第三節(jié) 患牙狀態(tài)
1. Is the tooth needed or important? Does it have an opponent? Could it some day serve as an abutment for prosthesis? 牙的重要性,對(duì)立牙?能不能作為橋基?
2. Is the tooth salvageable? 可修復(fù)性
3. Can the infection be controlled? 感染可否被控制
4. Is the tooth so severely involved periodontally that it would be lost soon for this reason?牙周狀況
5. Is the practitioner capable of performing the needed endodontic procedures?
牙體牙髓治療的預(yù)備
1. Radiography is needed, first as an aid to diagnosis, then periodically(定期地) during treatment.
2. Specialized endodontic instruments and equipment must be arranged for ready use.
3. Local anesthesia(局麻) of the involved tooth or area may be necessary.
4. Rubber dam placement sometimes requires special handling in endodontics.
Application of Radiography to Endodontics 牙髓病治療中X線(xiàn)片的應(yīng)用
(1) 有助于對(duì)牙齒及根尖周硬組織改變的診斷
(2) 確定牙根及根管的數(shù)目、位置、形狀、大小及方向
(3) 在器械操作前估計(jì)和證實(shí)根管長(zhǎng)度
(4) 通過(guò)插針X線(xiàn)片定位疑難根管或意外暴露的根管
(5) 有助于明確牙髓腔有無(wú)明顯鈣化和/或縮小
(6) 明確頰-舌向結(jié)構(gòu)的相對(duì)位置
(7) 證實(shí)主尖在根管內(nèi)的位置和與根管的適合情況
(8) 有助于對(duì)根管充填質(zhì)量的評(píng)估
(9) 有助于檢查外傷后唇、頰、舌有無(wú)碎牙片和其他異物殘留(除外塑料和木頭)
(10) 根尖周手術(shù)期間,有助于定位疑難根尖
(11) 根尖周手術(shù)縫合前,證實(shí)所有的牙碎片及多余的充填材料從根尖區(qū)及手術(shù)瓣膜附近清除干凈
(12) 復(fù)診時(shí)攝X線(xiàn)片,用于評(píng)估牙髓治療療效
改變水平投射角的X線(xiàn)攝片:
原理:隨著球管X線(xiàn)移動(dòng)方向的改變,將重疊的解剖標(biāo)志物(牙根或根管)的影像向相應(yīng)的頰或舌側(cè)移動(dòng),并被顯示在加拍的X線(xiàn)片上
其規(guī)律是:“舌側(cè)同、頰側(cè)反”。
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