Torusalnaya izinzwa amazinyo: izinto, izinzwa Zone

Anesthesia torusalnaya noma Veisbrem izinzwa izenzo phezu yonke indawo mandible, kuhlanganise nolwelwesi lwamafinyila, amazinyo, isikhumba isihlathi, kwesilevu, bese ithambo alveolar. Umahluko le ndlela kusukela bendabuko yokuthi udokotela ifaka inaliti ngokuqondile, ngaphandle noma yiziphi izinguquko kuthambekela. Torusalnoe izinzwa beshintsha izinzwa mandibular.

Izimpawu I-inqubo enjalo

Torusalny izinzwa indlela esetshenziswa ezimweni ezinjalo:

• nokwelashwa okubuhlungu zamazinyo kwesitulo yamazinyo (kusuka caries noma isizinda izinyo ku umhlathi ongezansi);
• airless isikhathi isondo Appliqué lapho ukuhlukumezeka mandibular;
• nokususa namazinyo ngokungalungile kwakhiwa;
• kokungenela kuhlinzwa yokususa izinhlumba kanye nezinye izimila kule mandible (sehlo nayo eyenziwa ngaphansi izinzwa wendawo);
• ohlwithayo izinyo usuvuthiwe washaya ithambo;
• kuvulwa abscesses (zokwakheka ubomvu), kodwa kulesi simo kufanele sihlanganise analgesia eziningana zezinto eziphilayo;
• cutting of hood of izinyo ukuhlakanipha ku umhlathi ongezansi.

Udinga ukwazi

Ukuze kahle nokuqalisa izinzwa kuyadingeka ukuze ubone sendawo kuvulwa emhlathini, esemgwaqweni endaweni ethukusiweyo ekhelini emhlathini (kusuka esifundeni phambi yokhalo emhlathini ku uhla of 15 mm ukusuka ohlangothini ezingemuva - 13 mm ukuqhela ohlangothini engaphakathi umhlathi ongezansi - 27 mm, futhi ukuzisika yayo - 22 mm). Kubantu abadala, lokhu imbobo isendaweni evele ukuhlafuna we molars aphansi, kanti izingane nasebekhulile - kancane aphansi.

Front kwelivi umqhewu ivikelwe ithambo okuthiwa mandibular ulimi zone. Ngakho-ke, ukuze alenze esilungele ukuqhuba torusalnuyu izinzwa, umjovo wenza khona 0.7-1 cm ngenhla ezingeni ukuvulwa, ie phezu iphuzu nolimi umhlathi ongezansi. Kuleli qophelo yayifanekisela nomxhantela ezinzwa ibekwa inkatho ithambo, lapho kukhona indwangu ukungena nakwamanye amazwe evumela ukuthi izidakamizwa ukusakaza ngokukhululekile.

Imiphi imigomo ozibekele izinzwa mandibular

Conduction izinzwa e- mandible ku Veisbrem ngokuvamile obizwa nangokuthi torusalnym. Ngokungafani inqubo ejwayelekile, umsebenzi le ndlela ingafika amagquma mandibular, lapho esekelwe ithambo isimila - izicubu condylar lemagalagala amagciwane coronal. It ibekwe ngaphandle wesabelo avaliwe ephansi emhlathini ithambo eduze nolimi. Lokhu inesikhala ilungiselelwe fibre, okuyinto uxhumeke kwi-buccal, lingual futhi mandibular nerve iziqu. Bakhiphe elezinga eliphansi alveolar ezinzwa block wenziwa izindlela intraoral futhi extraoral. Lapho indlela intraoral kusetshenziswa izindlela ezimbili izinzwa ezifana: palpation futhi apodaktilnaya (ngaphandle kumba).

indlela palpatory

Anesthesia usebenzisa palpation. Ukuze wenze lokho, udinga ukuthola indawo ngokuzwa Crest yesikhashana (kuba mlando inaliti wokubhoboza) kanye ikhefu pozadimolyarnogo. Temporal Crest ithambo isiguqo ezisabalele kusukela egciwaneni coronal odongeni lingual we mandible zone alveolar. Ngo engxenyeni engaphakathi ikamu sehlukaniswe Amabha nangaphandle. Bakha endaweni encane - unxantathu pozadimolyarny.

isidingo okunjalo ezicacile zomzimba ukuhlukanisa neoplasm kusukela pozadimolyarnoy fovea, etholakala phakathi Crest nesifunda yesikhashana emhlathini phambi aphansi. Kule kusobala ukuthi ikhefu lasesikoleni pozadimolyarnoe kahle ohlangothini unxantathu. Uma torusalnoe izinzwa wenziwa ngakwesokudla, khona-ke lapho zibona lezi zindawo bony palpated ne index ngomunwe esandleni sakhe sobunxele, uma kwesokunxele - isithupha esandleni esisodwa.

Torusalnaya imishini izinzwa:

1. Isiguli wathi esiphezulu umlomo wakhe simbe umphetho waphambili inqubo mandibular ezingeni we distal lwesithathu izinyo lomhlathi imiqhele izici (uma kungenjalo, khona-ke i-izinyo lomhlathi yesibili).
2. Ukuhambisa kancane kuya ngaphakathi ngomunwe, udokotela uthola ikamu yesikhashana, abese emisa umunwe pozadimolyarnoy e ekhosombeni, okuyinto ayisesemikhulu ngezithukuthuku zalezi zakhiwo yokwakheka.
3. Ukubeka isipetu phezu kobuso premolar ngakolunye uhlangothi, onguchwepheshe lucwaningo umjovo inaliti eduze Crest phezu yesikhashana 0.8-1 cm phezulu zidlule ukuhlafuna izinyo lomhlathi lwesithathu, khona-ke enza inaliti ngaphandle futhi ingaphakathi.
4. Manje torusalnoy izinzwa nqubo Ngakho: inaliti ifinyelela ithambo ngesikhathi ukujula endaweni ethile 0.5-0.7 cm, kule zoni yethulwa umthamo elincane yokwelapha ubuhlungu ezinzwa lingual, alveolar phansi kunabaphostoli elise phambi emsipheni.
5. Khona-ke uhamba isipetu umsiki ingxenye, futhi inaliti idluliswa ngenhla, ie zifana kuya yangaphandle okuyingxenye inqubo avaliwe umhlathi ongezansi, a ka 2-3 cm ukujula chamfer ithambo lapho emsipheni alveolar, futhi umthamo asele ka izinzwa is injected.

Uma usebenzisa imithi zamanje iqembu amide "R-S articaine Forte", kusho umthamo iqondiswa imayelana 2 ml.

Apodaktilnaya amasu

Isiqondiso esiyinhloko ukuqaliswa indlela enjalo kubhekwa nesibaya Pterygopalatine-mandibular, okuyinto ibanjiwe kahle. Kungaba ewumngcingo, ezibanzi noma naphakathi ububanzi, etholakala engxenyeni engaphakathi Crest yesikhashana.

Injani inqubo

Torusalnaya izinzwa amazinyo wenziwa ngendlela elandelayo:

1. Udokotela wamazinyo utshela isiguli umlomo wakhe ububanzi, futhi ngaleso sikhathi ithumba isipetu phezu ephansi emhlathini ezingeni.
2. Thrust inaliti wanyuselwa elingaphandle emthambekeni pterygopalatine-mandibular ngeshumi isikhungo phakathi izindiza ukuhlafuna we molars yasenhla nemithombo yasenzansi (uma ikhona - ke Midway ingxenye interm emikhulu alveolar futhi igciwane).
3. Uchwepheshe Eminye luthuthukisa inaliti ukuze ohlangothini elingaphandle futhi kwangaphakathi emphecweni kuya uxhumano ithambo fibre kumuntu ka 1.5-2 cm ukujula, kanjalo ethula yokwelapha ubuhlungu futhi phansi lingual nezinzwa alveolar. Pterygopalatine-mandibular nesibaya kuyinto inkomba kahle kuka ikamu yesikhashana.

ukufinyelela extraoral

Anesthesia torusalnaya mandible uqhutshelwa kule ndlela, uma, isibonelo, kuphakama izinkinga ngomlomo ukuvulwa. Kangakanani umcimbi:

1. Ingabe kunqunywa kwelivi we izimbotshana mandibular esikhumbeni. Le hole itholakala maphakathi strip, esukela onqenqemeni kobuso tragus we indlebe zone empambana yayibambene imisipha masseter.
2. Thrust inaliti senziwa esikhundleni base emhlathini at 1.5 cm kuya onqenqemeni phambi engela yayo.
3. Khona-ke inaliti ihamba ngenhla nje 3-4 cm phezu inqubo avaliwe mandibular ukuvulwa parallel uhlangothi lwalo emuva. Ngesikhathi ukudlula inaliti kufanele uzitholele contact yayo nge ithambo.
4. Ekupheleni izinzwa is injected. Khona-ke, ukusunduza inaliti phezulu by 1 cm, ohlanganyela nayo yonke enye ubuhlungu imithi, ukucisha ulimi emsipheni.

indawo izinzwa

Anesthesia torusalnaya ngokuyinhloko eyenziwa ukuze anesthetize ezinye esishintshashintshayo ngokushesha kule ngalo ingaphakathi ngomlomo, okuyilezi:

• lingual nabaphansi ezinzwa alveolar;
• kwesilevu isikhumba endaweni izinzwa;
• namazinyo mandibular isigamu;
• mucosal futhi isikhumba udebe lwangezansi;
• alveolar ithambo hlangothi nakuloluya ingxenye komzimba mandible;
• sublingual mucosa endaweni kanye phambi ulimi 2/3;
• ulwelwesi lwamafinyila we alveolar odongeni ikhomba lingual nesifunda vestibular.

Ezinye alveolar mucosa ekamelweni ingxenye mandible ku uhla kusukela maphakathi premolar yesibili maphakathi nawo lokuqala izinyo lomhlathi innervated. Ukuze anesthetize ngokuphelele endaweni izinzwa mandibular wenziwa ngendlela elandelayo: 0.5 ml injected imithi eyengeziwe emhlambini Lesisemkhatsini ngohlobo kokuziphatha izinzwa.

yi izinzwa e izinzwa uqala emva kwemizuzu 15-20. Isikhathi izinzwa cishe 60-90 imizuzu. Ubucayi ngokusungula indlela yokubulala izinzwa endaweni ye amazinyo futhi canines aphansi kakhulu ngenxa anastomoses onesandla okuphambene. Nale izinzwa wasebenzisa izidakamizwa ezifana: "Novocaine," "Trimekain", "Ultrakain" noma "lidocaine".

yezinkinga

Anesthesia torusalnaya kungaletha ngisho ezilimazayo, njengoba kulandela:

• hematoma kumiswa;
• ukwa umjovo izinaliti;
• ndikindiki pharyngeal kwezicubu;
• neuritis futhi lingual aphansi alveolar ezinzwa;
• umonakalo esicashile pterygoid imisipha contractures elinefomu ngokwengeziwe mandible.

Yezinkinga oshiwo ngenhla zenzeka ayephuli amasu zenqubo ngokusungula indlela yokubulala izinzwa. Ngakho, izinzwa eliyifa torusalnoy - inqubo kunzima futhi kudinga iziqu eziphakeme wamazinyo.