Amakilasi ku Blake: indawo izimbobo emazinyweni, ngezigaba kanye nokwelashwa caries zamazinyo

Kungani uhlukanise caries kwamazinyo? Kuyinto kuphela efika kuqala isifo elula yibo bonke abantu. Ukuze odokotela bamazinyo, kunomahluko ka esifika ngezindlela ezihlukahlukene, futhi ngayinye kuwo kudinga yayo indlela ekhethekile yokwelapha.

Caries ihlukile

Caries - lesi sifo ezivamile we ngalo ingaphakathi ngomlomo, ukuthuthukisa ezindaweni ezahlukene amazinyo kungaba ezahlukene futhi isithombe basemtholampilo inqubo. Ukuze kube lula ukuphathwa, uzokhetha ezinyweni nokulungiselela esetshenziselwa uphawu izinhlobo impahla zokuhlukanisa caries kwamazinyo. Ngakho ukwaba amakilasi ku Blake, ukujula ukunqotshwa ukujula, degree of umsebenzi inqubo ekubhujisweni, khona izinkinga, ubunjalo emitholampilo indawo lesion.

Ethandwa kakhulu iyona ngezigaba ezihlongozwayo ngo-1986 i-wamazinyo waseMelika uGeorge. Black. Injongo yalo kwaba systematization izimiso ukwelashwa ezihlukahlukene uhlamvu izinhlobo izinyo caries.

Amakilasi ku Blake

Black ezikhonjwe kwaba namakilasi amahlanu athatha localize phezu, okungukuthi, kuye ngokuthi lapho likhona ingaphakathi carious:

1. Kwasendaweni emifantwini (imifantu ayimigodi ku koqweqwe lwawo occlusal ebusweni), imigodi molars futhi premolars (molars ezinkulu nezincane), canines kanye amazinyo.
2. Yalimaza ezimbili noma ngaphezulu evele - ethunjwa le medial futhi distal (caries phambi ngamazinyo) noma occlusion (ukuhlafuna futhi ukusika evele) molars futhi premolars.
3. Ukuqhubeka kwesifo phezu ingxenye medial futhi distal we canines kanye amazinyo.
4. Kwasendaweni kuyafana ukuthi ekilasini lesithathu, plus engela entrained wesabelo umqhele noma ukusika ebusweni.
5. Cavity ithatha ingxenye wesibeletho kunanoma iyiphi amazinyo.

ngu Amabanga Black nokumisa zonke embodiments okungenzeka izimbobo emazinyweni, ngamunye wabo inikeza ukwelashwa ehlukile, indlela izinyo ukulungiselela isiguli kanye ukufaka uphawu.

Ikilasi lokuqala ngu Black

Kutholwe ingaphakathi carious ngaleyo ndlela kwande amathuba yokwephula uphawu emaphethelweni umfutho ophakeme kuso ngesikhathi ukuhlafuna. Lapho kulungiselelwa izinyo kuhlanganisa izinyathelo ukubeka eceleni kwakungenzeka lokhu. Lokhu kwenzeka ngokunciphisa koqweqwe lwawo wotho futhi wayinameka ungqimba mkhulu yokugcwalisa impahla. Lapho usebenzisa i-oluyinhlanganisela nge sokwelapha chemical sisetshenziswa parallel phansi komgodi yayo, njengoba ukuncipha izodluliselwa maqondana uginindela. Uma usebenzisa izinto ukukhanya abaphulukisa, kwayo lefanele, ungalibalekeli izingqimba. Ukuncipha Kulokhu uzoqondiswa umthombo polymerization. Izinhla Kumelwe ngilale kusuka phansi phakathi emaphethelweni ingaphakathi, ukukhanya kwenzeka ngokusebenzisa izindonga side, nangemva - perpendicular ebusweni nut. Ngenxa yalokho, waba nesifo sokuwa Friend kufinyelelwa ku uphawu ingaphakathi.

