Exacerbation echirwere pulpitis. Zvikonzero, differential Diagnostics, kurapwa echirwere pulpitis

kwete zvimwe munhu akadaro, uyo kumboita ndichinzwa zino. Zvino, sokutaurwa, kwacho zvakwatanga, vose nezvekufadza musimboti dzakapoteredza chete zino murwere. Kana akabvisa rokuenda wemazino kusvika ipapo, murwere ane mukana wakanaka kudzidza zvose "nemazango" echirwere pulpitis.

Chii muitiro?

Pulpitis kana iripo vataure, chinhu kushoma, kuva pakati neurovascular tsapo mukati hova pakati Midzi mazino uye korona chikamu. Kana murwere nyaya chiremba pamwe zvichemo zviri kurwadziwa (kureva. E. Nzvimbo kuti rikwanise pulpitis), mune zvimwe zviitiko kushoma inogona akadzivirwa, zino angaponeswa.

In ezvinhu chirwere pulpitis pulp zvishoma nezvishoma degenerating kuumbwa fibrous zvinyama, kana necrosis vakachengeta kutendeuka neurovascular tsapo kusvika padanho unozadza yose carious zvinyama mhango izvo zvakakonzera zvokurwara.

Kakawanda munguva chisingaperi pulpitis kurwadziwa haana kuitika, uye varwere kuuya chiremba kuti kununura zino rurege dzadzimwa. Zvisinei, kuti chirwere muchimiro pulpitis - koda nguva kusingarapiki chirwere.

zvinokonzera

Chero zvokurwara ane mabviro uye mamiriro ezvinhu kuti chamuita kuti kukura pathogenic muitiro. Hapana kurwadziwa uye pulp. Chirwere siyana chirwere kushatiriswa pathogenic zvigare uye dzavo metabolic zvigadzirwa. Kazhinji, kwakabva zvose zvakatanga zviri kuvapo ari murwere kwakadzama caries kurapwa kana murombo unhu chirwere ichi kwakapararira. By zvapedzisira izwi iri raireva murwere noncompliance iwe mazino kurapwa, kushomeka kucheneswa mhango, unamire havaratidzi wakabvunzwa m. P.

Ishoma kukonzera chirwere pulpitis, Nokumukira pave pathologic muitiro, anogona kuva nezino kunotevera, occlusion migero NVB munyu kuparidzirwa ( "calculi"). Uyewo, Chirwere pulpitis anogona somunhu kuomesa kwakaita maxillofacial uye vakawanda chirwere (sinusitis, yokuSpain, periodontitis, osteomyelitis, periostitis etc. D.) The muitiro aibuda zvirwere utachiona akadaro anogona kupinda kuburikidza pamusoro zino mudzi.

Mhando dzakasiyana-siyana chisingaperi muitiro

Vanachiremba vemazino vari 3 akasiyana chisingaperi pulpitis: hypertrophy, fibrosis, gangrenous.

With hypertrophic kwacho kuchengetwa ndege kuti carious zvinyama overgrowth pulp sezvo polyp. Kazhinji, murwere anoona ropa growths kuti kukuvara munguva kutsenga. The marwadzo anogona kuva vanyoro uye kakawanda zvinokonzerwa zvaitika irritants.

Fibrous chimiro rikauya kakawanda dzinoratidzwa nekorasi vachirwadziwa marwadzo nezvekufadza, izvo pamazuva 1-2 kumisa pachavo, asi carious mhango iri rinenge nguva dzose bleeds.

Gangrenosum chimiro kunoratidzwa kwakakwana manyowa zino tsinga rinenge kuparadzwa uye yakakura chikamu korona. chimiro ichi pulpitis anogara pamwe zvakaipa nokufema. Pain Kazhinji mwero kuitika nguva nenguva. zvichemo Typical murwere panyaya iyi ndeinotevera: "ari zino kurwara zvikuru, uye ipapo pacharo rakamira."

Zvinokosha kucherechedza kuti vakawanda (≈ 70%) vanachiremba chirwere chisingaperi fibrous pulpitis, shoma zvikuru - gangrenous. Hypertrophic chimiro kushanda hariwaniki nedzevakuru. dzimwe nguva chirwere ichi akarambwa vanachiremba vemazino nevana.

Chirwere echirwere pulpitis

Kuti chirwere, chiremba, kuwedzera kuteerera zvichemo murwere, kupedza imwe akagadzirwa mabasa, chine munhu kutarisana vakaongorora murwere zino, a lämpömittari, semuenzaniso, e uye X-ray.

Pamusoro chinooneka rokuongorora chiremba anowana vanenge 50% mashoko pamusoro mamiriro causal zino. Thermometer zvidzidzo pamusoro kumashoko inopisa uye kutonhora mikana yakawanda yokukurudzira kuti tikwanise kunzwisisa sei chirwere uye sei nokushivirira mhando nyaya yacho kuna chiremba. Somuenzaniso, Cold mhinduro inoti "tsinga" akaurayiwa.

Electric pulp bvunzo (Venera) ndiyo imwe akavimbika kupfuura nzira diagnosing papurupiti. Nzira iri inobva chokwadi, kuti varwere uye utano pulp rinenge vane zvakasiyana magetsi excitability. The utano marwadzo tsinga nezvekufadza sei zviduku zvainoita kuitika mu microamps 2-6, fibrous pulpitis marwadzo chete kuchinyanya achapindura 35-50 Ma, gangrenous zvinoda kugara 60-90 microamps.

Radiography kunosanganisira dzinoongorora mamiriro ezvinhu zino nokuda X-ray.

Differential chirwere echirwere pulpitis kunosanganisira misoro tinyatsonzwisisa zvose nzira iri-pamusoro apa uye kuenzaniswa kuongorora mashoko yakawanikwa iri nedanho nechirwere.

Symptomatology pamusoro pemamiriro chimiro pulpitis

Kazhinji panguva ino zvirwere zviri asymptomatic. Sezvo anogona kunzwisiswa kuti munhu ane chirwere pulpitis? Zvichemo kunyanya chete nokuva vachirwadziwa marwadzo nedzimwe nguva zvikamu Kunyarara pakati pavo.

Kana fibrous chimiro, vanowanzova chipo kurwadziwa kunokonzerwa yokuwana kunovhiringidza zvinhu (inopisa, kutonhora, rinotapira). Marwadzo kwenguva refu musapfuura kunyange mushure mugumisiro mikana yakawanda yokukurudzira chapedzwa. A maitiro chiratidzo kukura anganzi marwadzo kwenguva yakareba panguva kuchinja tembiricha kunze inotonhorera inodziya (somuenzaniso, kuchinja kubva mumugwagwa kuti musha). Kunyange zvazvo mune zvimwe zviitiko aibuda fibrous pulpitis zvinogoneka uye pasina zviratidzo pachena. Izvi ndizvo zvinoitika kana vakurukurirane asina mbune kuti mhango (somuenzaniso, zviri vemunyika pasi chingamu kana kuburikidza maererano pulp mukamuri). Mukupera nyaya, hapana kuzvimba, kuti pulp hauna "anobuda" uye, sezvo zvakaguma hapana marwadzo.

Kana gangrenous pulpitis nguva dzose muvigire risingafadzi munhuhwi kubva mazino uye muromo murwere. Inozivikanwa uchirwadziwa kubva zvinokonzerwa inopisa, vasingabvumi kumira kwenguva refu zvakakwana, kunyange pashure vakurukurirane chinobviswa. Kunzwa zvizere muna zino kakawanda varipo. Uyezve, inenge nguva anochinja Ruvara zino: rova grayish.

Hypertrophic pulpitis pamwe vachirwadziwa marwadzo kana kutsenga uye ropa. Izvi imhaka kumera kuti pulp ane mhango pakati mhando "yomusango nyama." chinhu ichi zvinokonzerwa kutyiswa murwere uye anowana kuona chiremba.

Zvokukura Chirwere kurapwa kwacho

Sezvo chirwere ichi dzakapfavirira zvinyama muna zino havazokwanisi kuchengeta, chikuru mhando kurapwa kubviswa zino pulp migero. Modern mazino yakawandisa anoda kunokosha extirpation nzira (nyoro dzokubudisa) tsinga kana kushandiswa chete dzokutindivadza pasina dzinobatanidza medicament yokuuraya pulp.

Dzimwe nguva, zvisinei, munhu zvechadenga murwere shaya, kushaya nguva uye kushayikwa dzokutindivadza zvakanaka hatibvumiri iwe kubvisa tsinga pakarepo nomusi wokutanga kushanya. Zvadaro shandisa mishonga echirwere pulpitis mumatanho, kana mhango twa chaiyo namatidza, izvo ndehwokuti agadzirire pulp kubvisa, izvo ndozvinoitika munguva kechipiri.

pashure kurapwa

Kazhinji, pashure pakurapa chirwere pulpitis apera, vanhu vakanyunyutira kurwadziwa. nezvekufadza aya anonzi postplombirovochnyh (sezvo dzinonzi vanachiremba vemazino). Kazhinji, pane kusagadzikana nezvikonzero zvinoverengeka uye anoiswa ari conditionally zvinogamuchirika zvaigara. The panowanikwa marwadzo pashure zvichiita Mabatirwo pulpitis nokuti kuti panogona kuva zvishoma chete akuvara zvinyama vakapoteredza zino murwere kana ine, unopinza voga "tsinga" iri nedanho raro rokubvisa. Uyewo, marwadzo anogona kuitika kana panguva pakurapa zino migero kupatsanurwa ne simba akambozvishandisa kuuraya utachiona, izvo zvishoma kunogona kuenda mhiri mudzi.

Chimwe chikonzero postplombirovochnyh marwadzo - the goho matete huchashandiswa kuti vanachiremba vemazino vanoshandisa ari kurapwa kwacho kushanda mukati migero, mhiri mudzi chakaderedzwa mutengo buri.

Zvinokonzera yematambudziko pashure kurapa

Dzimwe nguva pashure raiita kubudirira "nhaurirano" pamwe wemazino kunotanga kurwadziwa, uye pakutanga kubatwa exacerbation echirwere pulpitis kwakaoma. Zvikonzero izvi zvingava zvakawanda. Izvi murombo chokupika basa iri nezino achizadza mugero, nepakumedura kure ane mazino chishandiso panguva vanouwana ari mudzi Canal kana perforation (kusika mumakomba) ari parusvingo mudzi.

Kana migero vari havaratidzi chisimbiso, kana vaibvumirwa kupinda kuti kuzadza zvinhu mhiri chakaderedzwa mutengo pamudzi, nokuti dzimwe nguva (kubva mashomanana kuti gore) achaita periodontitis zviratidzo zviri rikwanise danho. Gurai chishandiso arege unooneka pakarepo, asi utachiona mune nedomytom uye gwara nezaplombirovannom vachiri kududzira pachayo anyatsofukidzwa, periodic chitarisiko ari chingamu fistula (akanakisisa) kana paumbwe cysts pamwe purulent mukati.

Exacerbation echirwere muitiro: zviratidzo

Kana hosha zino pamwe kuratidzwa rikwanise pulpitis haina kurapwa kwenguva, hosha anopinda chirwere chimiro, uye achakuyeuchidzai zvoga ane enviable nguva muupenyu. Sezvaratidzwa exacerbation echirwere pulpitis? Zviratidzo hachifadzi: kurwadziwa pakuona siyana kuitika (kupisa, kutonhora, zvinozipa, kuchinja kubva inotonhorera kupisa) zvakakwana manzwiro akaipa uye percussion palpation (kwete tsoka simba tapping mazino Chinoshandiswa kwezvikonzero zino). Kakawanda, varwere anorondedzera kurwadziwa somunhu paroxysmal. In danho muitiro hwokuratidza exacerbation echirwere marwadzo kupararira nzira ndima trigeminal etsinga. Chikonzero ichi kuti varwere vanoti kurwadziwa raiswa mutemberi kana pasi maziso, mhuno kana chirebvu.

Kusembura uye zvikonzero zvayo kukura

Exacerbation echirwere pulpitis anogona akanzwa kwemwedzi inoverengeka. Anorwadza nezvekufadza zvinozarurwa kwete zvakasimba sezvo ari rikwanise chimiro. Zvikuru zvinogara kusembura anogona mananara dzakadai kuparara water drainage ose exudate, mupfungwa kuti zino, chichiwedzera basa pathogenic mabhakitiriya. Uyewo, attenuation anogona kukonzera kudzokazve talk kutapata, kuzvimba node nodes uye zvachose kudhaka.

Exacerbation echirwere siyana pulpitis angaperekedzwa nezviitiko zvatichiri periodontitis. Muzviitiko zvakadaro, varwere vauye wemazino pakunyunyuta kwete kupfuura marwadzo. Kumwe kuchinja kunotanga zvinonyorwa pasi X-ray.

Temporary mazino muvarwere vaduku

Kwete chete Varwere akura chirwere pulpitis. Vana, uye kwete chete zvachose, asi vagari meno, chirwere Zvinogonekawo. All marudzi chisingaperi kuzvimba inozivikanwa raidudzwa zviratidzo.

Mwana haagoni kutsenga zvokudya zvakanaka. Causative zino ikasakendenga tembiricha kuitika. Kana gangrenous chimiro kurwadziwa kuonekwa semhinduro dzishande pamwe ushamwari, inopisa, kana apo kutamira kubva inotonhorera inodziya kamuri. Proliferative pulpitis (uye zvikurukuru hypertrophic muchimiro) kunoratidzwa nechitarisiko marwadzo uchikurukura zvokudya zvacho vari mhango. Uyezve, polyp bleeds pulp nomuviri chiito.

The peculiarity chirwere muchizvarwa ichi - yakaderera zvikuru kurwadziwa kuti kunogona kutsanangurwa STRUCTURAL zvachinja pulp yaro zvakasimba Links pamwe periodontitis. Panyaya iyi, iyo Zvakanyanya Kunaka Panguva Yepamuviri ezvinhu kuti vakasununguka yokururamisa kuti exudate, Somugumisiro, pane kurwadziwa.

Permanent meno muvana

Permanent meno ari vana uyewo kubatira zvirwere pulp. Form echirwere pulpitis muvana vakafanana nedzevakuru. Chirwere kwacho rikwanise danho, varwere vaduku anowanzoshandurwa dzinoratidzwa kwenguva refu nguva usimbe inoyerera kurwadziwa. Kazhinji kukura kusagadzikana pakarepo paichapfuura, uye mwana hazvisi kunetsa munhu zvakakwana kwenguva yakareba. Asi kakawanda, varwere chokunyunyuta pamusoro paroxysmal kubvambura kana kurwadziwa, smack nenzira mapazi trigeminal etsinga. Low electroexcitability (120-160 Ma) rinotaura pamusoro Kuchinja masero etsinga ari pulp akapfeka dystrophic uye dzinoparadza.

To muchidimbu

Zvinosuruvarisa kuti varwere, roga hauzopfuuri kana kuti rikwanise chokutambudzika chirwere, kana unozotevera exacerbation echirwere pulpitis. Dental kurapwa vachada tichikufunga. Uye zviri nani kuti ichi zviitike nekukurumidza kuponesa murwere kubva zvisingakoshi kutambura uye anodhura uye kurwadza zviitiko, uye chiremba - iri refu uye richikunetesa basa kuti kunoda ruzivo uye mwoyo murefu.