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大学牙折的病因及治疗方法.pptx

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单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,impacted by force,biting hard food.,Etiology,characteristics,按部位分,:,冠折,Crown fracture,根折,Root fracture,冠根联合折,Crown-root fracture,fracture,前牙,:,横折、斜折,Anterior tooth:horizontal or inclined,teeth:inclined or vertical,fracture,can be carried out by radiographic examination,fracture,fracture will often be inclined with pulp exposure,fracture,Without dentin exposure,selective grinding of the incisal edge is sufficient.,with Ca(OH),2,and composite resin restoration if dentin is expose and sensitive,case of a pulp exposure,pulpectomy is indicated if the root apical is developed,pulpotomy is sufficient if the root apical is developing.,fracture,根中,1/3,折,根尖,1/3,折,middle-thirds,apical-thirds,用夹板固定三个月,如牙冠端有错位,在固定前应复位。,Reposition the coronal fragment and use splinting for 3 months,for pulpal complications after 1 month,3 months,6 months and 12 months.If pulp necrosis occurs,root canal therapy should be done.,fracture:root canal therapy should be done,If fracture surface above gingival level,a post-retained full crown is fabricated after RCT.,surface between gingival and alveolar:a post-retained crown is fabricated after gingivectomy expose the fracture surface.,fracture surface is 4mm below the alveolar and the root length is enough,surgical or orthodontic extrusion of the root,to move the fracture surface to amore optimal location for final restoration,resin splint,tissue healing,The fragment is separated by chronic inflammation tissue,Calcified healing,Hard-connective tissue union healing,Healing of root fracture,fracture,:,可作根管治疗,具备桩核冠修复的冠根联合折,应保留。,The tooth with crown-root fracture which can be restored by a post retained full crown should be saved to receive RCT,root fracture,发生在牙根的纵裂,未波及牙冠者。,Vertical root fracture,not involving the crown.,durative traumatic occlusal force,Defect of root development,Pulpless tooth,tooth,内因:,牙本质脱水,失去弹性,牙变 脆,致使牙抗折力降低。,外因:,侧方加压充填根管,桩或桩核修复,其他,can be carried out by radiographic examination,Clinic,characteristics,tooth should be extracted if it is very loose or of severe periodontal lesion or vertical root fracture in single rooted tooth.,hemiresection or root resection is performed after RCT if the molar is steady and of limited periodontal lesion.,hemiresection,截根术,root resection,牙体慢性损伤,_ _,楔状缺损是牙齿唇、颊颈部硬组织缓慢磨耗所致,因该缺损常呈楔状而得名。,Wedge-shaped defect is caused by tardy abrasion of buccal cervix hard tissues.,of tooth cervix,Improper teeth brushing,Etiology,erosion,Weariness of hard tissues,have 2 or 3 surfaces,hard and smooth,tooth-like color,。,Clinic characteristics,classified with shallow,deep and pulp exposure according to the depth of the lesion,Most commonly occur on the buccal surface of bicuspids symmetrically and accompany with gingival recession,The sizes of abrasions increase with age,tooth brushing,Treatment and prevention,Careful observation if there is no tooth sensitivity and the lesions are small,if the lesions are extension,Desensitization with medicine or laser if there is dentin hypersensitive,canal therapy is performed if there is pulpitis or periapical periodontitis.,Root canal therapy or extraction are performed if tooth fracture is occurred.,tooth,又称不全牙裂或牙微裂,指牙冠表面非生理性细小裂纹。,Fine non-physiological crack on the surface of the crown,tache of tooth structure,Big cuspid pitch,Traumatic occlusal force,Etiology,characteristics,Most commonly occur on maxillary molar,and secondly on mandibular molar.The crack occurs on first molar is more than that on second molar.,line,adjustment,Balance occlusal force,Treat the cracked tooth,hypersensitivity,),又称,过敏性牙本质,(,hypersensitive dentine,),,是牙齿受到外界刺激,引起的酸痛症状。,不是一种独立疾病,是各种牙病共有症状。,115,characteristics and diagnosis,Exploration,Temperature test,evaluation,疼痛3级评判法,数字化疼痛评判法,Verbal rating scale,VRS,Visual analogue scale,VAS,the dentinal tubule to decrease or avoid the flowing of the liquid inside dentin,损,Abrasion,由于单纯机械摩擦作用而造成的牙体硬组织慢性磨耗称为磨损。,characteristics,咀嚼磨损,非咀嚼磨损,change,meaning,牙 症,Bruxism,睡眠时有习惯性磨牙或白昼也有无意识磨牙习惯者,称为磨牙症。,characteristics,磨牙型,紧咬型,混合型,蚀 症,Erosion,酸雾或酸酐作用与牙而造成的牙硬组织损害称为酸蚀症。,因,主要由无机酸,如盐酸、硝酸等所致,其中以盐酸的危害最大。,Etiology,characteristics,and prevention,改善劳动条件,局部药物脱敏,缺损严重者可充填法、修复法处理。,并发牙髓病变者,应先作牙髓病治疗。,
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