Ukugqithisa kwe-pulpitis engapheliyo. Izizathu, ukuxilongwa ngokuhlukileyo, unyango lwe-pulpitis engapheliyo

Mhlawumbi, akukho mntu onjalo ongakaze abe nesifo sezinyo. Yaye xa, njengoko bethetha, inkqubo ihambe, zonke iziko zentlupheko zijikeleze enye inyolo ekhuni. Ukuba uyeka ukutyelela kwidokotela wamazinyo kamva, isiguli sinalo lonke ithuba lokukwazi konke "ukuzonwabisa" kwesipilpitis esingapheliyo.

Iyintoni intsingiselo yenkqubo?

I-Pulpitis, xa ikhoyo, inqubo yokuvuvukala eqhubekayo kwisiqhwenga se-vascular-neural in the channel channel and their part. Ukuba isigulane saguqulela ugqirha ngezikhalazo zentlungu enzima (oko kukuthi, kukho i-pulpitis ephazamisayo), kwezinye iimeko, inkqubo yokuvuvukala inokumiswa kwaye izinyo zingagcinwa.

Kwimeko ye-pulpitis engapheliyo, i-pulp iyancipha, i-necrosis okanye inguqu ye-neurovascular sack isingqinisiso, kuze kube yimeko enjalo ukuba yonke into edibeneyo igcwele izicubu zayo, ezibangele ukukhubazeka.

Eyona nto ihlala ihamba nge-pulpitis engapheliyo, iintlungu ezinzima azenzekanga, kwaye izigulane ziza kudokotela ukuze zilondoloze izinyo ukususwa. Nangona kunjalo, uhlobo olungapheliyo lwe-pulpitis luhlala luhlala luyisifo esingenakuguquka.

Izizathu zokuphuhliswa

Nayiphi na isifo esinezinto ezifunekayo kunye neemeko eziye zaphazamisa ukuphuhliswa kwenkqubo ye-pathogen. Akukho nto kunye ne-pulpitis. Iifom ezingapheliyo zezi sifo ziyacaphunyiswa ngama-microorganism kunye nemveliso yezinto ezibalulekileyo. Njengomthetho, ukuqala kwazo zonke iziqalo kubakho kwisigulane se-caries enzulu okanye unyango olulungekileyo lwalukhuseleko olubanzi. Igama lokugqibela lithetha ukungabikho kokugcinwa kwenkqubo yokucubungula izinyo ezigulayo, ukucoca okwaneleyo kwendawo yokuhlala, isitywina esingenakulungelelwa, njalonjalo.

Izizathu ezincinci eziqhelekileyo ze-pulpitis ezingapheliyo, ezibangele ukuphuhliswa kwenkqubo ye-pathological, ingaba yintlungu kuzinyo, ukucinywa kweendlela ezithintekayo kwintsimbi ye-neurovascular with stops stoppers ("concrements"). Kwakhona, i-pulpitis engapheliyo ingabonakala njengenkxalabo kwi-maxillofacial kunye nezifo eziqhelekileyo (sinusitis, i-influenza, i-periodontitis, i-osteomyelitis, i-periostitis, njl.) Ngexesha lezifo ezinjalo izifo ezincinci zingangena kwi-root of the teeth.

Iintlobo zenkqubo engapheliyo

Amazinyo ahlukanisa iintlobo ezintathu ze-pulpitis engapheliyo: i-hypertrophic, fibrous, gangrenous.

Kwinkqubo ye-hypertrophic in a planeous plane, kukho ukunyuka kwama-pulp tissue ngendlela ye-polyp. Njengomthetho, isigulane sibona ukwakheka kwegazi, okuphazamiseka xa ufuna ukutya. Iintlungu zinokumodareyitha kwaye zibangelwa kwiimeko ezininzi ngeengxaki zangaphandle ezivuthayo.

Ifom yefiber ifumaneka ngokuphindaphindiweyo kwaye ibonakaliswa ngokukhawuleza ivakalelwa iintlungu ezibuhlungu eziphakathi kweentsuku ezingama-1-2 ziphela ngokwazo, kodwa i-carious cavity ihlala iphuma rhoqo.

Ifom ye-Gangrenous ibonakaliswe ngokuqhekeka okupheleleyo kweethambo zezinyo zezinyo kunye nokutshabalalisa okukhulu inxalenye yesithsaba sezinyo. Le fomu ye-pulpitis ihlala ihamba kunye nephunga elimnandi emlonyeni. Iimvakalelo zobuhlungu, njengomthetho, zinyameko, zivela ngezikhathi ezithile. Izikhalazo eziqhelekileyo zesigulane kule meko zibukeka ngathi: "inyoyo yayigula kakhulu, yabe isigcina".

Kubalulekile ukuba kuqaphele ukuba amaninzi amaninzi (≈ ama-70% amatyala) oogqirha abafumana i-pulpitis engapheliyo, ingaphantsi kaninzi. Ifom ye-hypertrophic kwizigulane zabantu abadala abakwenziyo. Ukuxilongwa ngamanye amaxesha kubeka amazinyo abantwana.

Ukuxilongwa kwe-pulpitis engapheliyo

Ukuze uhlolisise, ugqirha, ngaphezu kokuphulaphula izikhalazo zesigulane, kuya kufuneka ufezekise amanyathelo athile, equkethe uvavanyo olubonakalayo lwezinyo ezikhulayo, i-thermometry, i-EOD kunye ne-radiography.

Ekuhloleni okubonakalayo ugqirha ufumana malunga ne-50% yolwazi malunga nemeko yezinyo. Ucwaningo lwe-thermometric kwiempendulo ezibandayo kunye nezitshisayo zinika ithuba lokuqonda uhlobo luni lwesifo kunye naluphi uhlobo lwesifo isigulane saphendukela kugqirha. Ngokomzekelo, impendulo kumakhaza athi "inzwa" ayifile.

I-Electroodontodiagnosis (i-EOD) yenye yezona ndlela zithembekileyo zokufumanisa i-pulpitis. Le ndlela isekelwe ekubeni iishubhu ezigulayo kunye neempilweni ezinempilo zinobuchule obuhlukeneyo bombane. I-nerve ephilileyo iya kuphendula ngeentlungu ezincinci kwi-intensity ye-2-6 μA, i-pulpitis ene-fibrous ngentlungu efanayo efanayo iya kuphendula kwi-35-50 μA, i-gangrenous iya kufuna ukuvezwa kwi-60-90 μA.

Iimpawu zobugcisa ziquka ukuvavanya isimo sezinyo ukusuka kwimifanekiso ye-x-ray.

Ukuxilongwa okungafaniyo kwe- pulpitis engapheli kubandakanya ukuhlolwa okubanzi kwezi ndlela zingentla kunye nohlalutyo olulinganiswa nolwazi olufunyenweyo kwinkqubo yokuxilongwa.

Isibonakaliso se-pulpitis esingapheliyo

Ngokuqhelekileyo, isifo esi sihlandlo sisinxilongo. Ungayiqonda njani ukuba umntu unesipilpiti esingapheliyo? Izikhalazo ziyancitshiswa kakhulu phambi kobuhlungu obubuhlungu obuhlukeneyo phakathi kwexesha.

Ifom ye-fibrotic, njengomgaqo, kukho ukuvalelwa kwintlungu ngenxa yesenzo sezinto ezicasulayo (ezitshisa, ezibandayo, ezithambileyo). Iintlungu azihlali ixesha elide nangona emva kokuba umphumo we-stimuli ususwe. Uphawu oluphawulekayo kukuphuhliswa kwengqondo eqhubekayo xa ixesha lokushisa langaphandle liguquka ukusuka kubanda lifudumala (umzekelo, ukuhamba esitalato ukuya kwelinye igumbi). Nangona kwezinye iimeko i-pulpitis enefiber ingenzeka ngaphandle kwempawu ezicacileyo. Oku kwenzeka ukuba i-stimuli ayinakho ukufikelela ngokuthe ngqo kwisigxina (umzekelo, ilapha phantsi kwegum okanye inxibelelwano kunye negumbi le-pulp). Kwimeko yokugqibela akukho buqhophololo, i-pulp "ayifuni," kwaye ngenxa yoko, akukho ntlungu.

I- pulpitis enobuqhophololo ihlala iphosa elimnandi kwizinyo ezigulayo nasemlonyeni. Ubunzima bezinto ezivela kwimiphumo eshushu, engayeki ixesha elaneleyo nangemva kokuba i-stimulus isuswe. Ngokuqhelekileyo kukho iimvakalelo ze-raspiraniya kwizinyo. Ukongezelela, umbala wezinyo usuqula phantse njalo: uba ngumbala.

I-pulpitis ye-Hypertrophic ihamba neentlungu ezibuhlungu xa zifuna ukutya kunye nokuphuma kwegazi. Oku kubangelwa ukuhluma kwe-pulp kwi-carious cavity njenge "inyama yasendle". Le nto yinto esoloko iyamoyikisa isigulane kwaye imenze aphendule ugqirha.

