大學課件牙折的病因及治療方法

1、http:/ ,咀嚼咬到沙石、咀嚼咬到沙石、碎骨等硬物。碎骨等硬物。be impacted by force,biting be impacted by force,biting hard food.hard food. etiologyetiologyhttp:/ characteristicsclinic characteristics按部位分:冠折 crown fracture根折root fracture冠根聯(lián)合折 crown-root fracturehttp:/ :露髓不露髓http:/ fracture前牙前牙 : : 橫折、斜折橫折、斜折anterior tooth: hori

2、zontal or inclinedhttp:/ : : 斜折、縱折斜折、縱折posterior teeth:inclined or verticalhttp:/ fracturehttp:/ 1/3、根中、根中 1/3、根尖、根尖 1/3cervix-thirds,middle-thirds,apical-thirdshttp:/ 3859根折牙牙髓壞死率為2024，斷端間隙利于炎癥引流。http:/ can be carried out by radiographic examinationhttp:/ fracturehttp:/ fracture will often be incli

3、ned with pulp exposurehttp:/ fracturewithout dentin exposure,selective grinding of the incisal edge is sufficient.http:/ with ca(oh)2 and composite resin restoration if dentin is expose and sensitivehttp:/ case of a pulp exposure,pulpectomy is indicated if the root apical is developed,pulpotomy is s

4、ufficient if the root apical is developing. http:/ fracture根中1/3折，根尖1/3折middle-thirds,apical-thirds用夾板固定三個月，如牙冠端有錯位，在固定前應復位。reposition the coronal fragment and use splinting for 3 monthshttp:/ for pulpal complications after 1 month,3 months,6 months and 12 months.if pulp necrosis occurs,root canal t

5、herapy should be done.http:/ fracture:root canal therapy should be doneif fracture surface above gingival level,a post-retained full crown is fabricated after rct.http:/ surface between gingival and alveolar:a post-retained crown is fabricated after gingivectomy expose the fracture surface.http:/ fr

6、acture 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 restorationhttp:/ resin splinthttp:/ tissue healingthe fragment is separated by chronic inflammation tissue calcifie

7、d healinghard-connective tissue union healinghealing of root fracturehttp:/ fracture可作根管治療，具備樁核冠修復可作根管治療，具備樁核冠修復的冠根聯(lián)合折，應保留。的冠根聯(lián)合折，應保留。the tooth with crown-root fracture which can be restored by a post retained full crown should be saved to receive rct http:/ root fracture, not involving the crown.ht

8、tp:/ durative traumatic occlusal force defect of root developmentpulpless toothhttp:/ tooth內(nèi)因：牙本質(zhì)脫水，失去彈性，牙變 脆，致使牙抗折力降低。外因：側(cè)方加壓充填根管樁或樁核修復其他http:/ can be carried out by radiographic examinationclinic characteristics http:/ tooth should be extracted if it is very loose or of severe periodontal lesion o

9、r vertical root fracture in single rooted tooth. http:/ hemiresection or root resection is performed after rct if the molar is steady and of limited periodontal lesion.http:/ hemiresection截根術(shù)root resectionhttp:/ defect is caused by tardy abrasion of buccal cervix hard tissues.http:/ of tooth cervixi

10、mproper teeth brushingetiologyetiologyhttp:/ erosionweariness of hard tissueshttp:/ have 2 or 3 surfaces,hard and smooth,tooth-like color。 clinic characteristicsclinic characteristicshttp:/ classified with shallow,deep and pulp exposure according to the depth of the lesionmost commonly occur on the

11、buccal surface of bicuspids symmetrically and accompany with gingival recessionthe sizes of abrasions increase with age http:/ tooth brushingtreatment and preventiontreatment and preventioncareful observation if there is no tooth sensitivity and the lesions are smallhttp:/ if the lesions are extensi

12、ondesensitization with medicine or laser if there is dentin hypersensitive http:/ canal therapy is performed if there is pulpitis or periapical periodontitis.root canal therapy or extraction are performed if tooth fracture is occurred.http:/ non-physiological crack on the surface of the crownhttp:/

13、tache of tooth structurebig cuspid pitchtraumatic occlusal forceetiologyetiologyhttp:/ characteristicsclinic characteristicsmost commonly occur on maxillary molar, and secondly on mandibular molar.the crack occurs on first molar is more than that on second molar. http:/ linehttp:/ adjustmentbalance

14、occlusal forcetreat the cracked toothhttp:/ hypersensitivity）又又稱稱過敏性牙本質(zhì)過敏性牙本質(zhì)（hypersensitive dentine），），是牙齒受到外界刺激，引起的酸痛癥狀。是牙齒受到外界刺激，引起的酸痛癥狀。不是一種獨立疾病，是各種牙病共有癥狀。不是一種獨立疾病，是各種牙病共有癥狀。115http:/ pathogenesispathogenesis1.神經(jīng)學說：牙本質(zhì)中存在牙髓神經(jīng)末梢，感覺神經(jīng)學說：牙本質(zhì)中存在牙髓神經(jīng)末梢，感覺可由牙本質(zhì)表層傳導入牙髓可由牙本質(zhì)表層傳導入牙髓前期牙本質(zhì)前期牙本質(zhì)管間牙本質(zhì)管間牙本質(zhì)管周

15、牙本質(zhì)管周牙本質(zhì)2.牙本質(zhì)纖維傳導學說：成牙本質(zhì)細胞原漿突牙本質(zhì)纖維傳導學說：成牙本質(zhì)細胞原漿突中含有乙酰膽堿酶，它在受刺激后引起神經(jīng)傳中含有乙酰膽堿酶，它在受刺激后引起神經(jīng)傳導，產(chǎn)生疼痛導，產(chǎn)生疼痛3.流體動力學：外界刺激使牙本質(zhì)小管內(nèi)液體移動流體動力學：外界刺激使牙本質(zhì)小管內(nèi)液體移動攪動了牙髓內(nèi)容物，間接興奮游離神經(jīng)末稍，傳入攪動了牙髓內(nèi)容物，間接興奮游離神經(jīng)末稍，傳入沖動產(chǎn)生痛覺沖動產(chǎn)生痛覺http:/ characteristics and diagnosisclinic characteristics and diagnosisexplorationtemperature testh

16、ttp:/ 0度度：冷刺激和機械刺激無疼痛冷刺激和機械刺激無疼痛1 1度：可誘發(fā)疼痛，但疼痛較輕微度：可誘發(fā)疼痛，但疼痛較輕微2 2度：可誘發(fā)可以忍受的疼痛度：可誘發(fā)可以忍受的疼痛3 3度：可誘發(fā)難以忍受的疼痛度：可誘發(fā)難以忍受的疼痛http:/ evaluation疼痛疼痛3級評判法級評判法數(shù)字化疼痛評判法數(shù)字化疼痛評判法verbal rating scale,vrsvisual analogue scale,vashttp:/ the dentinal tubule to decrease or avoid the flowing of the liquid inside dentin http:/ characteristicsclinic characteristics咀嚼磨損非咀嚼磨損 http: