Exacerbation ka pulpitis ezingamahlalakhona. Izizathu, umehluko ukuhlola, ukwelapha pulpitis okungamahlalakhona

Mhlawumbe hhayi umuntu onjalo, akakaze kwadingeka ukunkenketha. Futhi lapho, njengoba kushiwo, inqubo uqalile, bonke emizweni isikhungo emhlabeni izinyo elilodwa isiguli. Uma silahle Ukuvakashela udokotela wamazinyo ukuze ke, isiguli has a sethubeni elihle ukufunda zonke "izintelezi" ka pulpitis ezingamahlalakhona.

Iyini inqubo?

Pulpitis uma ikhuluma atholakalayo, i ukuvuvukala ikhulela izinyanda neurovascular ngaphakathi iziteshi imisuka amazinyo kanye umqhele ingxenye. Uma isiguli badlulisela icala udokotela ngezikhalazo ahlekise (isb. E. indawo ukuba pulpitis acute), kwezinye izimo ukuvuvukala kungenziwa wayeka, futhi kungaba basindiswe izinyo.

In a state of ezingamahlalakhona pulpitis uginindela kancane kancane wezinga eliphansi kwakheka izicubu lunemicu noma necrosis waphawula ukuguqulwa neurovascular besigaxa kuze kube seqophelweni lapho sigcwalisa lonke carious izicubu umgodi lapho kuye kwaholela egunjini lokuhlolwa kwezifo.

Ngokuvamile e pulpitis obungapheli acute kungenzeki, kanti iziguli kudokotela ukuze asindise izinyo kusukela kuyasulwa. Nokho, ifomu njalo pulpitis - kuba isifo engelapheki cishe ngaso sonke isikhathi.

izimbangela

Kunoma zokugula kukhona preconditions nezimo emenza ukuthuthukiswa inqubo pathogenic. Kuyinto iyathinteka kanye uginindela. amafomu Okungalapheki lesi sifo cuphuluza nezilwanyana ezincane pathogenic kanye nemikhiqizo yabo umzimba. Ngokuvamile, umsuka zonke waqala kuba phambi endaweni ngesineke caries ngokujulile indlela yokwelashwa noma abone izinga abampofu lokhu nezifo ezithé chithi saka. Ngu ethemini mithandazo kwakusho art ukungahambisani ukwelashwa nesineke yamazinyo, enganele uhlanzekile ingaphakathi, unamathelise m kahle kwakunezinselele. P.

izimbangela Ngaphansi ezivamile pulpitis okungamahlalakhona, ingqondo ukuthuthukiswa inqubo pathologic, singase sibe ukuhlukumezeka ngezinyo, iziteshi occlusion NVB usawoti bavimbe ( "calculi"). Futhi, pulpitis Okungalapheki sengathi inkinga yesifo maxillofacial futhi jikelele (sinusitis, imfuluwenza periodontitis, osteomyelitis, periostitis njll D.) Inqubo ukugeleza izifo Amagciwane anjalo akwazi ukungena ngokusebenzisa phezulu impande izinyo.

Izinhlobonhlobo inqubo okungamahlalakhona

Odokotela bamazinyo 3 izinhlobonhlobo pulpitis okungamahlalakhona: hypertrophy, cystic, gangrenous.

Nge inqubo hypertrophic ebonwe endizeni carious izicubu overgrowth uginindela njengoba polyp. Njengomthetho, isiguli ubona neziqu ukopha ukuthi balimala ukuhlafuna. Lobu buhlungu ukuthi baba mnene futhi ezimweni eziningi zibangelwa ezizihluphayo zangaphandle.

ifomu fibrous kwenzeka avame libhekene okuvela ezidabukile ubuhlungu emizweni, okuyinto kwezinsuku ezingu-1-2 ukuyeka bebodwa, kodwa ingaphakathi carious cishe njalo esibhibhayo esivame ukopha.

ifomu Gangrenosum libhekene ephelele noqhekeko izinyo nerve izicubu zokubhubhisa kanye nengxenye enkulu yezakhi umqhele. Le ndlela pulpitis ngaso sonke isikhathi sihambisana onukayo. Ubuhlungu ngokuvamile ngokulinganisela ezenzeka ngezikhathi. izikhalazo ejwayelekile lesiguli kulokhu zimi kanje: "izinyo nezibi, bese uqobo kumisiwe."

