Pulpitis: gulu, mitundu, chipatala. Gulu la njira ya chithandizo cha pulpitis

Zachilendo koma zoona - matenda monga pulpitis, ali pafupi kuposa 20 gulu. Mano ntchito okha mu njira ya ntchito m'njira zosiyanasiyana mtundu wa ziyenera matenda, koma ananena kuti ngakhale iwowo akhoza 100% molondola kufotokoza mbali zonse za matenda obisika. Mano kuti ayenera yabwino ndi succinct gulu la pulpitis, amene adzalola kuti mufotokozere matenda ndi udindo zonse.

N'chifukwa chiyani ndikufunika m'kagulu guwa?

Pamaso pa chotero systematization lalikulu la matenda mano kugwirizana ndi mosiyana amafuna kufotokoza chithunzi cha matenda. zosiyanasiyana classifications pulpitises kupereka amaona poyamba osiyana: zimayambitsa ndi chitukuko, kupitirira matenda, mavuto a njira zakuya ku muzu ngalande ndi ena.

Pofotokoza ku kumathandiza kupeza ngodya zabwino classifications guwa kuti komabe yapangidwa. Choncho, mano ndi kutchula alipo chithunzi matenda pa mtima munthu mosapatuka njira zilipo za kuwunika. masikimu angapo gulu yapangidwa zaka zapitazo Komabe, ndipo tsopano ntchito ya kumapeto kwa matenda ndi mankhwala a pulpitis.

Zoyesayesa oyamba dongosolo matenda mano uyu anatengedwa mu 20s Mu zaka zapitazo ndipo akhala kufotokoza molondola kwambiri zamkati. classifications izi zinali m'malo ovuta ndiponso wolemera. N'chifukwa chake akatswiri anachita ntchito yopitirira pa kusintha kwa njira matenda kulongosola. Nthaŵi wa zaka 5-10 anaganiza gulu latsopano, ozikidwa pa ziwembu kale, koma anali ndi maganizo zatsopano za maguwa chithunzi.

WHO gulu

Mapeto kwa zaka za m'ma 20, akuti mu 1997, mano zinali zodzaza ndi kukhazikitsa gulu la International wa Matenda, 10 kuzilembanso, amene amadziwika mwa chidule ICD-10. Ndipo anavomereza ndi World Health Organization, ndipo mu 1999 anayamba chimagwiritsidwa ntchito ya kumapeto mano a matenda ndi mankhwala a pulpitis. dongosolo ili ndi dzina la zizindikiro ndi decryption awo kufotokoza chithunzi matenda a matenda. Gawo pulpitises ICD zikuphatikizapo zinthu zotsatirazi:

• Matenda a zamkati ndi periapical minofu mtundu zimasintha amaimira K04 code.
• Mwachindunji guwa encrypted K04.0.
• Siteji yoyamba ya matenda, yodziwika ndi hyperemia, amaimira K04.00.
• Pachimake pulpitis anapereka chitetezo K04.01.
• Ngati abscess ndi chikupezeka, ndi affixed malamulo K04.02.
• Mawonekedwe a pulpitis aakulu anasankha K04.03, ndipo ngati iyi matenda chilonda, iwo akufuna kuti chitetezo matenda a K04.04.
• Ngati wodwala anapeza zamkati polyp mu mawonekedwe aakulu, K04.05 yake.
• Pamene matenda a mantha ndi mtima minofu ya dzino ena mwachindunji chikhalidwe sitampu K04.08.
• Ngati chifukwa cha pulpitis si bwino, akuti malamulo K04.09.
• Necrotic kapena gangrenous chodabwitsa mu slurry ndi mmene malamulo K04.1.
• Ngati mano anaona njira osachiritsika monga dentikli, miyala zamkati kapena calcification, amatanthauza malamulo awo K04.2.
• Pankhani ya mapangidwe nthenda ya minofu khama zamkati Zamkati K04.3. Ndipo ngati osasamba (sekondale) dentin, iwo akusonyeza K4.3X code. Tikumbukenso kuti imeneyi sakuikidwamo calcification ndi miyala zamkati.
• Mu apical periodontitis pachimake chilengedwe zomwe ndi chifukwa cha kusintha kwa zimakhala neuro-mtima kwa dzino, analiyika cipher K04.4.
• Ngati mano wapeza kuti pamaso pake zamkati matenda ndipo zimakhala periapical kuti sizikugwirizana mu mfundo tatchula pamwambapa, izo zimapangitsa cholemba K04.9.

Gawo ili pulpitises WHO, malinga ndi mano, si yabwino kwambiri. Komabe, akadali ntchito ngati chiwembu boma ntchito yokonza malipoti zowerengera wa akatswiri pa ntchito pa ena nthawi. Zizindikiro ndi ciphers wa gulu ili dokotala ayenera kulemba pa khadi ndi mtima khadi. mano ambiri aona kuti nthaŵi ankawachitira kukhomereza matenda mosapatuka chiwembu cha bungwe la WHO, ngakhale ali m'njira chosiyana makhalidwe yachidule kudwala mano.

Makhalidwe guwa la kubadwa kwake

Gawo ili amaganizira pulpitis ndi periodontitis zimayambitsa matenda. Malinga ndi muyeso uwu, mano mitundu 4 matendawa:

• Infection.
• Mantha.
• Konkrementozny.
• Medical kapena mankhwala.

Tiyeni tikambirane lililonse zamkati kuti gulu pofotokoza zimayambitsa.

infective pulpitis

Mtundu wa matenda chifukwa cha ntchito mabakiteriya kuti tiyambe kupanga poizoni ndipo imautsa kutupa ndi mtima mitsempha mtolo dzino. Nthawi 9 pa 10 tizilombo kugwa mu M'mimbamo ngalande dentine kapena kusokoneza poyera padziko mitsempha. Wofala retrograde pulpitis, pamene majeremusi kulowa dzino mwa dzenje pamwamba pa muzu. Izi zimachitika pamene matenda monga matenda pachimake kupuma, chikuku, osteomyelitis, sinusitis kapena periodontitis. Nthawi zina matenda kuvala khalidwe hematogenous. Mbali yotsimikizika kuzindikira guwa - etiology. Gulu la mfundo imeneyi kawirikawiri amagwiritsidwa ntchito ndi madokotala.

zoopsa pulpitis

Tikumbukenso kuti zoipa chifukwa cha njira pathological zimenezi zingawachititse pulpitis. Pankhaniyi, sterility wathyoka dzino cavities ndi matenda awo amapezeka ndi pofuna kukwaniritsa mtolo kutupa kwa mitsempha. Nthawi zina sanaphwanye kukhulupirika kwa dzino ndi malo ake olondola (luxation kapena subluxation). Pankhaniyi, guwa ndi chinsinsi ndipo akuchita popanda nkhani ya tizilombo.

Kuvulala kuvala chikhalidwe tsiku ndi tsiku, zopezera chifukwa cha ngozi kapena choipa, koma mwina chifukwa cha phukusi wosadziŵa zachipatala. Mwachitsanzo, pamene akupera dzino "korona" pulpitis zambiri amapezeka monga chotsatira cha perforating minofu. zodabwitsazi amafuna kukonzedwa mwamsanga. Nkofunika kulemekeza dera dokotala: guwa - Gawo - chipatala - mankhwala. Pakuti katswiri mndandanda ntchito chilichonse, ngakhale nkhani yovuta kwambiri, mukhoza kukonza ndi kupewa kwambiri matendawo zosasangalatsa.

Konkrementozny guwa

Mtundu wa pulpitis kumachitika chifukwa ena mabungwe mu ngalande muzu - dentikley kapena petrifikatov. Iwo kukula mu ngalande ndi cavities compress Mitsempha. Chifukwa cha mikrotsirkullyatsiya wosweka, anapanga kutupa. Chotsatira ndi zamkati ndi.

Medical kapena mankhwala zamkati

Gawo ili guwa samasankha kufotokoza, koma kwenikweni sizachilendo ndipo chifukwa cha zolakwa dokotala. Izi zimachitika pamene mano ikugwira pokonzekera caries m'kamwa kapena periodontal mthumba wothandizila chilengedwe kwabasi (alcohols kapena esters) kapena zolakwa luso chinapangidwa pa wosindikiza.

Gawo ndi Platonov

Ngakhale kuti mtundu uwu wa ziyenera a matenda anali akufuna ndi Professor Platonov mpaka kumbuyo 1968, ndi lero ntchito ndi mano amachita zimenezi. Gawo ili la pulpitis ndi periodontitis amakhala ndi khalidwe lake, koma wabwino mosavuta kumva ndiponso mayiko. The pulofesa mu luso lake ophatikizana njira zitatu: kufufuza njira pathological mu zamkati, chikhalidwe cha matenda, komanso kutanthauzira cha ululu wa. Izi ndi yosavuta, koma matenda capacious dongosolo ziyenera anali ku sanakonde wa akatswiri ambiri amene akufotokoza kufunika kwake panopa. Mu systematization ino inalongosola mbali yaikulu ya zodabwitsazi, monga guwa - etiology, pathogenesis. Gulu la matenda a Platonov chiri motere:

• Pachimake mtundu pulpitis: lobular mawonekedwe (pachimake ululu, omwe ndi bwino kutanthauzira mtima) ndipo akakufunsani mtundu (CHOSADZIWIKA kutanthauzira, anakafika pamodzi mitsempha trigeminal pa nkhope).
• Pulpitis khalidwe aakulu hypertrophic (kutupa zamkati M'mimbamo kudzaza caries), gangrenous (necrosis minofu mitsempha ndi mtima mtolo) ndi fibrotic (mano minofu kusinthika).
• Pulpitis exacerbation mitundu aakulu.

Izi gulu ndi maguwa Clinic wosalira kwambiri ntchito mano, makamaka zipatala bajeti. Childs, zinthu zili choncho, dotolo alibe nthawi kufufuza zimayambitsa matenda mano. Pofuna kukhazikitsa mtundu wa matenda, akukwana kufunsa wodwalayo mafunso ena.

Gawo Gofungu

Njira imeneyi ndi yodziwika kwambiri pakati mano, chifukwa limafotokoza chinthu chofunika kwambiri kudwala ichi monga guwa - gulu, matenda chithunzi, chithandizo. Kamakupatsani Kuganizira magawo a matenda limalola magawo osiyanasiyana matenda ndi kusintha kafukufuku wakapangidwe kazachilengedwe mu zamkati pa ndondomeko yotupa. Malinga ndi dongosolo, mitundu ya matenda ndi izi:

• Mawonekedwe wokonda pulpitis: tsankho (kusintha, angathe kuchiritsidwa ndi kusunga mitsempha kwachilengedwenso), chiwerengero (akakufunsani, kuphimba zamkati lonse, ndipo kuchizidwa extirpation), okwana purulent (zedi ndi kulisiya kuwonongeka zamkati ankachitira extirpation kwambiri pa kupewa zosayembekezereka wa periodontitis).
• Mawonekedwe aakulu a pulpitis: wophweka, hypertrophic (awa mitundu iwiri mwangwiro n'ngochiritsika ndi kuthekera kupulumutsa mizu), gangrenous (zowononga mitundu extirpation ankachitira maulendo angapo kwa dokotala).

Gawo la MMSI

The njira kafukufuku wakapangidwe kazachilengedwe matenda neurovascular mtolo ndi mwachindunji kupitiriza Gofunga njira. Gawo guwa MMSI item zikuphatikizapo exacerbation mitundu aakulu a pulpitis ndipo amaganizira Mbali kutupa mano, pamaso pa kuchitiridwa. Malinga ndi kafukufuku wakapangidwe kazachilengedwe ichi, matenda lagawidwa:

• mitundu wokonda pulpitis: focal kapena akakufunsani purulent, serous.
• mitundu aakulu a pulpitis: gangrenous, fibrotic kapena hypertrophic.
• Exacerbation mitundu aakulu a pulpitis: fibrous kapena gangrenous.

Exacerbation wa gangrenous mtundu pulpitis zingachititse mavuto a periodontal, monga mwachangu osauka anaerobic microflora. Ngati kuchotsa tsankhu kwa mitsempha si vuto la kutupa, ndi hysterectomy wathunthu kapena mobwerezabwereza kukonzera mitembo kuti isawonongeke njira zambiri zochimwazo kumathetsa mavuto athu.

Gawo ndi Vinogradova

Gulu la maguwa ana ofalitsidwa ndi Professor Vinogradova dongosolo kuti amapereka matenda bwino osiyana mano deciduous ku nthawi zonse. dokotala anafotokoza kuti kutupa mu mammary ndi molars zimachitika m'njira zosiyanasiyana. Professor akuonetsa kuti dongosolo kulunjika pamwamba ndi mano kanthawi mankhwala njira akulimbikira kukana lathunthu njira HIV. Zimenezi zingadzetse kuwonongeka kwa okhazikika dzino Mphukira mwanayo.

