I-pulpitis: udidi, iintlobo, iklinikhi. Ukwahlulelwa kweendlela zokonyango lweplpitis

Okumangalisa kukuba, inyaniso kukuba isifo, njenge-pulpitis, sineendlela ezingaphezu kwe-20 zokuhlelwa. Amazinyo ngokwabo basebenzisa iindlela ezahlukeneyo zokuvavanya uhlobo lwesifo emsebenzini wabo, kodwa phawula ukuba akukho namnye unako ukukwazi ukuchaza ngokuchanekileyo zonke iimpawu zesi sifo esibi. Amazinyo ayaqaphela ukuba adinga ukuhlelwa okulula kunye nokwakhiwa kwamagulpitis, okuza kubonisa isifo kuzo zonke izikhundla ezifanelekileyo.

Kutheni kubalulekile ukuhlukanisa i-pulpitis?

Ubungqina bendlela eninzi yokusebenza kweso sifo sezinyoya kudibene neendlela ezahlukeneyo zokuzama ukuchaza isifo. Iindidi ezahlukileyo zokuhlelwa kwe-pulpitis zibonisa ukuba ziqwalaselwe ezikhundleni ezahlukeneyo: izizathu zokuqala nokuphuhliswa, umfanekiso weklinikhi, ukuqhubela phambili, iimeko zeenkqubo ezinzulu kwimigudu yamanxiwa kunye nabanye.

Ukuchaza kuzo zonke iimbombo ukufakwa kwepalpiti akukavelwanga. Ngoko ke, izazinyo zamazinyo kufuneka zitshintshwe umfanekiso okhoyo wekliniki kwisigulane esinye kwisakhelo seendlela ezikhoyo zokuvavanya kwayo. Ezinye iiplani zezicwangciso zaphuhliswa eziliqela kwiminyaka edlulileyo, kodwa nangoku ngoku zisetyenziselwa ukuxilongwa kunye nokunyangwa kwe-pulpitis.

Okokuqala ukuzama ukulungelelanisa lesi sifo samazinyo kwenziwa kwi-20 yekhulu lokugqibela kwaye babizwa ukuba bachaze ipulpiti ngokuchanekileyo ngokunokwenzeka. Ezi zihlulo zaziyinkimbinkimbi kwaye zinzima. Yingakho iingcali zenza umsebenzi oqhubekayo ukuphucula iindlela zokuchaza isifo. Ngexesha eliyiminyaka emi-5-10, isigaba esitsha sahlongozwa esekelwe kwizicwangciso zangaphambili, kodwa sinesimo esitsha ekuchazeni umzekelo wepppitis.

Udidi lwe-WHO

Ekupheleni kwekhulu lama-20, oko kukuthi, ngo-1997, ukuchithwa kwamazinyo kuye kwaphawulwa ukwenziwa kohlengahlengiso lwezizwe zohlaziyo olu-10, olubizwa ngokuba yi-ICD-10. Yavunywe yi-World Health Organisation, kwaye ngowama-1999 yaba yinkqubo esetyenziswa kakhulu kwizinyathelo zamazinyo ukuxilonga nokuphatha i-pulpitis. Le nkqubo ibizo leenkowudi kunye nokudibanisa kwabo ukuchaza umfanekiso weklinikhi yesifo. Ukwahlulelwa kwe-pulpitis kwi-ICD kuquka izinto ezilandelayo:

• Izifo zohlobo lwe-pulpal kunye ne-periapical zicetywayo ukuba zonyulwe ngokusebenzisa ikhowudi ye-K04.
• Ipulpiti ngokuchanekileyo i-encrypted K04.0.
• Isigaba sokuqala sesi sifo, esichazwe yi-hyperemia, sikhethwe i-K04.00.
• I-pulpitis ecacileyo inikwe ukubethela uK04.01.
• Ukuba i-abscess ifunyenwe, ikhowudi K04.02 ifakiwe.
• Ifomu engapheliyo ye-pulpitis yonyulwe i-K04.03, kwaye ukuba izilonda ziyafunyaniswa, kucetyiswa ukuba zibhafice ukuxilongwa ngendlela ye-K04.04.
• Ukuba isigulane sinombumba we-polyp kwifomu engapheliyo, ngoko ikhethiweyo i-K04.05.
• Xa isifo seengxube ze-neuromuscular yezinyo zenye indawo echaziweyo zifakwa K04.08.
• Ukuba i-pulpitis ayibonakali kakuhle, oku kuboniswe kwikhowudi K04.09.
• Iimpawu ze-Necrotic okanye ze-gangrenous kwi-pulp zichazwa yikhowudi K04.1.
• Ukuba iinkqubo ezinonophelo, ezifana nee-denticles, amatye ombumba okanye izibalo, zijongwa ngudokotela wamazinyo, ubachazela ngekhodi K04.2.
• Kwimeko yokwakheka okungavumelekanga kwezicubu ezinzima kummandla we-pulp, uphawu lwe K04.3 lwenziwe. Kwaye, ukuba le yinto engavumelekanga (esecaleni) yedentin, ngoko ichazwe yikhowudi K4.3X. Kufuneka ukuba uqaphele ukuba kule meko ukubalwa kunye namatye kwi-pulp kupheliswa.
• Ngexesha le-apticical of nature, elibangelwa utshintsho kwiisisu ezinamazinyo zezinyo, ikhowudi K04.4 ifakwe.
• Ukuba, nangona kunjalo, ugqirha wamazinyo akholelwa ukuba unamathambo kunye ne-periapical phambi kwakhe, engafanelekanga kumanqaku angentla, ubeka uphawu lwe-K04.9.

Olu luhlu lwe-pulpitis ngokutsho kwe-WHO, ngokweentloko zamazinyo, akuyona into efanelekileyo. Nangona kunjalo, isasetyenziswa njengesikimu esisemthethweni sokuqokelela iingxelo zeengxelo zengcali kwi-work done overtime. Iikhowudi kunye neenkcukacha zeli dokotela kufuneka zibekwe ekhadini kunye nekhuphoni yesigulane. Abaninzi bamazinyo bayavuma ukuba badla ngokubhala phantsi izifo abaye baphatha ngaphakathi kwesikimu esicetywayo ngu-WHO, nangona bayisebenzisa ngezindlela ezahlukeneyo ezichanekileyo zokubonakalisa i-pathology pathology.

Iimpawu ze-pulpitis ngokuvela kwayo

Olu luhlu lwe-pulpitis kunye ne-periodontitis luqwalasela iibangela zezi sifo. Ngokwale mqathango, izazinyo zamazinyo zihlukanisa iintlobo ezine zesifo:

• Sulela.
• Inkathazo.
• Ukuphetha.
• Ukugqithisa okanye imichiza.

Makhe siqwalasele ngokubhekiselele kwiplpitis nganye, ekwahlula kwayo ichaza izizathu zokuvela kwayo.

I-pulpitis echaphazelekayo

Olu hlobo lwesifo lubangelwa ngumsebenzi weebhaktheriya ezithe zafaka i-toxins kwaye zikhuphe ukuvuvukala kwe-vascular and nerve bundle yezinyo. Kwiimeko ezili-9 eziphuma kwii-microorganisms ezi-10 zivela kwi-carious cavity ngaphakathi kwimijelo yamazinyo okanye zithintela indawo evulekile yentsholongwane. Okungaqhelekanga kukubuyisela kwakhona i-pulpitis, xa ama-microbes engena kwizinyo ngokusebenzisa umgodi phezulu kweengcambu. Oku kwenzeka ngezifo ezithathelwanayo, ezifana ne-ARD, i-rubella, i-osteomyelitis, i-sinusitis okanye i-periodontitis. Kwiimeko ezizimeleyo, usulelo lunokuba lukhulu. Into eqinisekileyo yokubona i-pulpitis yile etiology. Ukwahlulelwa kwalo mgaqo uvame ukusetyenziswa ngabagqirha.

Iipppitis ezibuhlungu

Kubalulekile ukuba uqaphele ukuba ukulimala yimbangela yenkqubo ye-pathological, engakhokelela ekubeni i-pulpitis. Kule meko, ukunyaniseka kwezintambo zinozinyo kuphelelwa yintsholongwane kwaye ukusuleleka kwabo kuqhutyelwa ngokuphuhliswa okuqhubekayo kwesibonda se-neural. Ngamanye amaxesha akuyiyo ingqibelelo yezinyo ephukile, kodwa indawo yayo echanekileyo (ukuchithwa okanye ukuhluthwa). Kule meko, i-pulpitis iyimpawu ezivaliweyo kwaye iyaqhubeka ngaphandle kokubandakanyeka kwamachiza ezincinci.

Ukulimala kunokuba yinto yobomi, kufumaneka ngenxa yengozi okanye ukulimala, okanye kunokubangelwa ukungenelela kwezokwelapha. Ngokomzekelo, xa ugawula izinyo "ngaphantsi kwesithsaba," i-pulpitis idla ngokuphindaphindiweyo ngenxa yezihlunu. Le ngxaki idinga ukulungiswa ngokukhawuleza. Kubaluleke kakhulu ukuba ugqirha unamathela kwisikimu: i-pulpitis - udidi - iklinikhi - unyango. Ngomsebenzi oqhubekayo weengcali, phantse nabani na, nokuba yimeko enzima kakhulu, unokulungiswa, ukhuphe ubunzima beengxaki ezingathandekiyo.

Conjunctogenic pulpitis

Olu hlobo lwe-pulpitis luyenzeka ngenxa yezinye iifom e-canal ye-teeth - denticle okanye i-petricates. Ziyakhula kwimida yeemingxube kwaye zifake imithwalo yegazi. Ngenxa yoko, i-microcirculation iyaphazamiseka, i-edema yenziwa. Isiphumo si-pulpitis.

Imithi okanye i-pulpitis yamachiza

Olu hlobo aluqhelekanga ukuchaza i-pulpitis, kodwa eqinisweni, kudla njalo kwaye kubangelwa yimpazamo yonyango. Oku kwenzeka ukuba ugqirha wamazinyo usebenzisa izinto ezinamandla (i-alcohols okanye i-ethers) ekulungiseleleni i-caries okanye i- pockettime period , okanye iphutha lobugcisa lwenziwa ngexesha lokutywinwa.

Ukwahlulelwa nguPlatonov

Nangona le ndlela yokuhlolwa kwesi sifo iphakanyiswa nguNjingalwazi Platonov emva kowe-1968, usasetyenziswa ngamagqirha azinzi. Olu luhlu lwe-pulpitis kunye ne-periodontitis lunokwehluleka kwalo, kodwa lukulungele ukulula nokulula. Unjingalwazi ngendlela yakhe idibanise iindlela ezintathu: ukuhlolwa kweenkqubo ze-pathological in the pulp, uhlobo lwesifundo sesi sifo, kunye nokwakhiwa kwemvakalelo engathandekiyo. Le ndlela elula, kodwa inkqubo yokuhlola esi sifo sele iyanqwenela inzululwazi ezininzi, nto ichaza ukubaluleka kwayo kwangoku. Kule nkqubo, iinkalo eziphambili zolu hlobo njenge-pulpitis-etiology, i-pathogenesis iyaqwalaselwa. Ukwahlulelwa kwesi sifo ngokutsho kwePlatonov lulandelayo:

• I-pulpitis yolu hlobo olulungekileyo: ifom ye-focal (ubuhlungu obukhulu, ukusekwa kwendawo eqondakalayo kwisigulane) kunye nokubonakala okubonakalayo (ukuhlala endaweni engapheliyo, ukunikezela kunye nesibindi sezintlu ebusweni).
• I-pulpitis yesimo esingapheliyo: i-hypertrophic (ukwandiswa kwe-pulp kunye nokuzaliswa kwesigxina se-caries), i-gangrenous (necrosis ye-nervous and bundles) kunye ne-fibrous (ukuchithwa kwamathambo ezinyo).
• Ukukhushulwa kwe-pulpitis yesimo esingapheliyo.

Leli klinikhi ye-classification kunye ne-pulpitis yenza lula umsebenzi wezinyango zamazinyo, ngokukodwa kwiiklinikhi zebhajethi. Njengomthetho, kwiimeko ezinjalo, ugqirha akanalo ixesha elaneleyo lokufumanisa izizathu zesifo sezinyo. Ukuchonga uhlobo lwesifo, kwanele ukubuza isiguli imibuzo emibini.

