《医学英语实用情景教程》（徐青） Unit 6 Stomatology 口腔科

医学英语实用情景教程Unit6Stomatology口腔科知识目标掌握口腔科常见疾病的英文术语。掌握询问、描述口腔科常见疾病的相关英文表达。掌握口腔科英文病历的写法。技能目标能用英语与口腔科患者沟通。能读懂口腔科相关的英文病历。思政目标积极宣传口腔卫生保健，为民众提高口腔健康水平、树立正确口腔防治观念贡献力量。项目目标1．学习“知识储备”中的内容，掌握本单元的重点医学术语和常用表达。2．跟读“医患交流”下的英文对话，然后角色扮演各对话场景。3．仔细阅读“病历阅读”下口腔科相关的英文病历，总结其中重点句型及词汇。4．完成本单元的“任务检测”。5．根据以上任务的完成情况，给自己评分。任务描述目录123知识储备医患交流病历阅读章节导航01知识储备CommonDiseasesofStomatologyKeyWordsandExpressionsModelSentencesCommonDiseasesofStomatologycarcinomaoftongue /ˌkɑːsɪˈnəʊməəvtʌŋ 舌癌oralulcer /ˈɔːrəlˈʌlsə(r)/ 口腔溃疡recurrentaphthae /rɪˈkʌrəntˈæfθiː/ 复发性口疮sialolithiasis /saɪˌæləlɪˈθaɪəsɪs 涎石病pyogenicparotitis /ˌpaɪəˈdʒenɪkˌpærəˈtaɪtɪs 化脓性腮腺炎dentalcaries /ˈdentlˈkeəriːz 龋齿；龋gingivitis /ˌdʒɪndʒɪˈvaɪtəs （牙）龈炎pulpitis /ˈpʌlˈpaɪdɪs 牙髓炎periodontitis /ˌperɪədɒnˈtaɪtɪs 牙周炎CommonDiseasesofStomatologyperiodontaldisease /ˌperɪəˈdɒntldɪˈziːz/ 牙周病dentalplaque /ˈdentlplæk/ 牙菌斑dentaldefect /ˈdentlˈdiːfekt/ 牙体缺损dentalnecrosis /ˈdentlneˈkrəʊsɪs/ 牙坏死gingivalabscess /dʒɪnˈdʒaɪvəlˈæbses/ 牙痈alveolarabscess /ælˈviːələ(r)ˈæbses/ 牙槽脓肿apicalinfection /ˈæpɪklɪnˈfekʃn/ 根尖感染periapicalcyst /pɪəˈraɪəpɪklsɪst/ 根尖周囊肿KeyWordsandExpressionscavity /ˈkævətɪ/ n.

龋洞compositeresin /ˈkɒmpəzɪtˈrezɪn/ 复合树脂bacteria /bækˈtɪərɪə/ n.

细菌decay /dɪˈkeɪ/ v.

遭蛀蚀hygiene /ˈhaɪdʒiːn/ n.

卫生；卫生学makeanappointment 预约；约会plaque /plæk/ n.

牙垢tartar /ˈtɑːtə(r)/ n.

牙石stimulate /ˈstɪmjʊleɪt/ v.

刺激，使兴奋calcify /ˈkælsɪfaɪ/ v. （使）钙化instrument /ˈɪnstrəmənt/ n.

仪器；工具KeyWordsandExpressionsultrasonicscaler /ˌʌltrəˈsɒnɪkˈskeɪlə/ 超声波洁治器jaw /dʒɔː/ n. 颌，下巴molar /ˈməʊlə(r)/ n. 臼齿rootcanaltreatment 根管治疗pulp /pʌlp/ n. 髓prescribe /prɪˈskraɪb/ v. 给……开（药）；开（处方）painkiller /ˈpeɪnkə(r)/ n. 止痛药tablet /ˈtæblət/ n. 药片sensitive /ˈsensətɪv/ adj. 敏感的floss /flɒs/ n. 丝线

v. 用牙线剔牙KeyWordsandExpressionsdentalfloss 牙线extract /ˈekstrækt/ v. （用力）取出，拔出wisdomtooth 智齿tender /ˈtendə(r)/ adj. 疼痛的；一触即痛的recession /rɪˈseʃn/ n. 萎缩；衰退accumulate /əˈkjuːmjəleɪt/ v. 积累；积聚deposit /dɪˈpɒzɪt/ n. 沉积物polish /ˈpɒlɪʃ/ v. 磨光；擦亮fluoride /ˈflɔːraɪd/ n. 氟化物toothpaste /ˈpɒlɪʃ/ n. 牙膏ModelSentences1.MygumswillbleedwhenIbrushmyteeth.我一刷牙牙龈就出血。2.Mytongueisredandsore.Andthereisafoultasteinmymouth.我的舌头又红又疼，嘴里有股难闻的味儿。4.Therearetwocavitiesinyourteeth.Theyaresmallandcanbefilledeasily.你的牙上有两个龋洞，很小，容易被充填。3.Ihavesomesoreswellingsonmygumsandjaw,andtherearesomesoreplacesonoraroundthelip.我的牙龈和下巴肿痛，嘴唇及周围也有些地方很痛。ModelSentences5.Paymoreattentiontoyouroralhygieneandbrushyourteeththreetimesaday.注意口腔卫生，每天刷牙三次。6.Thereisalotofplaqueandtartaronyourteeth,whichcanstimulatethegumsandcauseinflammationandbleeding.你的牙齿上有很多牙垢和牙石，它们会刺激牙龈，并引起牙龈发炎和出血。7.Plaqueisthesoftsubstancelooselyattachedtotheteeth,whichisyelloworgrey.It’ssoftandeasytoberemoved.牙垢是附在牙齿表面的黄色或灰白色软垢，比较软且易去除。ModelSentences8.Tartaristhehardcalcifiedorcalcifyinglumpsontheteeth,whicharemainlyformedbydentalplaque.It’shardanddifficulttoberemoved.牙石是以牙菌斑为基质形成的，附在牙齿表面的，已经钙化或正在钙化的团块，比较硬，不易去除。9.Thelastmolarhasacavity,whichisverybigandhascausedpulpitis.下边最后一颗臼齿有个很大的龋洞，已经引起了牙髓炎。10.I’llremovethedeadnerveandpulpofyourdecayedtooth,thencleanandsealtheinsideofthetooth.我会先移除龋坏牙齿死去的神经和牙髓，然后清洁并密封牙齿内部。ModelSentences11.Aftercomingbackhome,keepyourteethcleanbyusingtoothbrushanddentalflossproperlyeveryday.回家后，每天正确使用牙刷和牙线清洁牙齿。12.MygumswillbleedwhenIbrushorflossmyteeth.Andmygumsarered,tender,andswollenwhichhavebotheredmefortwodays.我刷牙或用牙线清洁牙齿时牙龈就会出血，而且又红肿又痛，已经困扰我两天了。13.Periodontitisiscausedbybacteriathataccumulatedonyourteethandgums.牙周炎是由牙齿和牙龈上积累的细菌引起的。课堂小结这小结我们学习了口腔科医学中的常见病、关键词和表达式和模型句子。希望大家能加深对英语词汇的理解并灵活应用。02医患交流Conversation1DentalCaries龋齿Conversation2Gingivitis牙龈炎Conversation3Pulpitis牙髓炎Conversation4Extraction拔牙Conversation5Periodontitis牙周炎Conversation1DentalCaries龋齿D:Whatseemstobebotheringyou?P:Ihavepaininmyteeth.D:Howlonghasitbeenlikethis?P:Forabouttwoweeks.D:Openyourmouthandletmehavealook.Therearetwocavitiesinyourteeth.Theyaresmallandcanbefilledeasily.I’llfillthecavitieswithwhitecompositeresin.P:Whatcausesdentalcaries?D:Bacteriainyourmoutharethemostcommoncauseoftoothdecay.P:Iwonderifthelesionsdevelopinparticularregionsoftheteeth.D:That’sright.Theyoftendevelopinareasthatcan’tbecleanedeasily.医生：你觉得哪儿不舒服？患者：我牙疼。医生：疼痛持续了多久了？患者：大概两周。医生：请张开嘴，让我看看。你的牙上有两个龋洞，很小，容易被充填。我会用白色复合树脂来充填龋洞。

患者：请问龋齿是由什么引起的？医生：口腔中的细菌是造成牙齿龋坏最常见的原因。患者：我想知道这些病变是不是发生在牙齿的特定部位。医生：是的，它们通常发生在不易清洁的区域。Conversation1DentalCaries龋齿P:Howcanwepreventdentalcaries?D:First,paymoreattentiontoyouroralhygieneandbrushyourteeththreetimesaday.Second,don’ttaketoomuchsweetfood.Third,comehereregularlyforcheckups,onceortwiceayear.Fourth,takeexercisetoimproveyourhealth.P:OK,thankyou.D:Notatall.P:Ialsowanttohavemyteethcleaned.Couldyoumakeanappointmentforme?D:Allright.Ihavegotratherafullscheduletomorrow.Youcancomehereat10a.m.thedayaftertomorrow.P:Allright.患者：如何预防龋齿呢？医生：第一，注意口腔卫生，每天刷牙三次。第二，少吃甜食。第三，定期来这里检查，一年1次或2次。第四，增进身体健康。患者：好的，谢谢你。医生：不客气。患者：我还想洁齿，你能给我约定个时间吗？医生：好的。我明天的行程已经很满了，你可以后天上午10点钟来。患者：好的。Conversation2Gingivitis牙龈炎P:Doctor,mygumswillbleedwhenIbrushmyteeth.D:Howlonghasitbeenlikethis?P:Forabouttwomonths.D:Openyourmouth.Letmehavealook.Thereisalotofplaqueandtartaronyourteeth,whichcanstimulatethegumsandcauseinflammationandbleeding.P:Whatareplaqueandtartar?D:Plaqueisthesoftsubstancelooselyattachedtotheteeth,whichisyelloworgrey.It’ssoftandeasytoberemoved.Tartaristhehardcalcifiedorcalcifyinglumpsontheteeth,whicharemainlyformedbydentalplaque.It’shardanddifficulttoberemoved.患者：医生，我一刷牙牙龈就出血。医生：这种情况持续多长时间了？患者：大约有2个月了。医生：张开嘴，让我看看。你的牙齿上有很多牙垢和牙石，它们会刺激牙龈，并引起牙龈发炎和出血。患者：什么是牙垢和牙石？医生：牙垢是松散附着在牙齿上的软垢，呈黄色或灰白色，比较软且易去除。牙石是以牙菌斑为基质形成的，附在牙齿表面的，已经钙化或正在钙化的团块，比较硬，不易去除。

Conversation2Gingivitis牙龈炎P:Doyoumeanthatmyproblemiscausedbyplaqueandtartar?D:Yes.Ithinkyouaresufferingfromgingivitis.Thesymptomswillrelievewhentheplaqueandtartarareremoved.P:Sowhatwillyoudotoremovethem?D:Byusingaspecialinstrumentnamedultrasonicscaler.P:Gotit.(afterthetreatment)D:OK.Ithasbeendone.P:Thankyousomuch,doctor.患者：你的意思是我的问题是由牙垢和牙石引起的？医生：是的，我想你得了牙龈炎。等牙垢和牙石去除后，症状就可以缓解了。患者：你会怎么除去它们？医生：我会用一种名叫超声波洁治器的器具来除去它们。患者：明白了。（治疗结束后）医生：好，已经做好了。患者：太感谢您了，医生。Conversation3Pulpitis牙髓炎P:Ihaveanawfultoothache.D:Tellmewhichoneaches,please.P:Thelastoneinthelowerjawhurtswhencomingincontactwithhotorcoldthings.D:Doesthepaingetworseatnight?P:Yes,ithurtssomuchatnightthatIcan’tsleep.D:Pleaseopenyourmouthandletmeexamineyourteeth.Oh,thelastmolarhasacavity,whichisverybigandhascausedpulpitis.P:Whatshouldbedonetocureit?患者：我的牙痛得很厉害。医生：请告诉我是哪颗牙痛？患者：下颚最后一颗牙遇冷的或热的东西时疼。医生：晚上疼痛会加重吗？患者：是的，夜间疼得我无法入睡。医生：请张开嘴，让我检查一下你的牙齿。啊，下边最后一颗臼齿有个很大的龋洞，已经引起了牙髓炎。患者：我们该怎么做才能治好它？Conversation3Pulpitis牙髓炎D:Itisnecessarytodorootcanaltreatmenttorepairthetooth,whichmeansI’llremovethedeadnerveandpulpofyourdecayedtooth,thencleanandsealtheinsideofthetooth.(afterthetreatment)D:Doesithurt?P:Alittle.D:I’llprescribeyousomepainkillers.Takeonetabletifnecessary.P:Thankyou,doctor.D:Comehereagainforfurtherexaminationaftertwodays.P:OK.医生：为了修复牙齿，根管治疗是必需的。也就是说，我会先移除龋坏牙齿死去的神经和牙髓，然后清洁并密封牙齿内部。（治疗结束后）医生：疼吗？患者：有点。医生：我给你开些止痛药，需要的时候吃一片。患者：谢谢您，医生。医生：两天后再来这里做进一步检查。患者：好的。Conversation4Extraction拔牙D:Hello,what’swrongwithyou?P:Ihaveatooththat’ssensitivetohotorcoldfood.Andmygumarounditisswollen.D:Letmesee.Openyourmouthwide,please.Someofyourteetharegettingloose.CanyoufeelthistoothmovablewhenItouchit?P:Yes,Ican.Whatshouldbedonetosolvemyproblem,doctor?D:Thetartarandplaqueonyourteethhavetoberemovedfirst,whichwillbedoneintheclinicbyus.Aftercomingbackhome,keepyourteethcleanbyusingtoothbrushanddentalflossproperlyeveryday.医生：你好，你怎么了？患者：我有一颗牙齿对热的或冷的食物很敏感，周围的牙龈都肿了。医生：让我看看。请把嘴巴张大些。你有些牙齿已经松动了。我碰到这颗牙时，你能感觉到它晃动吗？患者：能感觉到。该怎么解决我的牙齿问题啊，医生？医生：你牙齿上的牙石和牙垢必须先清除，这将由我们在诊所完成。回家后，每天正确使用牙刷和牙线清洁牙齿。Conversation4Extraction拔牙P:Andwhatifitisnottreated?D:Ifnot,yourteethwillgetlooser.Eventually,theteethwillbecomeinfected.Asaresult,theywillprobablyhavetobeextracted.Andnowoneofyourwisdomteethisbadlydecayed.Theonlythingtodoistoremoveit.P:Willithurt?D:No,itwon’thurt.I’llgiveyouananestheticinjection.I’vefinishednow.Didithurt?P:No.itdidn’thurtmuch.Ihardlyfeltit.D:Wecanstartnow....It’sOK.P:Thankyouverymuch,doctor.I’mveryhappythatthetoothisout.患者：有了这种情况要是不治会怎样？医生：假如不治疗的话，你的牙齿会变得更加松动。最终牙齿会受到感染，结果可能都得拔掉！而且你有颗智齿蛀蚀很厉害，唯一的办法就是把它拔掉。患者：痛不痛？医生：不会痛的。我现在给你上麻药。现在注射完了。痛不痛？患者：不，不怎么痛，几乎没有感觉。医生：现在我们开始吧。……弄好了。患者：谢谢医生。牙齿拔掉了，我非常高兴。Conversation5Periodontitis牙周炎D:Goodmorning.What’swrongwithyou?P:MygumswillbleedwhenIbrushorflossmyteeth.Andmygumsarered,tender,andswollenwhichhavebotheredmefortwodays.D:Haveyouhadthistroublebefore?P:No,soI’mveryworriedaboutit.D:Letmeexamineyourteethnow.Yourgumsrecedefromyourteethandsmallpocketsformbetweengumsandteeth.Aslightrecessionisnormalwhenyougetolder.Whenitrecededtoomuch,there’sapossibilitythatperiodontitisisdeveloping.P:Periodontitis?Whatcausesperiodontitis?医生：早上好。你怎么了？患者：我刷牙或用牙线清洁牙齿时牙龈就会出血，而且又红肿又痛，已经困扰我两天了。医生：你以前有这种问题吗？患者：没有，所以我很担心。医生：让我检查一下你的牙齿。你的牙龈萎缩了，而且牙龈和牙齿之间形成了牙周袋。随着人年纪增大，牙龈轻微萎缩是正常的；但当它们过度萎缩时，就很可能发展成牙周炎。

患者：牙周炎？什么会引起牙周炎？Conversation5Periodontitis牙周炎D:Periodontitisisaseriousinfectionofthegums.It’scausedbybacteriathataccumulatedonyourteethandgums.P:Howisperiodontitistreated?D:Treatmentisaimedatremovingtheplaqueandbacterialdepositsonyourteethandgums.Accordingtotheconditionsofyourteeth,it’sintheearlystageofperiodontitis.Andaprofessionalcleaningshouldbedonetoyourteeth.P:Whatdoyoumeanbysaying“professionalcleaning”?医生：牙周炎是牙龈的严重感染。它是由你牙齿和牙龈上积累的细菌引起的。患者：那怎么治疗牙周炎呢？医生：治疗的目的是清除沉积在你牙齿和牙龈上的牙菌斑和细菌。根据你牙齿的情况，它还处于牙周炎的早期阶段。你应该对牙齿进行一次专业清洁。患者：你说的“专业清洁”是什么意思？Conversation5Periodontitis牙周炎D:ItmeansthatIwillremovetheplaqueandtartarfromyourteethandtheirroots,andthenpolishyourteethandtreatthemwithfluoride.P:OK.Thendoit.(afterthetreatment)D:It’sbeendone.P:Thankyousomuch,doctor.IsthereanythingIshouldpayattentiontoaftercomingbackhome?医生：意思是我将清除你牙齿和牙根上的牙菌斑和牙石，然后打磨你的牙齿，并用氟化物进行治疗。

