Torusalnaya ochititsa dzanzi pa mano: zida za magetsi, ochititsa dzanzi Zone

Mankhwala ochititsa dzanzi torusalnaya kapena Veisbrem ochititsa dzanzi zochita pa malo lonse la mandible, kuphatikizapo nembanemba mucous, mano, khungu la tsaya, ndi chibwano, ndipo alveolar fupa. Kusiyana njira ku miyambo chakuti dokotala amaika singano mwachindunji, popanda kusintha kulikonse ndingaliro. Torusalnoe ochititsa dzanzi akasintha mandibular ochititsa dzanzi.

Zikuonetsa kuti ndondomeko ngati

Torusalny ochititsa dzanzi njira ntchito Zikatero:

• chowawa chili chithandizo mpando matenda a mano (kuchokera caries kapena m'zigawo za dzino pa nsagwada m'munsi);
• airless nthawi tayala applique pamene mandibular zoopsa;
• kuchotsa mano molakwa anapanga;
• alowererepo opaleshoni pofuna kuchotsa cysts komanso zotupa zina mu mandible (chochitika otere anagwiritsanso pansi mankhwala ochititsa wamba);
• akwatule dzino kukula munakhala mu fupa;
• Kutsegula abscesses (mafinya formations), koma imeneyi ayenera kuphatikiza mitundu yambiri analgesia;
• yodula nyumba ya dzino nzeru nsagwada m'munsi.

Muyenera kudziwa

Kuti molondola kugwiritsa mankhwala ochititsa dzanzi m'pofunika kuona zimachititsa chilumbachi la nsagwada kutsegula, limene lili pamwamba wobisika wa nthambi nsagwada (kuchokera kudera kutsogolo kwa nsagwada lokwera mu osiyanasiyana 15 mamilimita ku mbali kumbuyo - mamilimita 13 ku malire lamkati la nsagwada m'munsi - 27 mm, ndi pa kudula ake - 22 mm). Akuluakulu, dzenje ili pa kali kutafuna wa molars m'munsi, ndi ana ndi okalamba - pang'ono.

Front ziyerekezo kudula kutetezedwa ndi fupa otchedwa mandibular lilime nthambi. Choncho, kupanga izo yabwino kunyamula torusalnuyu mankhwala, jakisoni anapanga malo pa masentimita 0.7-1 pamwamba mlingo kutsegula, mwachitsanzo padziko lilime kufika nsagwada m'munsi. Pa nthawi imeneyi mitsempha outgrowth aikidwa mu fupa poyambira, kumene nsalu porous kuti amalola mankhwala kufalitsa momasuka.

Kodi zolinga ndi ochititsa dzanzi mandibular

Conduction ochititsa dzanzi pa mandible pa Veisbrem zambiri amatchedwanso torusalnym. Mosiyana ndi ndondomeko lililonse ntchito njira izi ndi kukwaniritsa mandibular phiri, kumene akuchokera fupa chotupa - minofu condylar pawiri ndi majeremusi coronal. Iwo anaikidwa kunja kwa gawo chatsekedwa a m'munsi nsagwada fupa pafupi lilime. lumen Izi kukhazikitsidwa mu CHIKWANGWANI, amene olumikiza buccal, lingual ndi mandibular makungwa mitsempha. Otsika alveolar mitsempha chipika imagwiridwa njira intraoral ndi extraoral. Pamene intraoral njira ntchito maluso awiri ochititsa dzanzi kuti: palpation ndi apodaktilnaya (popanda akufufuza mpata).

palpatory njira

Mankhwala ochititsa dzanzi ntchito palpation. Kuchita, muyenera kupeza malo ndi kumverera Crest zosatha (ndi chikhomo cha singano puncture) ndi pozadimolyarnogo recess. Zosatha Crest fupa khushoni chimene chimafika pa nyongolosi coronal kwa lingual mpanda wa zone mandible alveolar. Mu gawo lamkati la zisa za lagawidwa mipiringidzo m'nyumba ndi panja. Iwo ndi malo ochepa - pozadimolyarny makona.

Tiyenera anatomic kusiyanitsa neoplasm ku pozadimolyarnoy fovea, lomwe lili pakati pa Crest ndi dera zosatha ya kutsogolo nsagwada m'munsi. Kuchokera pamenepa, ndizoonekeratu kuti pozadimolyarnoe recess pabwino kumbali ya makona lapansi. Ngati mankhwala ochititsa dzanzi torusalnoe amachitidwa pa dzanja lamanja, ndi zikhomo Bony palpated ndi index chala cha dzanja lake lamanzere, ngati kumanzere - chala chachikulu cha dzanja chomwecho.

Torusalnaya ochititsa dzanzi zida:

1. Wodwala anati kwa pazipita ndi pakamwa wake ndi probed m'mphepete kutsogolo kwa ndondomeko mandibular pa mlingo wa chachitatu molar akorona mbali wapotalikira (ngati izo siziri, ndiye kuti molar wachiwiri).
2. Kupita chala pang'ono mkati, adokotala wapeza Chisa wosakhalitsa, limayamba pozadimolyarnoy chala recess, amene mwapang'ono likuvutika nyumba izi anatomical.
3. Akukonzekera syringe padziko lapansi premolar Komano, katswiri akuchita jekeseni singano pafupi ndi Crest pa kanthawi 0.8-1 masentimita pamwamba mlingo wa kutafuna molar lachitatu, ndiye propels singano kunja ndi mkati.
4. Tsopano torusalnoy ochititsa dzanzi ndi njira motere: singano umalandira fupa pa akuya kwinakwake 0.5-0.7 cm, m'dera lino umayamba mlingo ka mankhwala ululu lingual mitsempha wochepa alveolar inali kutsogolo kwa mitsempha.
5. Ndiye syringe chimachititsanso gawo wodula, ndi singano anawamvera pamwamba, mwachitsanzo ikufanana kwa akunja gawo chatsekedwa ndondomeko ya nsagwada m'munsi, kuti akuya masentimita 2-3 kuti chamfer fupa kumene mitsempha alveolar, ndi buku otsala mankhwala ochititsa jekeseni.

Pamene ntchito mankhwala panopa amide gulu "R-S articaine forte" limatanthauza mlingo kutumikiridwa ndi za 2 ml.

Apodaktilnaya njira

The Chinthu chachikulu kukhazikitsa ngati njira imatengedwa Pterygopalatine-mandibular khola, amene bwino wapezeka. Zimakhala yopapatiza, yotakata kapena sing'anga m'lifupi, ankakhala mu gawo lamkati la Crest mwakanthawi.

Kodi ndondomeko

Torusalnaya ochititsa dzanzi pa mano imagwiridwa motere:

1. mano akuuza wodwala atsegule pakamwa pake lonse, kenako analanda syringe pa mlingo m'munsi nsagwada.
2. Adaponya singano anatengedwa ku lakunja otsetsereka pterygopalatine-mandibular khola mu malo pakati pa ndege kutafuna wa molars chapamwamba ndipo m'munsi (ngati zilipo - ndiye Midway gawo interm alveolar zitunda ndi nyongolosi).
3. katswiri Komanso mapanganowo singano pambali akunja lamkati la khola za kugwirizana kwa CHIKWANGWANI fupa kuti akuya masentimita 1.5-2, potero kuyambitsa mankhwala ululu ndi pansi lingual misempha alveolar. Pterygopalatine-mandibular khola ndi Buku zochepa molondola kuposa Chisa mwakanthawi.

mwayi extraoral

Mankhwala ochititsa dzanzi torusalnaya mandible umachitika mwa njira iyi, ngati Mwachitsanzo, mavuto ndi pakamwa kutsegula. Kodi chochitika:

1. Anatsimikiza ndi ziyerekezo kwa slits mandibular pa khungu. dzenje ili pakati pa Mzere wa, anakafika m'mphepete padziko tragus wa khutu ku zone mphambano ya mizere kutsogolo kwa minofu masseter.
2. Adaponya singano analengedwa mu malo nsagwada m'munsi pa 1.5 masentimita m'mphepete kutsogolo ngodya zake.
3. Ndiye singano ikuyenda pamwamba chabe 3-4 masentimita pamwamba pa ndondomeko chatsekedwa wa mandibular kutsegula likufanana ndi mbali kumbuyo. Pa nthawi ya chigawo cha singano ayenera kusunga kukhudzana wake ndi mafupa.
4. Kumapeto kwa mankhwala ochititsa a jekeseni. Ndiye, kukankhira singano oposa ndi 1 cm, akulowa ena mankhwala ululu, kutseka pansi chinenero mitsempha.

malo ochititsa dzanzi

Mankhwala ochititsa dzanzi torusalnaya makamaka ikuchitika kuti anesthetize ena mabacteria pomwepo M'mimbamo m'kamwa, akuti:

• lingual komanso otsika alveolar mitsempha;
• chibwano khungu pa malo ochititsa dzanzi;
• mano mandibular theka;
• mucosal ndi khungu la mlomo wa mmunsi;
• alveolar mbali fupa ndi gawo la thupi la mandible ya;
• sublingual mucosa m'dera ndi kutsogolo kwa lilime 2/3;
• mucous nembanemba wa alveolar khoma kuloza ku lingual ndi vestibular dera.

Ena mwa alveolar mucosa chipinda gawo la mandible mu osiyanasiyana kuchokera pakati pa premolar wachiwiri oyamba m'ma molar innervated. Pofuna anesthetize kwathunthu malo mandibular ochititsa dzanzi imagwiridwa motere: 0,5 ml ya jekeseni mankhwala zina m'khola wapakatikati ndi mtundu kusalola ochititsa dzanzi.

chifukwa mankhwala ochititsa mu mankhwala oletsa ululu ngati akuyamba pambuyo 15-20 Mphindi. Kutalika kwa mankhwala ochititsa dzanzi ndi pafupifupi 60-90 Mphindi. Popereka mankhwala ochititsa dzanzi m'dera wa incisors ndi canines asapatsiridwe kwambiri chifukwa cha anastomoses ndi dzanja zosiyana. Ndi mankhwala ochititsa dzanzi ichi ntchito monga: "Novocaine," "Trimekain", "Ultrakain" kapena "lidocaine wa".

zosokonezeka

Mankhwala ochititsa dzanzi torusalnaya akhoza kubweretsa ngakhale zoipa, motere:

• hematoma mapangidwe;
• wovulala jekeseni masingano;
• dzanzi pharyngeal zimakhala;
• neuritis ndi kutsikira lingual alveolar mitsempha;
• zobisika kuwonongeka pterygoid contractures minofu ndi mawonekedwe zambiri zokhudza mandible lapansi.

Tatchulawa mavuto zimachitika kuphwanya njira procedural wa mankhwala ochititsa dzanzi. Choncho, likhale torusalnoy ochititsa dzanzi - ndondomeko zovuta ndipo amafuna oyenerera mkulu wa mano.