医学资料口腔麻醉与拔牙课件

口腔局部麻醉与拔牙 Oral local anesthesia and extraction of teeth 常用局麻药物 Local anesthetic agent lLidocaine lProcaine lBupivacaine l Tetracaine (dicaine) lArticaine(碧兰麻) 口腔局部麻醉方法 l表面麻醉superficial anesthesia l浸润麻醉infiltration anesthesia l阻滞麻醉block anesthesia or conduction anesthesia 阻滞麻醉block anesthesia l上牙槽后神经阻滞麻醉Block anesthesia of posterior superior alveolar never l腭前神经阻滞麻醉Block anesthesia of anterior palatine never l鼻腭神经阻滞麻醉Block anesthesia of nasopalatine nerve l眶下神经阻滞麻醉Block anesthesia of infraorbital nerve l下牙槽神经阻滞麻醉Block anesthesia of inferior alveolar nerve l舌神经阻滞麻醉Block anesthesia of lingual nerve l颊神经阻滞麻醉Block anesthesia of buccal nerve 上牙槽后神经阻滞麻醉Block anethesia of posterior superior alveolar never l解剖标志:上颌结节 l进针点 l操作要点 l麻醉范围 腭前神经阻滞麻醉Block anethesia of anterior palatine never l解剖标志:腭大孔 l进针点 l操作要点 l麻醉范围 鼻腭神经阻滞麻醉Block anethesia of nasopalatine nerve l解剖标志:切牙孔 l进针点 l操作要点 l麻醉范围 眶下神经阻滞麻醉Block anethesia of infraorbital nerve l解剖标志:眶下孔 l进针点 l操作要点 l麻醉范围 下牙槽神经阻滞麻醉Block anethesia of inferior alveolar nerve l解剖标志:下颌孔 l进针点 l操作要点 l麻醉范围 舌神经阻滞麻醉Block anethesia of lingual nerve l进针点 l操作要点 l麻醉范围 颊神经阻滞麻醉Block anethesia of buccal nerve l进针点 l操作要点 l麻醉范围 上颌神经阻滞麻醉Block anethesia of maxillary nerve l解剖标志:圆孔 l进针点 l操作要点 翼腭管注射法 颧下翼突注射法（颧弓、下颌切迹及翼外板 为注射标志） l麻醉范围 下颌神经阻滞麻醉Block anethesia of mandibular nerve l解剖标志:卵圆孔 l进针点 l操作要点 l麻醉范围 局部麻醉的并发症和防治 l晕厥Swoon l过敏反应Anaphylaxis l中毒Toxication l感染Infection l血肿Hematoma l注射针折断Breaking the needle l暂时性面瘫Facial paralysis 拔牙适应症Extraction of teeth Indication lSevere caries lPeridontitis lSevere apix lDelayed deciduous teeth lMultidentine malposed lImpacted teeth lTraumatism lOrthodontic treatment lTeeth that are foci of infection lExtraction for treatment 拔牙禁忌症Contraindication lBloody disease: hemophilia refactory anemia leukemia lCardiovascular disease lDiabetes mellitus lHyperthyroidism:th yr-oid crisis lNephropathy lHepatitis lPregnancy and menstruation lAcute infection lMalignent tumor Instruments lDental forceps, elevator, chisel, lGingival seperator, curette, mallet 拔牙的基本步骤 l分离牙龈 l挺松牙齿 l安插牙钳 l摇动或扭转 l拔出 l拔牙创的处理 lCautions 各类牙拔除术 l阻生牙拔除 l牙根拔除 拔牙创的愈合 l拔牙创出血及血块形成15 l血块机化（24小时后一周） l骨组织的修复（第六天开始4周） l上皮覆盖拔牙创 l临床意义