Torusalnaya Ukubulawa bamazinyo: zombane, Ukubulawa Zone

Ukubulawa torusalnaya okanye izenzo zomzimba Veisbrem kwindawo yonke le mandible, kuquka inwebu yangaphakathi, amazinyo, isikhumba esidleleni, kwesilevu, kunye ithambo alveolar. Umahluko yale ndlela ukusuka zemveli yokuba ugqirha ufaka ngenaliti ngqo, ngaphandle naluphi na utshintsho ukuthambekela. Torusalnoe zomzimba ke elungisiweyo Ukubulawa mandibular.

Ezibonisa inkqubo enjalo

Torusalny zomzimba indlela ezisetyenziswa kwiimeko ezinjalo:

• ukuphathwa kabuhlungu yamazinyo esitulweni zamazinyo (ukusuka yidityaniso okanye nezokukhupha nezinyo emhlathini ongezantsi);
• ixesha isondo applique airless xa trauma mandibular;
• nokususa amazinyo abunjwe ngokungachanekanga;
• ungenelelo for zokususwa cysts kwakunye nezinye yamathumba kwi mandible (isiganeko eso nayo yenziwa phantsi iintlungu wendawo);
• libamba izinyo ikhule ngokupheleleyo exabileyo amathambo;
• kuvulwe amathumba (ububomvu ezakhiwe), kodwa le meko kufuneka sihlanganise analgesia iintlobo ezininzi;
• nangokukrola ukwesona nezinyo ubulumko emhlathini asezantsi.

Kufuneka wazi

Ukwenza ngokuchanekileyo zomzimba kuyimfuneko ukubona isimo se kuvulwa umhlathi, nto leyo kubekwe kwindawo ezifihlakeleyo eyayizalwa kwemihlathi (ukusuka kummandla phambi kummango kwemihlathi kuluhlu-15 mm kwicala ongasemva - 13 mm ukusuka eludinini engaphakathi yomhlathi ephantsi - 27 mm, kwaye ukugawula yayo - 22 mm). Xa abadala, kulo mngxuma ukwakweli iindawo ihlafuna le imihlathi asezantsi, kwaye abantwana kunye nabantu abadala - ezisezantsi kancinane.

Front kwelivi noqhoqhoqho ukhuselwe ithambo-kuthiwa ummandla ulwimi mandibular. Ngoko ke, ukuze kube lula ngakumbi ukwenza torusalnuyu zomzimba, ngenaliti kwenziwe kwindawo 0.7-1 cm ngaphezu kwenqanaba lokuqala, okt phezu komhlaba kwindawo ulwimi kwemihlathi asezantsi. Kweli nqanaba izalelwe luvo ibekwe emseleni ithambo, apho kukho laphu aneentunja evumela ichiza ukunwenwa ngokukhululekileyo.

Luphi usukelo Ukubulawa mandibular

Uhanjiso zomzimba kwi mandible kwi Veisbrem wayesoloko ebizwa kwakhona torusalnym. Ngokungafaniyo inkqubo eqhelekileyo, umsebenzi yale ndlela kukufikelela endulini mandibular, apho livela ithumba ithambo - inyama condylar ezimbaxa iintsholongwane coronal. Ibekwe phezu ngaphandle wesahlulo closed kwemihlathi ithambo ephantsi kufutshane ulwimi. Le mithambo ihleliwe e ifayibha, abaqhagamshelwe kwi buccal, zeelwimi kunye zemithi luvo mandibular. Enasilela alveolar nemithambo block olwenziwa iindlela intraoral kunye extraoral. Xa indlela intraoral iindlela ezimbini zomzimba ezifana: Ngokucofa kunye apodaktilnaya (ngaphandle zokuhlola).

indlela palpatory

Ukubulawa usebenzisa Ngokucofa. Ukuze wenze oko, kufuneka ufumanise indawo ngayo Crest, zexeshana (it is a yimbalasane inaliti okuhlatywa) kunye lekhefu pozadimolyarnogo. ithambo Crest, zexeshana ukuba ababetheki elisuke intsholongwane coronal nodonga zeelwimi kommandla mandible alveolar. Kwinxalenye engaphakathi ikama yohlulwe imivalo zangaphakathi nangaphandle. Zakha indawo encinci - unxantathu pozadimolyarny.

Ezo imfuneko zomzimba ukwahlula neoplasm evela pozadimolyarnoy fovea, ekummandla phakathi Crest, kunye nommandla nezenyama emhlathini esezantsi ngaphambili. Kulo kulandela ukuthi ikhefu pozadimolyarnoe ibekwe ecaleni nxantathu. Ukuba torusalnoe zomzimba yenzelwa kwi ekunene, ngoko amahlandinyuka nokudleka iviwe ngesandla nge umnwe esandleni sakhe sasekhohlo, ukuba ekhohlo - nakusithupha wesandla efanayo.

Torusalnaya izixhobo Ukubulawa:

1. Isigulane Wathi ubuninzi ukuvula umlomo wakhe lwenziwe ngohlangothi phambi inkqubo mandibular kwinqanaba le distal wesithathu izinyo izithsaba iimpawu (ukuba akunjalo, ngoko ngenxa izinyo yesibini).
2. Ukuhambisa ngomnwe kancinane ukuya ngaphakathi, ugqirha ifumana ikama zezomzuzwana, ke ubeka umnwe pozadimolyarnoy kwi elitywinwe, nto leyo iingqameko ngokuncama kwezi zakhiwo yokwakheka.
3. Ukulungisa isirinji phezu komhlaba premolar kwelinye icala, yingcali uphumeza inaliti inaliti kufutshane Crest, kwi-temporal 0.8-1 cm ngaphezu kwenqanaba ukuhlafuna izinyo wesithathu, ngoko eshukumisa inaliti ngaphandle kunye ngaphakathi.
4. Ngoku torusalnoy zomzimba nqubo Ngakho: inaliti ifikelela ithambo kubunzulu ethile 0.5-0.7 cm, kule ummandla yaziswa igcuntswana leyeza amayeza intlungu luvo zeelwimi, alveolar obuphantsi ibekwe phambi kwe-luvo.
5. Ngoko ke liya mgawuli isabelo isirinji, kunye inaliti kumphatha ngasentla, okt zifana kuya inxalenye yenkqubo engaphandle closed kwemihlathi ephantsi, ukuba ubunzulu 2-3 cm ukuya chamfer ithambo apho luvo alveolar, kwaye umthamo esele iintlungu na zifakwa.