Amanyathelo enyango yenkqubo engapheliyo

Njengaloo sifo izicubu ezithambileyo kwizinyo azikwazi ukugcinwa, uhlobo oluthile lonyango lukususwa kwe-pulp kuzo zonke iziteshi zedolophu. Amathambo amanamhlanje amaninzi amaninzi akhetha inkqubo yokukhutshwa okubaluleke kakhulu (ukukhutshwa komzimba), xa kusetshenziselwa ama-anesthetic agents kuphela ngaphandle kweyeza ukubulala i-pulp.

Nangona kunjalo, ngamanye amaxesha iimpawu zesigulane somguli, ukungabi nesikhathi kunye nokungahambi kakuhle kwe-anesthetics kukuthintela inzwa ukuba ingasuswa ngokukhawuleza ekuhambeni kokuqala. Emva koko unyango lwe-pulpitis engapheli lusetyenziswa kumagangatho, xa unobumba olukhethekileyo lubekwa kwisigxina, esilungiselelwe ukulungiselela i-pulp ukususwa, okwenzekayo ngexesha lokutyelela kwesihlandlo sesibini.

Emva kokuba unyango

Ngokuqhelekileyo emva kokuba unyango lwe-pulpitis esingapheliyo ludlulile, abantu bayakhalaza intlungu. Ezi ziseko zibizwa ngokuba yi-post-pilling (njengoko kuthiwa ngamazinyo). Njengomthetho, ukungathandeki kubonakala ngezizathu eziliqela kwaye kufanelana nesiqhelo esivumelekileyo ngokuqhelekileyo. Ukuvela kweentlungu emva kokuba unyango lwe-pulpitis lunokwenzeka ngenxa yokuba izicubu ezizungeze lezinyo ezigulayo zinokutshatyalaliswa kancinci okanye ngokuhlukumezeka ngokukhawuleza kwe "nerve" kwinkqubo yokususwa kwayo. Kwakhona, intlungu ibonakala ukuba ngexesha lokunyanga amayeza enyosi ayaphathwa ngamanxusa anamandla ane-anti-antiseptic, apho kwixabiso elincinci lingahamba ngaphaya kwengcambu.

Esinye isizathu sokubangela intlungu emva kokuhlawula isiphumo sesithambo esincinci abadokotela bamazinyo basebenzisa ngexesha lokunyanga ukusebenza ngaphakathi kwimijelo, ngaphaya kwe-apical foramen yeengcambu.

Izizathu zeengxaki emva kokunyanga

Ngamanye amaxesha emva kokuba "udibaniselwano" olubonakala luphumelelayo kunye nodokotela wamazinyo, luqala intlungu, kwaye ukunyanzeliswa kokuqala kwe-pulpitis engapheli kuyinkimbinkimbi. Izizathu zalo mcimbi zininzi. Le mi sebenzi eyenziwa kakubi ekuzaliseni izitya zinozinyo, ukuphula isicatsheni samazinyo xa kusemngxenyeni wamazinyo okanye kuqhutywe (ukudala imingxuma) eludongeni lweengcambu.

Kwimeko apho imingxube ingazalwanga kakuhle okanye ukungena kwezinto ezizaliswe ngaphaya kwesiqingatha seengcambu kuvunyelwe, iimpawu ze-periodontitis kwisigaba esicacileyo ziya kubonakala ixesha elide (ukususela kwiintsuku eziliqela ukuya kunyaka). Ukuqhekeka kwesixhobo akunako ukuzibonakalisa ngokukhawuleza, kodwa isifo kwisitya esingatshintshiyo kunye nesingatshitshiyo siya kuzimisela ngokwawo, ukubonakala kwexesha eliqhelekileyo kwi-gingiva ye-fistula ( ekugqwesileyo ) okanye ukubunjwa kwee-cyst ezinezinto ezingenanto.

Ukunyanzeliswa kwenkqubo engapheliyo: iimpawu

Ukuba iqhinga eligulayo kunye neembonakaliso ze-pulpitis elambileyo ngexesha aliphilwanga, lesi sifo siya kufomula kwaye siyakukukhumbuza ngokwaso ngokusisigxina ngokusisigxina kulo lonke ubomi. Ukuxhatshazwa kwe- pulpitis engapheliyo kubonakala njani ? Iimpawu azibuhlungu: iintlungu ezisuka kwimiphumo yezinto ezahlukeneyo (ezifudumeleyo, ezibandayo, ezithandekayo, ezitshintshileyo ezivela kubanda ukuya ekutshiseni), unomvakalelo ombi kwi-palpation kunye ne-percussion (ukubetha okucokisekileyo kwintsimbi yamazinyo kwizinyo ezichukumisayo). Ngokuqhelekileyo, izigulane zichaza intlungu njenge-paroxysmal. Kwinqanaba lokuxhatshazwa kwenkqubo engapheliyo, ukusasazeka kweentlungu kunye nezindlela zendlela yokuhamba kwintsimbi yezintlu eziqhelekileyo kuyimpawu. Kungesi sizathu sokuba izigulane zithi iintlungu zinikwe entsimini yetempile okanye phantsi kweso, impumlo okanye i-chin.

Ukuhlaselwa kunye nezizathu zokuphuhliswa kwayo

Ukugqithisa kwe-pulpitis engapheliyo kunokuvalelwa kwiinyanga eziliqela. Iimvakalelo zentlungu azinjengeziqhamo ezinjengelifom. Iimbangela eziqhelekileyo zokubandezeleka zingaba zizinto ezinjengokugqithisa ukuphuma kwe-exudate, ukuxhwaleka kwezinyo, ukuqiniswa komsebenzi we-bacteria ye-pathogenic. Ukongezelela, ukunciphisa ukukhuselwa komzimba jikelele, inkqubo yokuvuvukala kwi-lymph node kunye nokuxiliswa komzimba jikelele kunokuncedisa ukuphindaphinda.

Ukugqithiseleka kwefomu engapheliyo ye-pulpitis kunokuhambelana neengxaki ze-periodontitis. Kwiimeko ezinjalo, izigulane ziza kwidokotela wamazinyo ezinezikhalazo zentlungu eqhubekayo. Utshintsho lwezilwanyana lubhalwe kwi-X-ray.

Amazinyo okwethutyana kwizigulana ezincinci

Akukhona kuphela kwizigulane zabantu abadala, i-pulpitis engapheliyo ifumaneka. Kubantwana, kwaye kungekhona nje ngokusisigxina, kodwa nangamazinyo amancinane, esi sifo sinakho. Zonke iintlobo zokuvuvukala okungapheli zibonakaliswa zizibonakaliso ezibonakalisiweyo.

Umntwana akakwazi ukuhlafuna ukutya ngokufanelekileyo. Izinyo ezinomdla ziphendula kwiqondo lokushisa. Ngeentlobo ezibuhlungu zentlungu zivela ekuphenduleni ukucaphuka okufudumeleyo, ukutshisa okanye xa usuka kwindawo ebanda ebumbini elifudumeleyo. I-pulpitis ehamba phambili (kunye nefom ye-hypertrophic in particular) ibonakala ngokubonakala kwintlungu xa iziqulatho zokutya zingena kwisigxina. Ukongezelela, i-polyp ye-pulp yegazi ngexesha lokutshatyalaliswa kwemishini.

Ubunqwenelekayo kweso sifo kule minyaka ubukhulu bunzima beentlungu, ezinokuchazwa ngenguqu yenkqubela kwi-pulp kunye noxinano olunzulu kunye nexesha lexesha. Kule meko, iimeko eziphambili ziye zadalwa ngenxa yokuhambisa amanzi okungaxhamli, ngenxa yoko, akukho zintlungu ezinzima.

Amazinyo ahlala rhoqo kubantwana

Amazinyo ahlala rhoqo kubantwana abuye ahlaselwe zizifo ze-pulp. Iiifom ze-pulpitis ezingapheliyo kubantwana zifana nezigulane zabantu abadala. Inkqubo engapheliyo kwinqanaba elincinci kwizigulane ezincinci ngokuqhelekileyo zibonakaliswe yinkqubo elukhuni eqhubekayo kunye nexesha lobuhlungu obukhulu. Ngokuqhelekileyo, ukuphazamiseka okukhula ngokukhawuleza kuyahamba, kwaye umntwana akhathazeki ixesha elide. Kodwa kwiimeko ezininzi, izigulana zikhalaza nge-paroxysmal okanye ezigqithisayo ubuhlungu obunzima obunikela kwicandelo le-nerve trigeminal. Ukunyuka kwe-electroexcitability (120-160 μA) kubonisa utshintsho kwizinto ezinomdla kwi-pulp, ezinobungqingili kunye nobunobungozi.

Masizalise zonke ezi ngasentla

Ukuzisola kakhulu kwezigulane, ngokwazo akukho isigaba esiqatha sesi sifo okanye ukunyanzeliswa okuqhubekayo kwe-pulpitis engapheliyo kuya kudlula. Unyango kunye nodokotela wamazinyo uya kudala okanye kamva. Kwaye kungcono ukuba oku kwenzeka ngokukhawuleza ukwenzela ukugcina isigulane ekubandezelekeni okungadingekanga kunye nokungenelela okubi kunye nobuhlungu, kwaye ugqirha ovela emsebenzini omde kwaye onomsebenzi ofuna amava amaninzi kunye nomonde.