Izigaba ngokugcwalisa izimbotshana of ekilasini lokuqala

Izenzo ezinjalo kufanele wamazinyo kuthathwe ukuze elashwe Ibanga 1 ku Blake:

• anesthetize (sebenzisa gel izinzwa noma fafaza lidocaine) ,
• ukulungiselela izinyo (ukulungiselela kuhilela imishini ingxenye ezijulile carious kwezicubu kanzima)
• uma kunesidingo ukuphoqelela i gasket ekuvikeleni (ukuvimbela ukuchayeka we eyakhiwa uginindela ukucasuka yayo)
• amanzi okugqumisa acid hashaza, sula komgodi,
• behlukene ngamathe,
• ngempela isicelo primer (i dentin)
• Sebenzisa Yesigcilikisha (Ubuhlobo obuseduze phakathi ilungu esiyinhlanganisela izinyo indwangu noma primer)
• ungqimba by ungqimba yabalingisi impahla ukubamba sokwelapha yayo,
• kushintshwe ukuma efiselekayo, ukukhiqiza kokuqeda futhi wokucwebezelisa,
• ukwenza ukukhanya (sokwelapha yokugcina).

Eyesibili ekilasini by Black

Unezinkinga ayo Grade 2 Black kusikisela kubonakala endleleni aphatha ngayo imigomo emibili eyinhloko - ukwenza othintana naye strong phakathi kwamazinyo aso futhi unikeze kufanelekile Ukuthokomala we eyakhiwa emaphethelweni ingaphakathi main. Ngokuvamile inqubo ukubekwa uphawu nzima ukubonakala elengayo onqenqemeni zamanzi, ukuntuleka contact phakathi kwamazinyo aso noma impahla kanye izimbotshana. Ukuze uvimbele lokhu, i-matrix mncane is izinyo eyenziwa offset (ngokwalokho okuvunyelwa amandla ethu) usebenzisa amagejambazo lokhuni. Ngo Kwetfula interdental isikhala matrix kanye nesigaxa nquma ngalesosikhathi oswakanyiswe amanzi. Nesigaxa esinobudlova silokhu sanda futhi odlulela izinyo. Le ndlela uma ugcwalisa ukugwema imiphetho elengayo of ezikhaleni, nakho kungabangela ukuvuvukala izinsini. Ukuqina impahla kufaneleka ingaphakathi inikeza ukusetshenziswa lokwakha ingcina - isibopho uqobo ngoba esiyinhlanganisela kungenziwa ngokuqinile exhunywe kuphela ne koqweqwe lwawo, kodwa dentin.

Izigaba zokuvala amazinyo anezimbobo ekilasini lesibili

ngezimfanelo zawo nezigaba Black ekwelapheni zifana, kodwa ngamunye wabo kudinga ezicashile olukhethekile ukugcwaliswa. Nazi izinyathelo isigaba sesibili:

• izinzwa,
• ukulungiselela,
• uma kunesidingo, ukulungiswa izinsini,
• Ukufakwa matrix lapho umuntu eba uqhekeko lokhuni noma umnikazi,
• uma kunesidingo ezihambayo ngaphandle amazinyo,
• ahlawuliswe spacer ekuvikeleni (uma kunesidingo)
• enifeza inqubo etching, ukuwasha acid omiswe
  ingaphakathi
• ngabodwa izinyo kusukela ngamathe,
• isicelo primer kanye ingcina,
• uma kunesidingo - ukubuyisela emaphethelweni koqweqwe lwawo (uma ikhona),
• ukunqunywa izingqimba esiyinhlanganisela,
• Ukususa matrix nesigaxa,
• isilawuli interproximal contact,
• ukulungiswa, ezipholisha,
• sekugcineni ukukhanya.

amakilasi yesithathu neyesine

Lapha, indima esemqoka udlalwa yi-Ukukhethwa umbala we indaba ukugcwaliswa, ngoba kulesi simo ekonakaleni izinyo itholakala ku amazinyo angaphambili. Ngenxa Coefficient ezahlukene obala dentin kanye koqweqwe lwawo, ukuphathwa kuyadingeka ukusebenzisa esiyinhlanganisela emibili engafani. Kunendingeko ngezinyo kwakubonakala sengathi eyohlobo olulodwa, futhi uphawu akazange ibukeke isichibi. Ukwakha umphumela yemvelo kakhulu, sebenzisa abamhlophe we indaba ngokulingisa dentin, futhi cishe esobala - lokuphinda koqweqwe lwawo. Inguquko lalingabonakali ngamehlo, Bevel koqweqwe lwawo imbozwe 2-3 mm. Kubalulekile ukuthi umsebenzi omuhle kangaka ukwenza wamazinyo omuhle abangakwazi kahle ukunquma obala we izinyo. Kukhona degrees amathathu: opaque (ngokuvamile aphuzi, opaque onqenqemeni ngisho ukusika), okusobala (shades ophuzi-grey, okusobala cutting edge), kuyinto esobala kakhulu (lemicu empunga elinamathela othini, esifundeni esobala lifaka wesithathu izinyo.

Izigaba zokuvala amazinyo anezimbobo 3 kanye 4 amakilasi

Bonyana batshidze amakilasi yesithathu neyesine ka-izimbotshana ngabantu abamnyama, udokotela wamazinyo kumele uqedele izinyathelo ezilandelayo:

• ukuhlanza ebusweni qwembe
• ukucacisa umthunzi ngezinyo,
• anesthetize,
• ukulungiselela izinyo ukumkhulula nezicubu ezibolile
• setha imicu sokuhoxisa noma i-matrix, uma sidingeka (abathintekayo gingival margin)
• isicelo nangokuvikela ulwelwesi,
• uma kunesidingo, ukubuyisela wabuka amazinyo,
• hashaza acid sula komgodi,
• ukuhlukanisa ngamathe,
• Sebenzisa primer (uyazikhethela) kanye lokwakha ingcina
• plobiruyuschy abeke zamatshe impahla,
• ukususwa matrix kanye sesigcilikisha, uma kusebenza,
• ulungise onqenqemeni, ukuba balolonge ngezinyo,
• ukugaya nokuhlanganisa wokucwebezelisa,
• sekugcineni ukukhanya.

Ebangeni lesithathu by Black

Kulokhu, ukubaluleka main ubuhlobo izinsini kanye izimbotshana. Nge izilonda okujulile sokuvalwa onqenqemeni engezansi izinsini, ukopha wakhe, udokotela wamazinyo ezinhle ngokushesha kuthola ukuthi yokulungiswa wekhasi gingival. Ngemva zokukhwabanisa esifanele ushingamu izinsuku ezimbalwa, ukuphoqelela ukugcwaliswa yesikhashana ukuqeda nobunzima okwengeziwe uma ufaka njalo. Ebangeni lesithathu kuhilela ukusetshenziswa kwezinto eziphinde zisebenziseke esiyinhlanganisela futhi compomers (esiyinhlanganisela-ionomer nokusungulwa). Laba wasebenzisa izilonda olukha phezulu nge Ingcenye eqakathekileko yomsebenzi wehlelo kwasendaweni ngobukhulu. Ezimweni lapho ukubukeka yobuhle kubalulekile (noma ukwehluleka kuthinta kuphela koqweqwe lwawo), usebenzisa ukukhanya-sokwelapha zezinhlanganisela ngokukhethekile akhethiwe umbala.

Izinyathelo for zokuvala amazinyo anezimbobo ekilasini lesihlanu

Okufanele ukwenze lapho ukwelapha caries Ebangeni lesithathu:

• ukuhlanza ebusweni izinyo kusukela qwembe
• ukucacisa umthunzi,
• ukuchitha izinzwa
• enze asike izidumbu zabantu, kokukhipha izicubu othambile
• lesifanele wekhasi gingival, uma kunesidingo,
• faka intambo ukuhlehlisa,
• Sigcizelela gasket for ukwahlukanisa, uma kunesidingo,
• hashaza acid, ezomile,
• behlukene ngamathe,
• Sebenzisa primer kanye ingcina,
• ukupakisha izinto, ukukhanya,
• ukugaya nokuhlanganisa wokucwebezelisa,
• sekugcineni ukukhanya.

lesithupha

Adume udokotela wamazinyo waseMelika, egama layo linguJehova ngezigaba ubizwa ngokuthi, Kukhona amakilasi ezinhlanu izimbotshana. Kwaphela isikhathi eside, isimiso sakhe lalisetshenziswa ifomu yayo yasekuqaleni. Kodwa kamuva isinyathelo amakilasi Impilo by Black Umhlaba Inhlangano uye washintsha ezincane - ke ingezwe lesithupha. Uchaza kwasendaweni caries ngesikhathi usiko amazinyo nasemagqumeni amazinyo posterior.