Gulu la maguwa ana zikuphatikizapo zinthu zotsatirazi:

• Mkaka mano pulpitis pachimake: serous (chimaposa mofulumira, mawonekedwe lobular amakhala akakufunsani), purulent (msanga chimakwirira zamkati lonse ndipo mukhoza sizikutha).
• Pachimake pulpitis okhazikika khalidwe chiwerengero cha mano: pachimake serous okwana kapena tsankho pachimake purulent okwana kapena tsankho.
• Matenda pulpitis kanthawi okhazikika ya mano: wophweka, proliferative kapena hypertrophic, gangrenous.
• Exacerbation mitundu aakulu a pulpitis mano kanthawi okhazikika, nthawi zambiri amapezeka ndi maziko a pulpitis yosavuta aakulu.

The peculiarity wa yotupa ndondomeko mu dzino zosakhalitsa ndi ndondomeko linafalikira mezhkornevyh malo ndi Mwina mkulu. Ichi ndi chifukwa dentin m'dera lino ali ndi digiri yapamwamba ya permeability. zodabwitsazi ndi oopsa chifukwa zingayambitse zipolowe mu mapangidwe molar dzino Mphukira, kusintha tsiku la kuphulika ake, kuchepetsa kukana ake.

Matenda pulpitis mano zosakhalitsa yodziwika kuti Iwo angachokere m'njira yaikulu anyalanyaza gawo pachimake. Iwo akhoza kukhala asymptomatic, koma sioneka chifukwa chakuti mofulumira ndithu wakafika zimakhala periodontal. Choncho m'pofunika kuti aziona bwinobwino moyo wa M'mimbamo m'kamwa mwa ana ndipo sibwino kunyalanyaza matenda a mano chachikulu.

Features ya chithandizo cha pulpitis

Gulu la njira ya chithandizo cha pulpitis mwachindunji ndi matenda. Ndi mwaluso kudziwa mlingo wa kuchulukitsa kwa matenda kudzadalira bwino mankhwala.

Ngati kuitana kwa mano anali ikuchitika pa chiyambi cha chitukuko cha pulpitis, dokotala ulendo wopita ku chithandizo kwachilengedwenso. Amakhala otsatirawa: mitsempha ya dzino kuchotsedwa, ntchito yapadera mankhwala kashiamu-protivogistaminnye. Chifukwa cha zimenezi kutukusira kwa zamkati mipita, aumbike substitutive dentin. Kugwiritsidwa pa kutsukidwa cavities chisindikizo.

Ngati mankhwala yake kwa dokotala sizinkachitika, ndiye kuti n'zotheka chithandizo Tizilombo anaphonya. Pa nthawi imeneyi, mano adzakhala kumvetsa zimene zamkati mtima. Lingaliro, gulu ndi njira yodziwira kupanga izo molondola zotheka.

Kaŵirikaŵiri ntchito njira kuchotsa tsankhu zamkati. Mchikakamizo cha mankhwala ochititsa dzanzi anapanga achire ya mitsempha pa mlingo wa korona, woyendera nthambi muzu amakhalabe yotheka. Kenako anaika chiphunzitso ndi calcium, ndi dzino wasindikizidwa. Ngati mungafune kuti, ikuchitika physiotherapy, mankhwala odana ndi yotupa mankhwala. Njira imeneyi imagwira akulimbikitsidwa ana amene mano nsonga komabe anapanga.

Izo zikusonyeza mano kuchita, nthawi zambiri, ntchito kuchotsa kotheratu kwa mitsempha. Izi zikhoza kuchitika pogonekedwa ndi mankhwala kapena njira anakuta devitaliziruyuschey phala munali Arsenic. Nkhanizi ndi poizoni kwambiri, ndi bandeji ayenera kuchotsedwa pa ndendende nthawi zotchulidwa dokotala. Kenako, chithandizo endodontic, imene kudzazidwa njira dzino gutta percha.

Pambuyo mankhwala ikuchitika X-ray kufufuza chinthu khalidwe opangidwa ku mitsinje mpheto. Ngati ali odzazidwa pamwamba, superimposed chisindikizo.

Pankhani ya chiwonongeko pafupifupi dokotala dzino amagwiritsa pini -copings, womwe wapangidwa kwa dzino kubwezeretsedwa. Aliyense katswiri angakuuzeni kuti adzaperekedwa kwa kudziwa gulu la guwa. Chithandizo ndi zomveka kutambasuka bwinobwino matenda a mano wodwalayo.

Kudandaula ndi mano mu magawo oyambirira pulpitis n'kopindulitsa la wodwalayo. Chithandizo pa siteji ili pafupi sabweretsa chisoni ndi yotchipa. Ngati inu kuthamanga matenda amene angathe periodontitis, amene ali kovuta kwambiri kuchitira ndi zambiri.