Kuyaphawuleka ukuthi abaningi (≈ 70%) odokotela kwatholakala ukuthi nginesifo esingelapheki pulpitis lunemicu ingasaphathwa - gangrenous. ifomu Hypertrophic cishe ingekho abadala. Lokhu ukuxilongwe ngezinye izikhathi odokotela bamazinyo zezingane.

Ukuxilongwa pulpitis okungamahlalakhona

Ukuze lokwenza ukuxilongwa, udokotela, ngaphezu kokulalela izikhalazo isiguli, kudingeka bachithe ezithile imisebenzi, esakhiwa kuhlolwe ngamehlo ezinyweni lesiguli, thermometer, isib e futhi x-ray.

Lapho kuhlolwe ngamehlo udokotela uthola cishe 50% ulwazi ngesimo izinyo esiyimbangela. Thermometer izifundo mayelana yokusabela ezintweni ashisayo nabandayo enze kube nokwenzeka ukuba baqonde indlela isifo nokuthi uhlobo nesineke badlulisela icala udokotela. Ngokwesibonelo, ku-impendulo abandayo lithi "nerve" wabulawa.

Electric uginindela test (ESI) ingenye yezindlela onokwethenjelwa kunayo yonke ekuxilongweni epulpiti. Le nqubo kusekelwe eqinisweni, ukuthi iziguli kanye uginindela izicubu onempilo ehlukile excitability kagesi. I enempilo ezinzwa ubuhlungu emizweni basabela umphumela ezincane phezu samanje microamps 2-6, fibrous pulpitis ubuhlungu umfutho efanayo uyosabela 35-50 ma, gangrenous zidinga ukuchayeka 60-90 microamps.

Radiography Kuphatha ukuhlola isimo izinyo ngu-X-ray.

Imiphumela yaloku kuhlola okungenhla Ukwahlukaniswa ka pulpitis ezingamahlalakhona kuhilela ukuhlolwa okubanzi kwazo zonke izindlela ngenhla echazwe futhi Luhlatiyo ulwazi olutholakale inqubo ukuxilongwa.

Symptomatology yefomu njalo pulpitis

Ngokuvamile ngalesi sigaba zezifo asymptomatic. Njengoba kungaqondakala ukuthi umuntu pulpitis okungamahlalakhona? Izikhalazo ikakhulukazi kungagcini kokuba ezidabukile ubuhlungu nge ezahlukene isikhathi kwezikhawu ukuthula phakathi kwabo.

Lapho ifomu lunemicu ngokuvamile ubuhlungu kwamanje okubangelwa ukuchayeka nezici kuyacasula (hot, ezibandayo, amnandi). Ubuhlungu isikhathi eside ungadluli ngisho nangemva umphumela ezintweni iqedwe. Ukuthuthukiswa uphawu isici kungaba ngokuthi ubuhlungu isikhathi eside ngesikhathi ushintsha izinga lokushisa ngaphandle nge aqandayo efudumele (isibonelo, aphuma mgwaqo emagcekeni). Nakuba kwezinye izimo ukugeleza fibrous pulpitis kungenzeka futhi ngaphandle izimpawu ezisobala. Yilokhu okwenzekayo uma umfutho akanayo ukufinyelela ngqo ingaphakathi (isibonelo, itholakala ngaphansi gum noma ngokusebenzisa uxhumano nge ekamelweni uginindela). Kulo mBhalo, akukho ukuvuvukala, uginindela is hhayi "okuncane" futhi, ngenxa yalokho, ayikho ubuhlungu.

Lapho pulpitis gangrenous njalo nilethe iphunga ezingemnandi kusukela amazinyo nomlomo isiguli. Libhekene ubuhlungu emiphumeleni ashisayo, abangafuni ukuyeka isikhathi eside ngokwanele, ngisho nangemva kokuba umfutho iyasuswa. umuzwa ukugcwala e izinyo ngokuvamile abakhona. Ngaphezu kwalokho, cishe ngaso sonke isikhathi kushintsha umbala izinyo: iba lemicu empunga elinamathela othini.

Hypertrophic pulpitis ephelezelwa ezidabukile ubuhlungu lapho ukuhlafuna futhi opha. Lokhu kungenxa ukuhluma kwezinhlobo uginindela e umgodi lohlobo "inyama zasendle". Lokhu isici ngokuvamile iningi kuyabethusa isiguli kanye ongayibona udokotela.

