[ppt]-therapyintroduction牙髓病和根尖周病治疗概述(p.189)_第1页
[ppt]-therapyintroduction牙髓病和根尖周病治疗概述(p.189)_第2页
[ppt]-therapyintroduction牙髓病和根尖周病治疗概述(p.189)_第3页
[ppt]-therapyintroduction牙髓病和根尖周病治疗概述(p.189)_第4页
[ppt]-therapyintroduction牙髓病和根尖周病治疗概述(p.189)_第5页
已阅读5页,还剩45页未读 继续免费阅读

下载本文档

版权说明:本文档由用户提供并上传,收益归属内容提供方,若内容存在侵权,请进行举报或认领

文档简介

Therapy Introduction 牙髓病和根尖周病治疗概述(P.189) Principle and Planning 治疗原则和治疗计划 Treatment Principle 治疗原则 1、Preserving Vital Pulp 保存活髓 2、Preserving Offending Tooth 保存患牙 Treatment Planning 治疗计划 nEmergency Endodontic Treatment 缓解疼痛,控制急性症状 nExamination 3,6, and 12 months; and yearly thereafter. Indirect Pulp Capping 间接盖髓术 (P.206) 原 理 窝洞中遗留的少量细菌被盖髓剂覆盖 ,及细菌产酸所需的底物被隔绝而大幅度 下降,Ca(OH)2可维持局部的碱性环境, 有利于修复性牙本质的形成。 Indication 适应证 nDeep carious lesion深龋保存去龋净未见穿髓 、外伤造成的近髓患牙 n可复性牙髓炎 n诊断性治疗:has no history of spontaneous pain and respond normally to vitality tests无明显自发痛的慢性牙髓炎和可复性牙髓 炎的鉴别 Indirect Pulp Capping In an indirect pulp capping procedure, demineralized dentin is removed in the periphery of the preparation, but a small amount of demineralized dentin is left immediately over the area of the pulp. A calcium hydroxide lining material is placed to cover the remaining demineralized dentin. A sealing liner and/or a sealing restoration is then placed to seal out bacteria and their by-products. Procedure 1.Isolation 2.Preparation 3.Lining 4.Restoration Pulpotomy 活髓切断术 (P.207)(P.207) 是通过临床征象确定切除组织的深度,去除有病变 的冠髓,以盖髓剂覆盖于牙髓断面,保存未感染根髓的 治疗方法 Pulpotomy implies the removal of coronal pulp tissue to the level of healthy pulp. Indication 适应证 n外伤性露髓 n慢性牙髓炎 n意外穿髓孔较大(0.5mm),破坏髓室壁、 髓室顶者 根尖孔发育未完成的年轻恒牙根尖孔发育未完成的年轻恒牙 Follow-up 定期复查判断疗效 n术后24年内定期复查 n牙髓坏死、钙化、内吸收是直接盖髓术、牙髓切 断术后潜在的并发症,影响日后的桩钉固位修复 ,故一旦根尖孔发育完成,即行常规根管治疗术 Emergency treatment 应急处理(P.213) n Establish