanga anowanzotadza kushaya kukwana. Pakutanga kwekutanga isingaonekwi, zvakaoma kuongorora. Nekanguva refu yechirwere, mumvuri werima unowanikwa munzvimbo yechironda. Chiratidzo chikuru chechiremara chakave chakafanana nechokuti mazino anoita zvinorwadza kumusana wekushisa kwakakwirira kana kwakadzika, zvokudya zvinotapira, zvinokonzera (kuchenesa). Chikonzero chekuvandudzwa kwechirwere chacho chingave chisina kutenderwa nehutano hwemuromo, kushandiswa kwakashata kwebhurashi - kana mushure mekuchenesa pasi pefupa rakasara rinoramba riri bhakitiriya, rinoparadza sora, rinotungamirira kuremara yakaita semakumbo. Uyezve, chirwere chegum chakadai se gingivitis uye periodontitis, utachiona husina kunaka, huwandu hwegastric acidity, hunoita kuti kuora mwoyo kunogonawo kuva chikonzero. Kurapa kwechiremera chakafanana nemakumbo kunoenderana nekuoma kwechiremera.

Nekusavhiringidza kuduku, zvakakwana kuita zvirongwa zvekudzorera izvo zvichazadza calcium ne fluoride muzino rezino uye kupedza kugona kwaro kune zvinhu zvekunze. Nekukuvadza kukuru, haugoni kuita kunze kwekuisa chisimbiso. Nemhaka yenzvimbo isinganzwisisi yechirema, zvisimbiso zvakadaro zvinowanzobuda. Idzo dzakanakisisa dzemakiriniki dzinogona kugadzirisa dambudziko iri nekukanda gomba reimwe chimiro chinobata chisimbiso, uye kushandisa zvinyorwa zvakasununguka.

Necrosis yematundu akaoma

Necrosis yematokisi akaoma emazino epakutanga kwekutanga anotaridzirwa nekurasikirwa kweganda re enamel, kuonekwa madonho maduku. Mune nzira yekuvandudza chirwere chacho, inosviba. Munharaunda yakatambudzwa, kunyorera kwemasumbu kunoitika, iyo enamel inorasikirwa nesimba rayo, murwere anokwanisa kunyunyuta kuti zino rakaparadzana. Ikoko kune mavara eve dentin. Kazhinji hazvisi nhengo imwechete inobatwa, asi yakawanda. Kunzwa kuwedzera kunokonzera kukurudzira. Iyo inowanikwa panzvimbo pfupi pamutsipa wezino, pamwe chete nechiremera chakafanana nemakumbo uye kudengenyeka. Asi, pasinei nezviratidzo zvakafanana uye nzvimbo yechironda, chirwere chemazino chichiziva chinogona kusiyanisa zvirwere izvi kubva kune umwe uye kuita sarudzo yakarurama. Izvi zvirwere zvinopesana nehutachiona hwekushungurudzika kwehomoni mumuviri. Chirapa chinangwa chekusimbisa mazino emazino, kubvisa hypersensitivity (hyperesthesia), uye nechirwere chakakomba chinogadzirisa chirwere cherape.

Kukuvara kumeno

Izwi re "tsvina rinokonzera" rinosanganisira kukanganisa kwechimiro chemagetsi chekunze kana mukati memakumbo ezino. Zvikonzero zvekuitika kwavo zvinogona kunzi mapofa, jabs pamasana panguva yemitambo, hondo, njodzi. Nekuwedzerwa kwenguva yakareba kune dzino kune dzimwe nyika kana zvokudya zvakasimba, mishonga inowonda uye inoputika. Munyaya iyi, dambudziko rinogona kuitika kunyange kana ichichera zvokudya.

Kukuvara kwemazino kunogona kukonzerwa nekutadza kwemazinyo maitiro, semuenzaniso mashomanana ekuisa pini. Zvimwe zvirwere, zvakadai se hypoplasia, fluorosis, cervical caries, uye midzi midzi inogona kutungamirira kukuvara. Kukuvadza kunosanganisira kuputsana kwekorona kana midzi, kusanganisa, kuora mazino. Kurapa kwekukuvara kunobva pakuregererwa kwezvisikwa zvemuviri pane chirwere chinorwara, kuramba kwezvokudya zvakasimba. Mukurapa kwekusimuka, dzino rinodzokera kune tsime kune mamwe engraftment. Kana kushanda kwakadaro kusina tarisiro, maererano nehutano hwemazino, prosthetics kana kushandiswa kunoitwa. Kuputsana kwekorona kunoda kurapwa nokukurumidza kuti usadzorere kwete chete chekuita mabasa, asiwo maitiro akadai, kunyanya kana mazino epamberi akaparara. Muchiitiko ichi, korona dzisiri dzisingabviswa dzinoiswa. Nekuvhuvhuka kwemuti, dheti rakakwana rezino rinowanzoitwa kuti rise pini kana kuiswa.