患者：好，那就做吧。（治疗结束后）医生：已经做好了。患者：太感谢你了，医生。有什么是我回家之后要注意的吗？Conversation5Periodontitis牙周炎D:Goodquestion!It’sveryimportanttokeepyourteethandgumscleanindailylife.Herearesomeadviceforyou:first,brushyourteethtwiceadaywithfluoridetoothpaste;second,considerusinganelectrictoothbrush,whichmaybemoreeffective;third,flossatleastonceadaytoremoveplaque;fourth,visityourdentistatleasttwiceayearforaprofessionalcleaning;fifth,don’tsmokeorchewtobacco.P:Thankssomuch,doctor.I’llfollowwhatyoutoldme.医生：问得好！在日常生活中保持牙齿和牙龈的清洁是非常重要的。这儿有一些建议：第一，每天用氟化物牙膏刷牙两次；第二，考虑使用电动牙刷，这可能更有效；第三，每天至少使用牙线清洁一次牙菌斑；第四，每年至少看两次牙医，进行专业清洁；第五，不要吸烟或咀嚼烟草。患者：谢谢您，医生。我会按照您说的做的。课堂小结这小结我们学习了如何用英语进行医患交流。希望大家课下多加复习，加深对英语的灵活应用。03病历阅读OutpatientMedicalRecords—PeriodontalDiseaseOutpatientMedicalRecords—ProsthesisofDentitionDefectOutpatientMedicalRecords—ToothExtractionExaminationReports—OralExaminationChiefComplaint:Thepatienthadgumbleedingfor1weekwhenbrushingteeth,accompaniedwithbadbreathandmassivesmoker’spatcheswhichimpairedappearance.HistoryofPresentIllness:Thepatienthadgumbleedingfor1weekwhenbrushingteeth,accompaniedwithbadbreath,andrequestedexamination.Atpresent,thepatient’sdentitionwascompleteandthesanitaryconditionofthewholemouthwaspoor,withtartar(gradeⅡ),periodontalbleedingonprobing(+),swellingofthegum,toothmobility(gradeⅠ),periodontalpocket,massivestainsonteethandbadbreath.PastMedicalHistory:Thepatientdeniedmedicalhistoryofcardiovasculardiseasessuchashypertensionandcoronaryheartdisease,etc.,medicalhistoryofdiabetesandinfectiousdiseasessuchashepatitis,etc.Thepatientdeniedhistoryofdrugallergysuchaspenicillinandcephalosporin,etc.Thepatientdidnottakeanymedicineintherecenttwoweeks.OutpatientMedicalRecords—PeriodontalDiseaseDiagnosis:1.Chronicperiodontitis2.ChronicgingivitisTreatment:Rinsethemouthwith0.1%chlorhexidinesolutionfor1minute.Afteroraldisinfection,ultrasoundliquidwasusedtoclean.Supragingivalplaquescaling,subgingivalcalculusscaling,androotplaningwereperformedwithmanualsubgingivalcurettecombinedwithultrasonicworktip.Ultrasonicwavewasusedtoremovesupragingivalcalculus,plaqueandcoloringmatterofthefullmouth.Therootsurfaceanddentalfacewerepolishedbypolisherdippedwithdesensitizer.3%hydrogenperoxidesolutionand0.9%normalsalinewereusedforflushing.Theresidualsmallcalculusandgranulationtissueswereremoved.Iodineglycerinwassmearedingingivalsulcus.Doctor’sSignature:Li××OutpatientMedicalRecords—PeriodontalDiseaseOutpatientMedicalRecords—PeriodontalDisease门诊病历—牙周病主诉：刷牙时牙龈出血一周，伴有口腔异味，牙齿烟斑多，影响美观。现病史：患者自述一周前刷牙牙龈出血，并伴有口腔异味，要求检查。现患者牙列完整，全口卫生状况较差，牙石（Ⅱ度），牙周探诊出血（+），牙龈有红肿，牙位图松动度（Ⅰ度），有牙周袋，牙体色斑较多，有口腔异味。既往史：患者否认有高血压、冠心病等心血管疾病史，糖尿病史，肝炎等传染性疾病史。患者否认有青霉素类、头孢等药物过敏史。