Izigaba Okungalapheki inqubo yokwelashwa

Njengoba kule isifo izicubu zomzimba ezithambile e izinyo Ngeke ukwazi ukukugcina, uhlobo eyinhloko kwelashwa ukususwa imiselekazi izinyo uginindela. Modern zamazinyo lilidlula ukhetha esibalulekile extirpation indlela (isizinda ezimanzi) ezinzwa uma kusetshenziselwa imithi yokubulala izinzwa kuphela ngaphandle elibandakanya nomuthi ngokubulala uginindela.

Nokho, ngezinye izikhathi izici ngamunye yomhlathi lesiguli, ukuntuleka kwesikhathi kanye nokuntuleka imithi yokubulala izinzwa okuhle ungavumeli ukuthi ususe emsipheni ngokushesha ekuhambeleni kokuqala. Khona-ke isicelo ekwelapheni pulpitis ezingamahlalakhona ngezigaba, lapho umgodi selibekiwe nokunamathisela ekhethekile, okuyinto ihlose ukulungisa uginindela ukususa, okwenzeka ngesikhathi kuhambele yesibili.

emva kokwelashwa

Kaningi, ngemva ekwelapheni pulpitis ezingamahlalakhona kuphelile, abantu bakhononda ubuhlungu. Lezi emizweni abizwa ngokuthi postplombirovochnyh (njengoba bebizwa bamazinyo). Njengomthetho, kukhona ukungakhululeki ngenxa yezizathu eziningana futhi ibekwe inkambiso eyamukelekayo kunemibandela. Okuvela ubuhlungu emva kokwelashwa okungenzeka pulpitis ngenxa yokuthi kukhona kungenzeka kuphela imihuzukwana izicubu emhlabeni izinyo lesiguli noma nge emangelengele, ukuzehlukanisa abukhali "nerve" e inqubo isuswe. Futhi, ubuhlungu zingenzeka uma ngesikhathi ekwelapheni iziteshi izinyo icutshungulwe ngu- enamandla isinqandakuvunda, okuyinto okuncane ungadlulela ngalé impande.

Esinye isizathu ubuhlungu postplombirovochnyh - okukhiphayo ithuluzi mncane ukuthi odokotela bamazinyo ukusebenzisa inqubo yokwelapha ukusebenza ngaphakathi iziteshi, nangale impande imbobo isihloko.

Izimbangela yezinkinga emva kokwelashwa

Ngezinye izikhathi ngemva "inkhulumomphendvulwano" zibonakala ziphumelela ne wamazinyo iqala sebuhlungwini obunzima, futhi ekuqaleni ziphathwe exacerbation of pulpitis ezingamahlalakhona inkimbinkimbi. kungenzeka eziningana Izizathu zalokhu. Lokhu Kungasebenti kahle kwaletinye umsebenzi kuziteshi izinyo ukugcwalisa, nasekuhlephuleni off ithuluzi kwamazinyo ngesikhathi abayitholayo e umsele impande noma perforation (ukudala izimbobo) udonga impande.

Uma iziteshi kabi uphawu, noma Ukungena avunyelwe ngokugcwalisa impahla ngale sokudlondlobala impande, kwabanye isikhathi esithile (kusukela izinsuku ezimbalwa ngonyaka) ngeke periodontitis izimpawu esigabeni oyingozi. Khumulani ithuluzi kungenzeka ngokushesha ukuzibonakalisa, kodwa isifo e nedomytom futhi nezaplombirovannom isiteshi namanje ukumemezela ngokwawo kwamanzi, ukubukeka gqwa kule fistula gum (kakhulu) noma ukwakheka izinhlumba nge okuqukethwe ubovu.

Exacerbation yenqubo okungamahlalakhona: izimpawu

Uma izinyo obuhlungu ngemithi kuwukubonakaliswa pulpitis acute is zingelashwa, lesi sifo ingena ifomu okungamahlalakhona, uzonikhumbuza zalo nge ukuqinisela enviable kukho konke ukuphila. Njengoba kuboniswe exacerbation of ezingamahlalakhona pulpitis? Izimpawu ezingemnandi: ubuhlungu nokusondelana ezishukumisa ehlukahlukene (ukushisa, amakhaza, ezinoshukela, aphuma abandayo hot) imizwa ngokwanele engemihle futhi eshaywayo palpation (hhayi ngezinyawo eqinile evunyelwe ithuluzi kwamazinyo ngenxa yezizathu izinyo). Ngokuvamile, iziguli ukuchaza ubuhlungu njengoba paroxysmal. Ngo isinyathelo inqubo libhekene exacerbation of obungapheli esiphelweni ezindleleni ukudlula emsipheni trigeminal. Kungenxa yalesi sizathu ukuthi iziguli ukuthi ubuhlungu kunikezwa ethempelini noma ngaphansi amehlo, ikhala noma kwesilevu.

Okubi kakhulu kanye nezizathu ukuthuthukiswa yayo

Exacerbation ka pulpitis okungamahlalakhona kungase wazizwa ezinyangeni ezimbalwa. emizweni Buhlungu ziyabonakala hhayi njengoba olunzima njengoba ifomu oyingozi. I njalo kunazo izimbangela okubi kakhulu angase abe ezinjengokungcoliswa Ukuwohloka outflow ka exudate, ukuhlukumezeka ukuze izinyo, umsebenzi anda namagciwane abangela izifo. Futhi, attenuation kungase kube nomthelela babuyela amasosha omzimba jikelele, ukuvuvukala lymph node kanye ukudakwa Imininingwane.

Exacerbation amafomu njalo pulpitis kungase kuhambisane izenzakalo periodontitis eqondile. Ezimweni ezinjalo, iziguli ukuza wamazinyo ukukhononda hhayi odlulayo ubuhlungu. izinguquko sokugembula ezilotshwe-X-ray.

namazinyo lesikhashana e seziguli ezisencane

Hhayi kuphela iziguli omdala ukuthi nginesifo pulpitis ezingamahlalakhona. Izingane, hhayi kuphela unomphela, kodwa ngamazinyo yesikhashana, lesi sifo singumbulali ezimbi zingenza nokuhlukileko. Zonke izinhlobo ukuvuvukala ezingamahlalakhona libhekene izimpawu evelele.

Ingane ayikwazi ukuhlafuna ukudla kahle. izinyo Causative iphendula lokushisa ezishukumisa. Lapho ifomu gangrenous zobuhlungu avele ekuphenduleni Ingqondo nge yafudumala, kushise noma uma usuka umkhuhlane ekamelweni efudumele. pulpitis Proliferative (ikakhulukazi hypertrophic ifomu) libhekene ukubukeka ubuhlungu nabo izinhlayiyana zokudla e umgodi. Ngaphezu kwalokho, polyp kuchitheka igazi uginindela ngesenzo lokukhanda.

I engavamile lesi sifo kulonyaka - umfutho eliphansi ubuhlungu ukuthi zingachazwa ngezinqubo tingucuko tekuhleleka uginindela izixhumanisi zalo waqiniswa periodontitis. Kulokhu, lo kwezimo ezifanele umdlalo khulula uketshezi, ngenxa yalokho, kukhona ubuhlungu obukhulu.

namazinyo Permanent ezinganeni

namazinyo Permanent ezinganeni futhi othambekele yezifo uginindela. Indlela pulpitis okungalapheki izingane ziyefana kwabadala. inqubo Okungalapheki esigabeni oyingozi, iziguli abasha ngokuvamile ebonakala isikhathi eside ukugeleza evilaphayo nobuhlungu oyingozi. kungazelelwe ukungakhululeki ezikhulayo Ngokuvamile lidlula, futhi ingane akazihluphi inkathi ngokwanele eside. Kodwa ezimweni eziningi, iziguli esekhala paroxysmal Ukubhidliza noma ubuhlungu acute, Smack bebheke amagatsha emsipheni trigeminal. electroexcitability okuphansi (120-160 ma) liyakhuluma ngokuphela izinguquko njengoba amangqamuzana ezinzwa e uginindela egqoke dystrophic futhi elimazayo.

Kufinyeta

Ngeshwa for iziguli, ngeke ngokwalo ukudlula noma esigabeni oyingozi kakhulu lesi sifo, futhi exacerbation alandelayo pulpitis ezingamahlalakhona. ukwelashwa kwamazinyo kuyodingeka ngokushesha noma kamuva. Futhi kungcono wenze lokhu kwenzeke ngokushesha ngangokunokwenzeka ukulondoloza esigulini phakathi ukuhlupheka okungadingekile kanye nemicimbi kuyabiza futhi kubuhlungu, futhi udokotela - ku umsebenzi eside futhi oyisicefe ukuthi lidinga isipiliyoni kanye nesineke.