大学课件牙折的病因及治疗方法

1、http:/ ,咀嚼咬到沙石、咀嚼咬到沙石、碎骨等硬物。碎骨等硬物。be impacted by force,biting be impacted by force,biting hard food.hard food. etiologyetiologyhttp:/ characteristicsclinic characteristics按部位分:冠折 crown fracture根折root fracture冠根联合折 crown-root fracturehttp:/ :露髓不露髓http:/ fracture前牙前牙 : : 横折、斜折横折、斜折anterior tooth: hori

2、zontal or inclinedhttp:/ : : 斜折、纵折斜折、纵折posterior teeth:inclined or verticalhttp:/ fracturehttp:/ 1/3、根中、根中 1/3、根尖、根尖 1/3cervix-thirds,middle-thirds,apical-thirdshttp:/ 3859根折牙牙髓坏死率为2024，断端间隙利于炎症引流。http:/ can be carried out by radiographic examinationhttp:/ fracturehttp:/ fracture will often be incli

3、ned with pulp exposurehttp:/ fracturewithout dentin exposure,selective grinding of the incisal edge is sufficient.http:/ with ca(oh)2 and composite resin restoration if dentin is expose and sensitivehttp:/ case of a pulp exposure,pulpectomy is indicated if the root apical is developed,pulpotomy is s

4、ufficient if the root apical is developing. http:/ fracture根中1/3折，根尖1/3折middle-thirds,apical-thirds用夹板固定三个月，如牙冠端有错位，在固定前应复位。reposition the coronal fragment and use splinting for 3 monthshttp:/ for pulpal complications after 1 month,3 months,6 months and 12 months.if pulp necrosis occurs,root canal t

5、herapy should be done.http:/ fracture:root canal therapy should be doneif fracture surface above gingival level,a post-retained full crown is fabricated after rct.http:/ surface between gingival and alveolar:a post-retained crown is fabricated after gingivectomy expose the fracture surface.http:/ fr

6、acture surface is 4mm below the alveolar and the root length is enough ,surgical or orthodontic extrusion of the root ,to move the fracture surface to amore optimal location for final restorationhttp:/ resin splinthttp:/ tissue healingthe fragment is separated by chronic inflammation tissue calcifie

7、d healinghard-connective tissue union healinghealing of root fracturehttp:/ fracture可作根管治疗，具备桩核冠修复可作根管治疗，具备桩核冠修复的冠根联合折，应保留。的冠根联合折，应保留。the tooth with crown-root fracture which can be restored by a post retained full crown should be saved to receive rct http:/ root fracture, not involving the crown.ht

8、tp:/ durative traumatic occlusal force defect of root developmentpulpless toothhttp:/ tooth内因：牙本质脱水，失去弹性，牙变 脆，致使牙抗折力降低。外因：侧方加压充填根管桩或桩核修复其他http:/ can be carried out by radiographic examinationclinic characteristics http:/ tooth should be extracted if it is very loose or of severe periodontal lesion o

9、r vertical root fracture in single rooted tooth. http:/ hemiresection or root resection is performed after rct if the molar is steady and of limited periodontal lesion.http:/ hemiresection截根术root resectionhttp:/ defect is caused by tardy abrasion of buccal cervix hard tissues.http:/ of tooth cervixi

10、mproper teeth brushingetiologyetiologyhttp:/ erosionweariness of hard tissueshttp:/ have 2 or 3 surfaces,hard and smooth,tooth-like color。 clinic characteristicsclinic characteristicshttp:/ classified with shallow,deep and pulp exposure according to the depth of the lesionmost commonly occur on the

11、buccal surface of bicuspids symmetrically and accompany with gingival recessionthe sizes of abrasions increase with age http:/ tooth brushingtreatment and preventiontreatment and preventioncareful observation if there is no tooth sensitivity and the lesions are smallhttp:/ if the lesions are extensi

12、ondesensitization with medicine or laser if there is dentin hypersensitive http:/ canal therapy is performed if there is pulpitis or periapical periodontitis.root canal therapy or extraction are performed if tooth fracture is occurred.http:/ non-physiological crack on the surface of the crownhttp:/

13、tache of tooth structurebig cuspid pitchtraumatic occlusal forceetiologyetiologyhttp:/ characteristicsclinic characteristicsmost commonly occur on maxillary molar, and secondly on mandibular molar.the crack occurs on first molar is more than that on second molar. http:/ linehttp:/ adjustmentbalance

14、occlusal forcetreat the cracked toothhttp:/ hypersensitivity）又又称称过敏性牙本质过敏性牙本质（hypersensitive dentine），），是牙齿受到外界刺激，引起的酸痛症状。是牙齿受到外界刺激，引起的酸痛症状。不是一种独立疾病，是各种牙病共有症状。不是一种独立疾病，是各种牙病共有症状。115http:/ pathogenesispathogenesis1.神经学说：牙本质中存在牙髓神经末梢，感觉神经学说：牙本质中存在牙髓神经末梢，感觉可由牙本质表层传导入牙髓可由牙本质表层传导入牙髓前期牙本质前期牙本质管间牙本质管间牙本质管周

15、牙本质管周牙本质2.牙本质纤维传导学说：成牙本质细胞原浆突牙本质纤维传导学说：成牙本质细胞原浆突中含有乙酰胆碱酶，它在受刺激后引起神经传中含有乙酰胆碱酶，它在受刺激后引起神经传导，产生疼痛导，产生疼痛3.流体动力学：外界刺激使牙本质小管内液体移动流体动力学：外界刺激使牙本质小管内液体移动搅动了牙髓内容物，间接兴奋游离神经末稍，传入搅动了牙髓内容物，间接兴奋游离神经末稍，传入冲动产生痛觉冲动产生痛觉http:/ characteristics and diagnosisclinic characteristics and diagnosisexplorationtemperature testh

16、ttp:/ 0度度：冷刺激和机械刺激无疼痛冷刺激和机械刺激无疼痛1 1度：可诱发疼痛，但疼痛较轻微度：可诱发疼痛，但疼痛较轻微2 2度：可诱发可以忍受的疼痛度：可诱发可以忍受的疼痛3 3度：可诱发难以忍受的疼痛度：可诱发难以忍受的疼痛http:/ evaluation疼痛疼痛3级评判法级评判法数字化疼痛评判法数字化疼痛评判法verbal rating scale,vrsvisual analogue scale,vashttp:/ the dentinal tubule to decrease or avoid the flowing of the liquid inside dentin http:/ characteristicsclinic characteristics咀嚼磨损非咀嚼磨损 http: