Rehunga Torusalnaya i niho: o taputapu, Rohe rehunga

torusalnaya rehunga e Veisbrem mahi rehunga i runga i te rohe katoa o te kauwae, tae atu ki ngā kiriuhi mucous, niho, kiri o te paparinga, te kauwae, me ranei pūtake wheua. Ko te rerekētanga o tenei tikanga i te tuku iho ki te meka e kōkuhu i te tākuta he ngira tika, kahore tetahi huringa hehema. whakarerekētia Torusalnoe rehunga te rehunga mandibular.

Tuhinga hoki taua tukanga

tikanga rehunga Torusalny whakamahia i roto i ngā take pēnei i:

• maimoatanga niho mamae i roto i te parahiraa niho (i caries tangohanga o te niho i runga i te kauae raro ranei);
• e whae wā mauiui applique ka te whētuki mandibular;
• te tango i niho hē i hanga;
• wawaotanga hāparapara mo te tango o cysts me te tahi atu pukupuku i roto i te kauwae (Kei te hoki te hui taua kawea i roto i raro i whakarehu rohe);
• ka to niho tino tupu titi i roto i te wheua;
• whakatuwheratanga o abscesses (ngā pus), engari i roto i tenei āhuatanga kia ngā rave rahi analgesia momo;
• whakairo o te araa o te niho te whakaaro nui ki runga ki te kauae raro.

Me ki mohio koe

Hei whakatinana tika rehunga he tika ki te kite i te mahere whenua o te whakatuwheratanga kauae, kei nei i runga i te mata huna o te pekapeka kauae (i te rohe mua o te hiwi kauae i roto i te awhe 15 mm i te taha ki muri o te - 13 mm i te taha i roto o te kauae raro - 27 mm, me i runga i tona whakairo - 22 mm). I roto i ngā pakeke, kei tenei poka te i runga i nga mata ngangau o nga molars raro, me nga tamariki, me te kaumātua - he iti raro.

wāwāhi ngä mua tiakina e te wheua pera-ka karanga rohe arero mandibular. Na reira, ki te hanga i taua mea atu watea ki te kawe torusalnuyu rehunga, he werohanga hanga i roto i te wahi i 0.7-1 cm runga ake te taumata tuwhera, arā i runga i te mata o te pūwāhi arero o te kauae raro. I tenei wāhi whakanohoia te tereraa io te i roto i te haehae wheua, te wahi i reira ko te papanga maiengi e taea te tarukino ki horapa noa.

He aha ngā whāinga i rehunga mandibular

Āriponga rehunga i roto i te wheua kauwae maha ano ka karanga i runga i Veisbrem torusalnym. Rerekē te tukanga angamaheni, te mahi o tenei tikanga, ko te ki te whakatutuki i mandibular, te wahi e hāngai ai ki runga ki te wheua puku maunga - kiko condylar pūhui me iroriki coronal. Kei te whakanohoia te reira i runga i te waho o te wahi kati o te wheua kauae raro ofi ki te arero. whirihoratia tēnei lumen te i roto i te muka, e kua hono ki te buccal, reo me kahiwi karere mandibular. whakamana iho poraka karere kauae te tikanga intraoral me extraoral. A, no te whakamahia huarahi intraoral rua tikanga taua rehunga: palpation me apodaktilnaya (kahore pūkenga).

tikanga palpatory

Rehunga te whakamahi i palpation. Ki te mahi i reira, e hiahia ana koe ki te kitea i roto i te wāhi mā te mana'o tihi pae tino (ko reira he rohe mo te ngira poka) me te hikinga pozadimolyarnogo. wheua tihi pae tino he urunga e toro i te iroriki coronal ki te taiepa reo o te rohe kauae kauwae. I roto i te wahi i roto rawa o te heru e wehea ki tutaki roto, o waho. ahua ai ratou he wāhi iti - tapatoru pozadimolyarny.

hiahia anatomic taua ki te wehe neoplasm i pozadimolyarnoy fovea, kei nei i waenganui i te tihi me te rohe pae tino o te kauae raro mua. Mai i tenei whai reira e pozadimolyarnoe hikinga tūnga i roto i te taha o te tapatoru. Ki te whakamana i torusalnoe rehunga te i runga i te tika, ka palpated nga tohu whenua a Ihakara ki te maihao taupū o tona ringa maui, ki te te maui - te koromatua o te ringa kotahi.

taputapu rehunga Torusalnaya:

1. ka mea te manawanui ki te mōrahi puaki tona mangai, a Kua whakamatauria te mata mua o te tukanga mandibular i te taumata o te distal toru niho kauoro karauna āhuatanga (ki te kore he reira, na hoki te rua o nga titiwha).
2. Moving te maihao, he iti ki te roto, kua kite i te tākuta he heru pae tino, ka whakatakoto ana maihao pozadimolyarnoy i roto i te hikinga, whāiti nei i te utu o enei hanganga kikokiko.
3. Whakatika pūwero i runga i te mata o te pūrākau i runga i te tahi atu i te ringa, te maua e te mātanga i te ngira te werohanga tata te tihi i runga i te pae tino 0.8-1 cm runga ake te taumata o ngaungau toru titiwha, ka propels te ngira ki te waho me te roto.
4. Na technique rehunga torusalnoy ko te kupu: te ngira tae te wheua i te hohonu vahi 0.5-0.7 cm, i roto i tenei rohe whakaurua te he horopeta iti o te rongoā mō te mamae karere reo, kauae iti iho kei roto i mua o te karere.
5. Katahi ka oho te nekehanga pūwero ki wahi cutter, me te ngira te runga ake, arā, faitatau ki te wahi tukanga kati waho o te kauae raro, ki te hohonu o te 2-3 cm ki te chamfer wheua i reira patia i te karere kauae, me te toe rōrahi o te rongoā te.

A, no te whakamahi i rongoā o nāianei rōpū amide "R-S articaine forte", te tikanga te horopeta whakahaere he e pā ana ki te 2 ml.

Apodaktilnaya technique

whakaaro te aratohu matua mo te whakatinanatanga o te tikanga taua te kainga Pterygopalatine-mandibular, Kei te pai i kitea. Ka taea e te reira kuiti, te whanui reo ranei whanui, kei roto i te wahi i roto rawa o te tihi pae tino.

Kia pehea te Ko te tikanga

Torusalnaya rehunga i roto i te niho whakamana te rite e whai ake nei:

1. parau te TEETH te manawanui puaki tona mangai, a ka hopu i te pūwero i runga i te taumata kauae raro.
2. Akina ngira kawea ki te pinakitanga taiepa pterygopalatine-mandibular waho i roto i te pokapū i waenganui i nga rererangi ngangau o nga molars runga me raro (ki te wātea - ka tiko a wahi interm tupuke pūtake, me te iroriki).
3. Kōkiritanga mātanga anō te ngira ki te taha ki waho, me te roto o te taiepa ki te hononga ki te muka wheua ki te hohonu o 1.5-2 cm, reira te whakauru rongoā mō te mamae, me te raro raru pūtake reo. taiepa Pterygopalatine-mandibular he tohutoro iti tika i te heru i te pae tino.

uru extraoral

puritia rehunga torusalnaya kauwae kei roto i tenei tikanga, ki te, hei tauira, e ara fifi ki te mangai whakatuwheratanga. Kia pehea te ko te hui:

1. Kei te whakaritea e te ngä o te Kosi mandibular i runga i te kiri. Kei tēnei kohao kei roto i te pokapū o te Unuhia, whakawhānui i te mata mata o te tragus o te taringa ki te rohe pūtahitanga o te rārangi mua o te ua ngaungau.
2. hanga Akina ngira e i wahi o te kauae turanga i 1.5 cm ki te mata mua o tona koki.
3. Na ka te neke i te ngira tika i runga 3-4 cm i runga i te mata o te tukanga kati o te whakarara whakatuwheratanga mandibular ki tona taha hoki. I te wa o te wahi o te ngira kia mau tonu tona whakapā ki te wheua.
4. I te mutunga o te rongoā patia te. Na, e aki ana whakarunga te ngira i te 1 cm, hono te toenga o te mamae rongoā, tutakina iho te reo io.

wahi rehunga

Rehunga torusalnaya matua kawea atu i roto i te tikanga ki te anesthetize etahi rohe tonu i roto i te kōhao-waha, ara:

• reo me te iti iho karere kauae;
• kauae kiri i te pae o te rehunga;
• niho mandibular hawhe;
• mucosal me kiri o te ngutu o raro;
• pūtake taha wheua, me te wahi o te tinana o te kauwae;
• sublingual rohe mucosa me te mua o te arero 2/3;
• membrane mucous o te wāhi taiepa kauae ki te reo, me te rohe vestibular.

Ētahi o te wahi mucosa ruma kauae o te kauwae i roto i te whānui i te pokapū o te rua o nga niho ki te waenganui niho kauoro tuatahi innervated. I roto i te tikanga ki te tino anesthetize te wahi whakamana rehunga mandibular te e whai ake: patia 0.5 ml rongoā atu ki te puninga takawaenga i te momo kookuhutanga rehunga.

hua rongoā i roto i te taua rehunga tīmata i muri i 15-20 meneti. Ko te roanga o te rehunga ko āhua 60-90 meneti. He nui raro te pakeke o te rehunga i te rohe o te incisors me canines no o te anastomoses ki te ringa ritenga. Ki tenei rehunga whakamahia taero pērā i: "Novocaine," "Trimekain", "Ultrakain" ranei "lidocaine".

pōauautanga

Ka taea e rehunga torusalnaya kawea ara kino, e whai ake:

• kanokanototo hanganga;
• ngira whati i werohia;
• te kopa te kōpā pharyngeal;
• neuritis me reo raro karere kauae;
• kino moe contractures uaua pterygoid ki te atu ahua o te kauwae.

Ko te pōauautanga i runga ake-whakahuatia puta i roto i te ofatiraa o te technique ngā o rehunga. Ko te kupu, ko te rehunga pupuri torusalnoy - te tukanga he uaua me titau te tohu tiketike o te niho.