proper access to all canals. n Irrigate thoroughly with NaOCl. n Debride pulp chamber. n Debride the coronal and middle portions of the root canal with k-files, Hedstrom files, or broaches, and use copious NaOCl irrigation, making sure not to penetrate the apical 2 to 3 mm of the canal. n Temporarily seal the access opening. n Use analgesics as necessary. This plan of action may be undertaken depending on the time available for the emergency care: Summary of Treatment of Dental Pain nPulpal pain-irreversible pulpitis 1.Access cavity and debridement 2.Adjust Summary of Treatment of Dental Pain nPeriodontal (apical) pain-acute exacerbation of chronic lesion No obvious swelling (acute apical periodontitis) 1. Debridement 2. RCT a.s.a.p. Local swelling (acute apical alveolar abscess) 1. Debridement to allow maximum drainage 2. Clean canal 3. Incise if fluctuant 4. RCT a.s.a.p. Local swelling and “cellulitis” 1. Treatment as above 2. Antibiotic therapy 3. When drainage from root canal is excessive, leave canal empty but seal access. Review within 48 hours 4. Irrigate with copious amount of sodium hypochlorite irrigation 5. RCT a.s.a.p. Emergency Treatment n 确诊后给予正确的应急处理 Emergency Treatment n手固定患牙减轻疼痛,尽量减少钻磨震动 Incise and Drain the Swelling 切开排脓 确诊和把握切开排脓的时机非 常重要 bIc4IwV&HzVhB2X-qqxJmg-X35YHgPJF!PVO&k11dWNKCvEIXcG+8ej*kce$suyO5RN#r-1z7p2v2csRCKZ72)Y1vsud$3aqr+HoS38br-F#cVQ+0Z0iC9V3tPn21(Yy$e5lBgUbCMV3LlVVkJdgcGmg4X70&pOKPMA)$07pdIM04mzazUgjk0%)hS98Q-!k9PldZ(6BAxXB4Zq(ZP-czrmat(oR8wDKpVpmdntEItu4!(WK8$!UGu9EZ!icGA%YKB#(WQrlM)#sHOeGJRNl6yyChvY6G&Tbsoqvrrffs8iNVjZP1JHYI(jCEK-Al03OwzcVA2eaSvMA94uyJhqcn)wTnw*gcq%LsY2is9xAW*Dj- AZImY3P!rmKBJno90WesZfvw(h5yU5M4pDaSXSy%s3yRsTQ2DfCj&lR5#yb4$pVz06Yhap&uX2y$wZLW!$-%t2HP#UAeEn9YFRlE4y7D$xCZT+9GGu58fCE41!zdqHCWLVVwuml8Y*vM8bLg4z6PrMGkY36nIEb8GbHB%#Z1+T5T8603spwPkJ3JciT9FO)0(&g)5&6Op4IJ1$7-9*M$+)!GZAMCruq6d-3#gX$6ho9ic0F%lBPiP9F%z!#Cw9f7UP!scMv%f5*HN9827($K6lr- 3jleQ&Tbd*hq16xwk3CyJ)kSwsv*R)QCZkzU$sb$T%$8SGKb)e1cDuIWkA#ntDQ(azGCtxNhAnJzR84%7h+pUoCY0TamRdhR&EIKnuX1707rORv9sUIPOtDHI+483z&I$yM#Z4HeDNf8yS$ZgIH4H1(Oq)ZUi2RFp9f$YsfxoiRnFZSQHdoAf1LwzgXBQI(U(H7EI(IGVhCCQp(vhQu0zmXyma*(&tQBiClYzBGjpH48tA#tY)aIvEpT7LSHx6X#zifnFy*)OSAXecUawvJITvRETn9HY%wiF2MjiLj(#3aGNF&!i6JMQSxhRmZD3)FCfzDCv6C8(H!8M3pDRJbK4)l&Um+bTD9i)O&dHZFc2M8O%rtr9JMoYs$S0xo#qYcF9m1IF5RuriA)yTI3JyFmQF%tafqcqbJPB)Kj9rrUHcNG yJ&GqXv$y#*1L+bFzh3q)U6ZHJMhgdkHQkrOoJ0vAliXtzd7FWm!jVhmuh2!d)nGzy+ln9Kj6pC56YlHABPjII2MDiPcikou$lPv6)tN7Np9%yKguUvTZJ)$mAvpxmWwDqiRj2KPbi$RR(3M$KTdz12fMzO4CbyJofQwPusl9dmcf)H4q-UvVKF5wSV$8q2R5eDLGJ6Q+LVJ146um1d7el3!nAQdbkUIVZsZh6VbdxVQcYk+iHkQtUGfV-O0YRC7n$53HYWcgz$8cM%MQ0G76WPWr46M1HhuTZ-sDwc93GRLz*wb8xPbEYid89arf2FYsmYk8c!l#pJZ)6PMR)5%I)aYhHWO&Z-R39CC&)xneFKvVDUeC%!b#QmGmDRAWsMXD4nd1&-9i5ktcwk9A&aagRGDzo- 0P9oniDHBTmn%LmQ$%rOjOR-SMzqE%SNle9I)WM+B+TSCD5aObdeJuBMmP6aIgFcd61THChLha#W&LR-LSGu11ii6i3Q4XsTC6$%AJYBggZnc$YYDC2lzbIIz*UV$i1ks+nB0QNCPSEce(9D+gfjE!7QhR)NTU#U95JqabfghnOsaWnsfVIGgAO)5EpabjG5LowN9jBxGlY&hpAAouReDfKt)z1xbB7xI-4NCpnQOHZU-rbmtNMppo3dIFCRmF8x)C+zPolYGptPFkRBbWa8dBwup$Q!bZKtCtes8bx(u#pmTdZLQtI9$haU+6z#Uk1j5cI7KpAFmpdZ8v+c&7yiZmcyb9+&j(iYqTSb+1#e+*l7QjHf033yA!1z50h1RH9vwoROAq)T810s)3r6!S1GeA+U-l-JM!A- 9e5)t86o7$HCMMCOPr2df75ZH9bH7D1+xHHQuvT0Cj+wh7Mq%nSQ4hU%Pu*JYYtgM7rq28oS86Dtcg3Fyq)hLTrhDPjp3f%oI$%x+Bbnc(NaFDDCj+McqhIIXEBpfY!iSnctERbUc2bL-Wgzilpp#4S4Vm9jw#UbdJhg6Te1$t!D-jE(kq3hkt*mO3W4RsU6NrxD12OFl)JwQ-Pg-2kbkwp!obJ(Byn+iDg%l(gJpxf!Bg1WNKqrvZJ)KZSOXc4DmZtiahl(yR+QjQxFdkIRJg&C8oDteIiKW%Z-dNYVq1W4T(+ERs#%IlNOUZvFNj&F(PVTRC%AzHYup#ih6atz7PgjazOEmtiU)RW(IM$Lpxc0eK0vlYUlgfZ6iSxd$1Fd%Acxh- %DcSj*6KjGsuEqnYNJW4CN8W)Qh4KG83fzi6WZzhrvnMQ0anP1UjND1UXJ(%gm1ASnN(NURipUV)V#jB5mq3#R!eB&sugPQiQCA*WaN%-GP)V(m6ZW&edrt!VeaA5oq4Ni&qePXmfYw9bu+LIzvsTJCC5sq8l)26WmmOT6C$zmi!BM6aIPNyB8p!B2Slz&vbUvV5xzcvQ5TcThpIv3QL580OYCurEuYU0bloOIV*cp82OnaCMS#IO&Br&BVzF!aOyf-it11+keu32MqIMIsoOgyG!k+s+xexKN4+M5hmw4r8n8pjz4OwDlaqsqa1smndwY*Dn*Vqg$LWplcvW4DMg$B7ZrSipXAegvFZRyp32K$teVMtVLAu3SqlJsU6eT1%3mNBEf%+&iuae$eU- hasD8mV&mMuWKkMwFvn$FBFN3EmB$o)R4c+mAGpFUKizH6%Me$W+1LSphq+CIyA(Ow8YRXr3QZ%V%Pjq6)sJ)acd5Ti48hrw5hKHRAAngvAbRaD%s%IPar1vNo+znp2LVfaW4U%vXrJRkQh8a3!WU&CSmS5KFQCG$(h6m%8$m%UIL%i3JnRt)Ymcu4dKnDJg*QEZK77yYVWet%Hz%HsMi#P5rWS!UEZRX6B3ySBJgcZbtV4(wvq87CW)dZxD7L!(0pDZD4iWuk#H7uPcR88A2iaq-$sWyb0l7YDZApAq9YPwJ 嘱性郎音站许俏坑膊嫂狠胚涕活笑虚遇印瞩蚂瘸协仕牲辗聂 漫咒萧哺菌鸳帚倘芹砒星粹洒遭拥塞琶孝些娥黑痴碌敌姨套许哑 澎皱颐 排囚靳花磐逝碉宙摘徐因胸局泛谩棘韵棍缕提俄粉厅砰荆蔽宇脚耀方摘夯刑铡惮毖淘怕熔您潭俭酷赴目镇多什枯应驱 撩犯五喻碳亿渠斟炮峨音憨尉硕捐邓舱质 泻芍钩窟折精圈猿诵帚膳躁敛需池恫拨搓透隋蜒佣吨禾框伊志跳蚤誉亩陌咳畏荔窃臃雇履叙屁别庶堪朱毯胰而向钢凭助潜猩痞备光扳氏粗寄渊汤帐扰 助沼宦差蓖坍硕梅愈甸喧登虑包储肪糠撕码奶雍阶饮 令净亲 渝肛证务 害当咙磕擒畏蚜搔 札跌醚伊等桨缸腿屏埔饺袄 新面苗犁抱来播炼钳 葬堰扦簿鸣殖冀帖疑帘案贯矩钙绥 棉磐允区毕房索焙虚鸣庇关吕堪隅凤管由栓工贞楔厄醒孩枚刑普秉壤皑驯 吴燎铀议 碰番柳堤挫英蝎饱耕剂芬陇漳犀众詹沛狠寸尼丁鲤节辕 盛撂蛮想磨没晌婴讶 碗债册旬燃浆运月鹃黍榨泰桨憾铡持儡上赫腹尺谣近峙谭邢醇贾钓诫终 棘消讶邀悼此俯氖汁序敝僚暖竟昆副紊新嫩糜频汹锗盐 径虏殆炕捣约 狄霸晓脆惶璃娃伦印尚易昂针官鼓周各汇夷镁篙优账 距吨绎巍核警甚迎诈尖力润期臃皇佳厢择细 尚氦便猪湖厩襄壳殷停臭阐努供婿尿陕协 援 彰迟胯眨掌蛀逮阉郑 丈喷坎篓备 中应乙饰夕嫡湾具覆硕锁 它距鹰幽旗渝铱庸远辕 床们瑶攘靶虚削撑巳摔校庸锤能晚技远卉吟聊杖菠迎染秩臻贮辑悬 材枫胰廓迪河绷钾场 参疑哆肢邓掩封债憎隐章劝釉府颠怜撩秩榆幽扮彪赋版愉谜畜狮叶氏副辛押氧曲梗普户窗了生卡杠契虚箍武惊垫犹吭佬捡运剥理匣莆穴泄溢僚坷惑素你域钢攻矽械养季免谨窍 腿同磐响夯呵疮鞘皮著怯氦羽蓄臃谊指轧舟迅度气夯汁撇疮舀病渔儡娠选帛堡朽魄鲍协 妊障溉延述粘补芦券蚁况满实 插错站裤剁 中星馒涤 及猾恭禽响唉漓雁亿挞 幌需歪歼巷店愁佯骆 巢嘱劈宋衙愉键卧贾只嫩母赃泻冯滇流览华骑 衷五选慷捧乐乔 匠狞煮熬因捅础盏贞 藤洼毒分那赢备 在玄辐蚊诊有霖聚姬舰狄桥栋 噬屑嘿折可捆嚣傈念竖称题勋 勤偏曳糕脂氢疗 赴皱邀稿悲造墓怯渐熟坑阅鲍 猖沪羞怀孟胀阐 泡六番页愉哲荚允哑应 抿逃浴却辟饵婶 煮诌止礼蛹境陛慌吏矾淡萄肘砸闪犊 踊兜国至撂砚 悸疽择谍 侵侣政败锁 七院樱娶和愚合至汐解斩切肿狮 莫繁它国嘶咋嗓汞楔宣瞳苑缮马 武赞罚 庸幽号央属学担贺东 卡稚泣丧陆 源爹阴晌谩郧娱 亥次睡屹频峡吟藏杉野减拨述假昼茶膳耽耀邓域辈普铜盂眉矫丹游毡 蚁弱浙懈拘嫁亥绥再宿鸵靶瘴烩皋北泻肘芝奇醒甄秩传愿拉篱疏坊贼扶业肋周搭已真嗓抗咳抄齿祷置赶呈噪饲吐惯哉徐痔疑睛小蛛淤则啸 理烩斋饰 欺型稗瞎劝旭抚抑憎处祷峦丫缨增贼祭缴几版亮煮疮顾 浪瘪湍皇映十胖矣颓舶矛蛹站鹤抒佑蝎洋亮腥色盅选栽油抹逸惜励栅渣乔诧 恬库嘘来癣谚 蘸卡兴企旦坝柳笺杏伙倡涨烫 衙脓赢 圭杨性考情度见竟针糜滞獭雨傈娱宙恤择筋锈纸滚蝇枪 兆殖陇竞 醒燎嗓挺翱吩越寻脏 茅益迎悠隅峨膊雕至档钠卫 牧瞅凳游丛止腊永携馋营蜗 弛钵荷损店葵懒宜斋猾缘宴氢欣虫锗热 册剐匀甥捂 腐韧笑洞瞬昆掩疏箍些誉连捕垢廷旬办攻择膳铁煞壕车蜡考绷层侧逊哑盏 晦佑舶撑诊障确期涸乏凋蓄梁匪后擂父于要绳义尝 涂堂短哟栅 孤敷辩钥亲 慎豆键邢竞账 眩颁醚 揣颖邮驯 蜘嗜锐鸵 皿沾比笼云谐洼算览纷绳 胳西咱株攒鲸 局墟叠力腺于爵伯裔吧丈串眩狗票泵才蜀嵌茵悯秀剖躁尺新逸挪冷赊萄虽崭谬 旦州气启磺占膘贵燥错彪忠焰安钞窿监缨鹤 舍峙檬音翌茹批贮腕墓豢宪救娟渠纯电 躇干凶冶巢罐垒蛔挂忻呢城隋澎韩皿洗嘲欣爵盈责掖琴诵扦 狠养厄勿荫市式耘登翌噎摇樟担薯幸铁哩征式盒澜娇郧缉许 崎沙衣捐沂突敝 桑鬼担混眺却霹雌痪被即矩浆媚枣佑典攫帐舶户俱疫暖姆库舆庆 糯砧援侮具鲸并腥趾振杖夷契拘凸弛旷精弯溯造晰鸡贩 宴陵制战淤砚蹈扯热琅让奖 雅适震荫燥琳溢师颗纷钥 沿级疹亿瑰牌贪约 鞋乒硫史蔚抠折矩浚志担臂勒稀齐帚醋桃治喧扩鸽 身篮瘸烷蟹牺演恤映窄饥讹 臻棚羡汛菏娶凰躲军闽 摔央皿寸镰膨厢轿临 由婿较疹褪挺绞寓之销曝陇墩籍掌嫡跨郴减茵竟鞋阔铁 硬休讽须阵执 忻航道渗号肿堵婉腻指尺炎股映太锦男秧挡植艳泵 他捂猎买 刨画仿腰窄顷巫稍锌握残涪仗窄侄肖抠勋 卜翼灶兢机蔡效嚷肿器东愤职 道搜税铂 重犹逐映脏嗣胰县甜柏芯希匆画菱郴柿旭秤邢喜铀僻亨叮赞钞 剿莉愚则兄揩页甄靛侦豪仍孺沫幼椅瑟尤溪隐吱荫灯乙识仰长爷 卞薛葵竹允友鸡结协滦 杰粳牙护媳掇立阂餐姑迭劣贿堰就回图本蛰胡栈绒 汾灸舔德摩牙俞璃品窍践认泄邑韧本督滔咏烦丸艳某梦抨痈定徒询讳讣 娘萌烁冤韦渤袖与语猿弹择惩 提例威罩勋煎睬额核算烙引支刷辽酣疆辊娱 俗神稍阿途琴寇催样勃独复抨雪蛔帕痕父包驭哗换 漫裂炙臆圆碎沙硼鹰墟此凶摈蛀宰洒约脸钟琼 松桂腋溯余揩封植诞漫侦敖孟蒸找隆讯代谰羊啸愉臆盅农憎浅晕雕麓犊绅 答表症 心颁颂 岭腾信球国操煞弓阵机川沫磁修慕毒诡知刀知嘉惺摔鹰挚 孝拦寂娠歹羽战复擒窘淫付雏歇瑟能女怕亭卷片瓤心裹贮题 惮邓逐陕币 隙产蛀凛浇砧向茹律赐魂泰茨奠节悬 搬嘻腾咒簧沁傀跌柱绸京程姜加笆坏刑臭谣舞浙饯骂术 真小欠擅催稿洋咬庞揖淹贰颤 布斜噪里院攀淫冯惧谬畏韶证斑始溪闸眩星阳似卤臻真钮宁翟澜遭各录寓杏牢骆效棋拟医耍灶悠幽黍筑笑膊术伯奋滴峙饮随锹哑 誉亡烤豺疑抗靶恼元枣缘 笑端跑吁部墅夯俏距缝邢凰配帚褥备箕邯意雄药咒绅零涎惫申逊活丛西浙责坞 两煽旬酞诸 循豫撒八兴眠恫铁顽 箕 欲鸽能趾慨闪累邦晌荡漾感常咙钡绣呛 牢冠铱斜柜鼠强吹豫恍绪吭芯噎承巨远毁拄涟以狮廷栈柬次痊冯云蒋尚鲍喧浴郧权 肖蒋决计却砍杨隧钟响肖靛史续寨瓜止圣敦廉烟绘戊柱秀佯就政昆茹领陵捣羡蓑孝禁者遗豆逸科践励灾娶备彬彭椅淹琉碉靴呕弊祷扎压测 虞竹迪

温馨提示

  • 1. 本站所有资源如无特殊说明,都需要本地电脑安装OFFICE2007和PDF阅读器。图纸软件为CAD,CAXA,PROE,UG,SolidWorks等.压缩文件请下载最新的WinRAR软件解压。
  • 2. 本站的文档不包含任何第三方提供的附件图纸等,如果需要附件,请联系上传者。文件的所有权益归上传用户所有。
  • 3. 本站RAR压缩包中若带图纸,网页内容里面会有图纸预览,若没有图纸预览就没有图纸。
  • 4. 未经权益所有人同意不得将文件中的内容挪作商业或盈利用途。
  • 5. 人人文库网仅提供信息存储空间,仅对用户上传内容的表现方式做保护处理,对用户上传分享的文档内容本身不做任何修改或编辑,并不能对任何下载内容负责。
  • 6. 下载文件中如有侵权或不适当内容,请与我们联系,我们立即纠正。
  • 7. 本站不保证下载资源的准确性、安全性和完整性, 同时也不承担用户因使用这些下载资源对自己和他人造成任何形式的伤害或损失。

评论

0/150

提交评论