Xa usebenzisa amayeza yangoku iqela amide "R-S articaine Forte", ithetha ithamo elawulwa yi malunga 2 ml.

Apodaktilnaya ndlela

Isikhokelo esingundoqo ukuphunyezwa indlela enjalo ingqalelo likriwa Pterygopalatine-mandibular, nto leyo ibanjiwe kakuhle. Kusenokuba ububanzi emxinwa, ebanzi okanye medium, ibekwe kwinxalenye engaphakathi Crest zexeshana.

Njani na inkqubo

Torusalnaya Ukubulawa woogqirha bamazinyo lwenziwa ngolu hlobo lulandelayo:

1. Wamazinyo uxelela isigulane ukuvula umlomo wakhe ububanzi, yaye emva koko ithumba isirinji kwinqanaba umhlathi elisezantsi.
2. Yolula inaliti awazithwalela engaphandle ithambeka pterygopalatine-mandibular likriwa kwi embindini phakathi iinqwelomoya ihlafuna le imihlathi ephezulu nesezantsi (ukuba iyafumaneka - ngoko tiko inxenye interm lwamawa alveolar kunye intsholongwane).
3. zeengcali ezithe vetshe ukhuthaza inaliti kwicala nomphandle wocango lomphetho ukuya uqhagamshelwano ifayibha ithambo ukuya ubunzulu 1.5-2 cm, ngaleyo ndlela amayeza eentlungu kunye luvo ezantsi zeelwimi alveolar. Pterygopalatine-mandibular ivalile reference echanileyo ngaphantsi ikama zexeshana.

ukufikelela extraoral

Ukubulawa torusalnaya mandible ebanjwe ngale ndlela, ukuba, umzekelo, kuvela ngomlomo lokuvula iingxaki. Njani lo mcimbi:

1. Umiselwa ezayo i slits mandibular apha esikhumbeni. Kulo mngxuma ise embindini zephetshana, osusela kumphezulu elunxwemeni tragus wendlebe ukuya kwindawo ekudibaneni kwe-imigca phambi esihlunwini masseter.
2. Yolula inaliti wenziwe endaweni kwemihlathi isiseko kwi 1.5 cm ukuya kwikona phambi engile wayo.
3. Ngoko ke inaliti ihamba nje ngentla 3-4 cm phezu komhlaba inkqubo okuvala mandibular lokuvula eyayingqalene ecaleni layo umva. Ngexesha sicatshulwa inaliti kufuneka ukugcina qhagamshelana zawo ithambo.
4. Ekupheleni kwale iintlungu leyo zifakwa. Emva koko, eliqhubela inaliti anokunyuswa 1 cm, izibandakanya abanye amayeza iintlungu, iyavala ulwimi luvo.

indawo Ukubulawa

Ukubulawa torusalnaya ngokuyintloko yenziwe ukuze anesthetize eminye imimandla nangoko em- zomlomo, ezizezi:

• zeelwimi nemithambo obuphantsi alveolar;
• kwesilevu isikhumba kwisiza Ukubulawa;
• amazinyo mandibular inxenye;
• mucosal nolusu umlebe asezantsi;
• kwicala bone alveolar kunye inxalenye umzimba mandible;
• indawo isifo sublingual kwaye phambi ulwimi 2/3;
• inwebu kwiinwebu i alveolar kodonga indawo ukuya zeelwimi kunye kummandla vestibular.

Ezinye alveolar isifo egumbini inxalenye mandible kuluhlu ukusuka embindini premolar yesibini yee yokuqala izinyo innervated. Ukuze anesthetize ngokupheleleyo indawo zomzimba mandibular lwenziwa ngolu hlobo lulandelayo: 0.5 ml zenyuse amayeza ezongezelelweyo emhlambini eliphakathi ngohlobo nokungena zomzimba.

japan iintlungu kwindawo zomzimba ezifana iqala emva kwemizuzu 15-20. Ubude zomzimba nama-60-90 imizuzu. Ebukhulwini zomzimba kule ndawo siphume kunye canines zithe kakhulu ngenxa anastomoses ngesandla esahlukileyo. Nale zomzimba asebenzisa iziyobisi ezifana: "Novocaine," "Trimekain", "Ultrakain" okanye "lidocaine".

ukungaphili

Ukubulawa torusalnaya ingenza nokuba yingozi, ngolu hlobo lulandelayo:

• hematoma kwenkumbulo;
• iinaliti zaphuka;
• izixwexwe ube pharyngeal;
• neuritis kunye zeelwimi asezantsi luvo alveolar;
• umonakalo ebhekiswe contractures kwezihlunu pterygoid kunye luhlobo ngakumbi mandible.

Iingxaki zikhankanywe ngasentla kwenzeka nokunyhashwa ubuchule enkqubo zomzimba. Ngoko ke, lo zomzimba ebambe torusalnoy - inkqubo kunzima kwaye ifuna emfundo ephakamileyo wamazinyo.