Ukwahlulelwa yi-Gofung

Le ndlela ithandwa kakhulu ngamagqirha wamazinyo, njengoko ichaza iinkalo ezibalulekileyo zolu hlobo lwezilwanyana njenge-pulpitis - udidi, iklinikhi, unyango. Unika ingcamango yezigaba zesifo, uqwalasela iinkcazo ezahlukeneyo zeklinikhi kunye ne-morphology ye-pulp utshintsho ngexesha lokuvuvukala. Ngokwale nkqubo, ezi zifo zilandelayo ziyahlukana:

• Ifomu ephawulekayo ye-pulpitis: inxalenye (inokuguqulwa, inokuphulukiswa ngeendlela zendalo kunye nokulondolozwa kwentsholongwane), ngokubanzi (idibanisa, ihlanganisa yonke i-pulp kwaye iyaphathwa ngokutshatyalaliswa), i-purulent jikelele (ukuphazamiseka okukhulu kunye nokungenakuphikiswa kwe-pulp, iphathwa ngokukhutshwa okubalulekileyo ngokuthintela i-periodontitis).
• Ifomu engapheliyo ye-pulpitis: elula, i-hypertrophic (ezi zimbini zintle kakhulu unyango kunye nokukwazi ukugcina ingcambu), uhlobo olubi (uhlobo olubhubhisayo, luphathwa ngokutshatyalaliswa kwintsebenzo ematyeni amaninzi).

Ukwahlula ngokwe-AIM

Le ndlela ye-morphology yesivuno se-neurovascular is a continuation of the Gofung method. Uhlobo lwe-pulpitis I-MMSI ifaka i-point of exacerbation yendlela engapheliyo ye-pulpitis kwaye iyayicingisisa into yokuvuvukala kwizinyo eziphathwa ngaphambili. Ngokwe-morphology, lesi sifo sihlulwe:

• Iifomu eziphambili ze-pulpitis: zijolise okanye zenze i-purulent, i-serous.
• Iindidi ezingapheliyo ze-pulpitis: i-gangrenous, fibrotic okanye i-hypertrophic.
• Ukugqithisa kwe-pulpitis engapheliyo: i-fibrous or gangrenous.

Ukhushulo lwendlela yokuxhamla i-pulpitis ingabangela iingxaki zesifo se-periodontal, kuba i-anaerobic microflora ikhula ngokukhawuleza kuyo. Ukuba ukususwa ngokukhawuleza kwentsholongwane akusombululi ingxaki yokuvuvukala, ukugqitywa ngokugqithisileyo okanye ukuphinjwa ngokuphindaphindiweyo kweziteshi ngokuqhelekileyo kusombulula ngokupheleleyo ingxaki.

Ukwahlulelwa nguVinogradov

Ukwahlulelwa kwe-pulpitis kubantwana kuqhutyelwa ngokwenkqubo yoNjingalwazi Vinogradova, ebonisa ukuba izifo zamazinyo okwethutyana kufuneka zihlukane ngokucacileyo nakusisigxina. Ugqirha uchaza ukuba iinkqubo ezivuthayo zobisi kunye neengqungquthela zenzeke ngokwahlukileyo. Unjingalwazi uncoma ukuba acinge ngokubhekiselele kwindawo ethile yeengcebiso zamazinyo okwethutyana kwaye, kwindlela yokwenza unyango, ugxininisa ekwenzeni inqaku elipheleleyo le-canal. Oku kungonakalisa ukukhwabanisa kwezinyo zentsana.

Ukwahlulelwa kwe-pulpitis kubantwana kuquka izinto ezilandelayo:

• I-pulpitis yamazinyo obisi obunzima: i-serous (iqhubela phambili ngokukhawuleza, ifom egxininiswayo iya kuba yinto ehambelana nayo), i-purulent (ngokukhawuleza igubungela i-pulp yonke kwaye ingaya kwimeko engapheliyo).
• I-Pulpitis yomgca ohlala rhoqo wamazinyo eziqatha: i-serous epheleleyo okanye inxenye, i-general or puralent.
• Amapapu angapheliyo omqolo wexeshana kunye osisigxina wamazinyo: elula, eninzi okanye enokuxhamla.
• Ukugqithisa kwe-pulpitis engapheliyo kwamazinyo okwethutyana kunye anesigxina: ngokuqhelekileyo ivela kwimvelaphi ye-pulpitis engapheliyo.

Isici senkqubo yokuvuvukala kwizinyo zesikhashana kukuba mhlawumbi inkqubo iya kusasazeka kwi-inter-root root. Oku kungenxa yokuba i-dentin kule ndawo inomgangatho ophezulu wokungena. Le ngxaki inobungozi, njengoko inokubangela ukuphazamiseka ekubunjweni kwengcambu yezinyo, ukutshintsha ixesha lokuqhuma kwayo, nokunciphisa ukumelana kwayo.

Amapulpsu angapheliyo amazinyo asesigxina abonakaliswa kukuba bangakwazi ukuvela njengeendlela eziphambili, ngokugqithisa izigaba ezinzima. Ziyakwazi ukuzibonakalisa, kodwa zikhohlakeleyo ukuba zisasazeka ngokukhawuleza kwizicubu ze-periodontal. Ngoko ke, kufuneka uqaphele ngenyameko imeko yomlomo womlomo kunye nabantwana kwaye ungayihoyi unyango lwamazinyo ezinsana.

Iziganeko zonyango lweplpitis

Ukwahlulelwa kweendlela zokunyanga i-pulpitis kuhambelana ngqo nokuxilongwa. Kuvela ekuqheleni ngobuchule kwinqanaba lobunzima besifo kuya kuthi impumelelo yonyango ixhomekeke.

Ukuba isibheno kwidokotela wamazinyo senziwa ekuqaleni kokuphuhliswa kwe-pulpitis, ngoko ugqirha uvelisa indlela yezinto eziphilayo zokwenza unyango. Yile ndlela ilandelayo: i-nerve evela kwizinyo ayisuswanga, i-calcium equkethe ne-antihistamine isetyenzisiweyo. Njengomphumo wale nyango, ukuvuvukala kwepalp kudlula, kwaye i-dentin yenziwa. Isitywina sifakwe kwisigxina esicacileyo.

Ukuba ukufowunelwa ngexesha elifanelekileyo kumgqirha akuzange kwenzeke, ngoko kwenzeka ukuba uphelelwe unyango lwe-biological. Kule nqanaba, udokotela wamazinyo kufuneka afune ukuba ngubani isigulane esineplpitis. Ingcamango, udidi kunye neendlela zokuxilonga ziya kunceda ukwenza oku ngokunje ngokunokwenzeka.

Inkqubo yokususwa ngokukhawuleza kwepilp isetyenziswa rhoqo. Ngaphantsi kweempembelelo ze-anesthesia, inxalenye yentsholongwane ihoxiswa kwinqanaba lesithsaba, ngelixa iindawo zengcambu zihlala zisebenza. Emva koko, ukulungiswa kwekhalsiyamu isetyenziswe, kwaye inyoyi ivalwe. Ukuba kuyimfuneko, i-physiotherapy yenziwa, unyango oluchasayo luyalelwe. Le ndlela inconywa kubantwana abangenalo izitho ezingaphezulu ezingenakunyulwa ngokwaneleyo.

Njengoko umzimba wamazinyo ubonisa, kwiimeko ezininzi, ukukhutshwa kweentsimbi kuzalisekile. Oku kunokwenziwa phantsi kwe-anesthesia okanye ngokusebenzisa i-pasti yokuzibandakanya equkethe i-arsenic. Le nkunkuma inetyhefu, kwaye ibhanji kufuneka ithathwe ngexesha elichanekileyo elichazwe ngugqirha. Emva koko, unyango lwe-endodontic lwenziwe , ngexesha apho umsele wezinyo ze- gutta-percha uzaliswe .

Emva kokuba unyango olunjalo, i-X-ray ithathwa ukuba ikhangele umgangatho wokunyanziswa okwenziweyo kwimizila. Ukuba zizaliswe phezulu, itywina liyasetyenziswa.

Kwimeko yokutshatyalaliswa ngokuqinileyo kwezinyo, ugqirha usebenzisa i- insert ye-caul ebaluleke kakhulu ukuze abuyisele lezinyo. Iingcali nganye ziza kuthetha ukuba kuqinisekiswe ukuncedisa ukuhlukanisa i-pulpitis. Unyango luqhubekile ngokuqhubekayo ukuxilongwa ngokucacileyo kwamazinyo omguli.

Isibheno kwinyango yamazinyo kumanyathelo okuqala e-pulpitis inenzuzo kwisigulane. Unyango kulesi sigaba luphantse lubuhlungu kwaye alubizi. Ukuba uqala isifo, i-periodontitis ingahlakulela, eyona nzima kuninzi kwaye ikwazi ukunyanga.