近两周内未服用任何药物。诊断：1．慢性牙周炎2．慢性牙龈炎处置：0.1%氯己定溶液含漱口一分钟，口腔消毒后采用超声液清洁，手用龈下刮治器结合超声波工作尖，行龈上菌斑洁治、龈下结石刮治及根面平整术；超声波去除全口牙龈上结石、菌斑及色素。采用抛光器蘸取脱敏剂抛光根面及牙面，3%过氧化氢溶液及0.9%生理盐水冲洗，去除残留小结石及肉芽组织，龈沟内上碘甘油。医师签名：李××ChiefComplaint:Prosthesisoffulldentitionwasrequested.HistoryofPresentIllness:Thepatienthadalossofteethofthefullmouth.PastMedicalHistory:Thepatientadmittedthemedicalhistoryoftreatmentinoralsurgerydepartmentandprosthesis,anddeniedmedicalhistoryofcardiovasculardiseasessuchashypertensionandcoronaryheartdisease,etc.,medicalhistoryofdiabetesandinfectiousdiseasessuchashepatitis,etc.Thepatientdeniedhistoryofdrugallergy.PhysicalExamination:ExaminationofMaxillofacialRegion:Themaxillofacialregionsweresymmetricwithnormalproportion,withoutdeformation.Thesmilelinewashigh.ExaminationofTemporal-mandibularJoint:Themotionoftemporal-mandibularjointwasgradeⅡ,withsnapping.Noabnormalitywasfoundinopeningdegreeandmouthopening.Noabnormalitywasfoundinmandibularlateralmovement.OutpatientMedicalRecords—ProsthesisofDentitionDefectInternalExaminationofOralCavity:Dentitiondefectoffullmouthwasfound.Thecuspridgeofthesuperioralveolarsocketwasflat.Theintermandibularverticaldistancewaswell.Noevidentabnormalitywasfoundinthegingivalandoralmucosa.Noevidentabnormalityofsalivationwasfound.Diagnosis:DentitiondefectTherapeuticPlan:PartialDenture:Generalrepairformotionabnormalityoffullmouthwasperformedwithordinarymetalrack,titaniumalloyrack,andpuretitaniumrackandcompletedenture.Implantcombinedwithprosthesiswasperformed.OutpatientMedicalRecords—ProsthesisofDentitionDefectTreatment:1.Arrangeandrecordspecificworks.Explaintheoperatingstepstobeperformedandnotestothepatientindetail.2.Getpreliminaryimpressionandmakeindividualtray.3.Getpreciseimpressionandpourinplastermodel.4.Testracks;rectifycontacthighspotthroughslowpolishing;performpolishingandcolorcomparisonofteeth,andrecordoccludingrelation.5.Afterarrangementofteeth,testandregulatetheteeth;deliverthemouldswiththepatient’sapproval.6.Weartheteeth;payattentiontonotesafterregulation.Doctor’sSignature:Li××OutpatientMedicalRecords—ProsthesisofDentitionDefectOutpatientMedicalRecords—ProsthesisofDentitionDefect门诊病历—牙列缺失修复主诉：要求修复全口牙列。现病史：患者全口牙齿缺失。既往史：患者自述有口腔外科治疗史、修复病史。否认有高血压、冠心病等心血管疾病史。无糖尿病史，无肝炎等传染性疾病史。无药物过敏史。检查：颌面部检查：颌面部对称，颌面部比例无异常，颌面部无畸形，笑线高。颞下颌关节区检查：颞下颌关节活动度（Ⅱ度），颞下颌关节有弹响，开口度及开口型无异常，下颌侧方运动无异常。口腔内部检查：全口牙列缺失，上牙槽牙尖嵴低平，颌间垂直距离尚可，牙龈及口腔黏膜未见明显异常，唾液分泌无明显异常。OutpatientMedicalRecords—ProsthesisofDentitionDefect门诊病历—牙列缺失修复诊断：牙列缺失治疗方案：活动修复：普通全口活动异常修复，普通金属支架、钛合金支架、纯钛支架全口义齿。种植活动联合修复。处置：1．交代及记录具体工作，向患者详细解说即将进行的操作步骤及注意事项。2．取初印模，制作个别托盘。3．取精印模，灌注石膏模型。4．试支架，慢机打磨校改接触高点、抛光、牙齿比色、记录咬合关系。5．排牙后试牙，调改，经患者满意后送模。6．戴牙，调改后注意事项。医师签名：李××

ChiefComplaint:Thepatienthadrepeatedswelling(ofpermanentteeth)andrequestedextractionofupperrighttoothandupperlefttooth.HistoryofPresentIllness:Thepatienthadrepeatedswellingofaffectedteethwhichinfluencedmasticationandrequestedtoextractthem.PastMedicalHistory:Thepatientdeniedmedicalhistoryofcardiovasculardiseasessuchashypertensionandcoronaryheartdisease,etc.andmedicalhistoryofdiabetesandinfectiousdiseasessuchashepatitis,etc.Thepatientdenieddrugallergyhistory.Examination:18/28/38/48(high/middle/low+mesioangular/distoangular/buccal/lingual)impaction;noterupted/eruptedOutpatientMedicalRecords—ToothExtractionX-rayDentalFilm:Noterupted.PanoramicRadiography:Mesioangularimpactionof48toothwasfound,whichwasfarfromtheinferioralveolarnervecanal.CBCTExamination:38endosseoushorizontaluneruptedimpactionwasfound.Inferioralveolarnervecanalwaslocatedbeneath38fanganddentalcrownandbothwerecloselyadjacent.Diagnosis:ImpactedwisdomteethTherapeuticPlan:Removetheaffectedteeth.Treatment:Chestdrapingwasperformed.Dentalclearwasusedtorinsethemouth.Salivawassuckedbydisposablesalivapump.Routineanesthesia/inferioralveolarnerveobstructedanesthesiawasperformed.Gingivalwasopenedandflapoperationwasperformed.OutpatientMedicalRecords—ToothExtractionBoningwasperformedbycuttingdrillanddentalcrownwasopened.Thefangwasseparatedandtheaffectedtoothwasloosened.Residualrootwasremovedandalveolarbonewasrepaired.Curettagewasperformedforapicalregionandalveolarsocketwasrecovered.Theincisionwassuturedby1stitch.1drainagestripwasindwelt.Cottonsliverwasbittenforhemostasis.Routinedoctor’sorderwasprovided.Doctor’sSignature:Li××OutpatientMedicalRecords—ToothExtractionOutpatientMedicalRecords—ToothExtraction门诊病历—拔牙主诉：（尽头牙）反复肿痛不适，要求拔除右上牙及左上牙。现病史：患牙反复肿痛不适，影响咀嚼，要求拔除。既往史：患者否认有高血压、冠心病等心血管疾病史，糖尿病史，肝炎等传染性疾病史。无药物过敏史。检查：18/28/38/48（高/中/低+近中/远中/颊侧/舌侧）阻生，未/已萌出X线牙片检查：未萌出。全景片检查：48牙近中阻生，与下牙槽神经管相隔较远。OutpatientMedicalRecords—ToothExtraction门诊病历—拔牙CBCT检查：38骨内水平埋伏阻生，下牙槽神经管位于38牙根及牙冠下方，二者紧密相邻。诊断：智齿阻生治疗方案：拔除患牙。处置：铺胸巾，口洁素漱口，一次性吸唾器吸唾，常规麻醉/下牙槽神经阻隔麻醉，起开牙龈，翻瓣，切割钻去骨，磨开牙冠，分根，挺松患牙，去除残根，牙槽骨修复，根尖搔刮，复位牙槽窝，缝合伤口1针，置引流条1根，咬棉条止血，常规医嘱。医师签名：李××26Cariouscavitywasfoundonocclusalsurface;probing(−);percussion(−);cold(+−);hot(−);noevidentlooseningandspontaneouspainwasfound.Noswellingandpyorrheaofthegumwasfound.Noabnormalhyperostosisnodulewasfound.Noevidentabnormalitywasfoundintherestparts.X-rayexaminationshowedimageoflow-densityshadowindentaltissuesofocclusalsurface.45Cariouscavitieswerefoundondistoangularandocclusalsurface;probing(−);percussion(−);cold(+);hot(+);noevidentlooseningandspontaneouspainwasfound.Noswellingandpyorrheaofthegumwasfound.Noabnormalhyperostosisnodulewasfound.Noevidentabnormalitywasfoundintherestparts.X-rayexaminationshowedimageoflow-densityshadowindentaltissuesofocclusalsurfaceExaminationReports—OralExaminationExaminationReports—OralExamination46Largeanddeepdentalcarieswerefoundonmesioangularandocclusalsurface,withseveresensitivity;probing(+);percussion(+−);cold(+++);hot(++);noevidentlooseningandspontaneouspainwasfound.Noswellingandpyorrheaofthegumwasfound.Noabnormalhyperostosisnodulewasfound.Noevidentabnormalitywasfoundintherestparts.Dentalpulpvitalitytesting:Readingof47toothis25;readingof46toothis22.X-rayexaminationshowedimageoflargelow-densityshadowinteethsofocclusalsurface.15Noevidentdentalcarieswasfoundintooth;cold(+−);hot(+++);percussion(+).Thepainlastedforlongtime.Swellingofthegumwasfound,withoutpyorrhea.Noabnormalhyperostosisnodulewasfound.Noevidentabnormalitywasfoundintherestparts.Dentalpulpvitalitytesting:Readingof25toothis30;readingof15toothis6.ExaminationReports—OralExamination36Largeareaofdefectwasfound,reachingpulpcavity;probing(−);percussion(+++);cold(−);hot(−).Evidentlooseningwasfound,withgradeⅠtoothmobilityandspontaneouspain.Evidentfistuloustractandpyorrheaofbuccalmucosawerefound.Noevidentabnormalitywasfoundintherestparts.X-rayfilmshowedimageoflargearealow-densityshadowindentaltissuesandimageoflargerlow-densityshadowinperiapicaltissues.Mildabsorptionofalveolarbonewasfound.Noevidentabnormalitywasfoundintherestparts.Doctor’sSignature:Li××ExaminationReports—OralExamination检查报告—口腔检查26面可见龋洞，探（−），叩（−），冷（+−），热（−），无明显松动，无自发性疼痛，牙龈无红肿、溢脓。未见异常骨质增生结节，余未见明显异常。X线检查可见颌面牙体组织低密度影像。45远中及面可探及龋洞，探（−），叩（−），冷（+），热（+），无明显松动，无自发性疼痛，牙龈无红肿、溢脓。未见异常骨质增生结节，余未见明显异常。X线检查可见颌面牙体组织低密度影像。46近中及面可探及较大、深龋坏，敏感严重，探（+），叩（+−），冷（+++），热（++），无明显松动，无自发性疼痛，牙龈无红肿、溢脓。未见异常骨质增生结节，余未见明显异常。牙髓电活力测试：47牙读数为25；46牙读数为22。X线检查可见颌面牙体大面积组织低密度影像。ExaminationReports—OralExamination检查报告—口腔检查15牙体未见