Okuqukethwe
I-fistula ezinsini kubantu abadala noma ezinganeni ihambisana nenqubo yokuvuvukala kwe-purulent endaweni yezinyo elinesifo esingaphezu kwama-XNUMX. Lokhu kuyindlela yokuzivikela yomzimba, uphawu oludinga ukunakwa nokwelashwa ngokushesha, ngaphandle kwalokho imiphumela emibi ebeka usongo empilweni ngisho nokuphila ngeke kube isikhathi eside.
Iyini i-fistula
Lena iphaseji ehlanganiswe ne-epithelium, futhi ixhumanisa ukugxila kokuvuvukala okwenziwe empandeni yezinyo kanye nomgodi womlomo ngokwawo. Umsebenzi wawo ukuqinisekisa ukuphuma kobomvu kusukela ekugxilweni kokuvuvukala. Ukuthuthukiswa kwe-fistula kwenzeka kancane kancane futhi ngokungaguquki.
Uma ukugxila kokuvuvukala kwe-purulent kuye kwakha, khona-ke ngokuhamba kwesikhathi umthamo wayo uyanda, ngakho-ke, ukucindezela kwezicubu ezingomakhelwane, kuhlanganise nethambo, kuyanda. I-Pus ibheka indlela yokuphuma futhi izohamba ibheke lapho ingamelani khona kancane, yenza indlela yayo. Kusukela ebugqileni bomhlathi, ubomvu busebenza ngaphansi kwe-periosteum, futhi yile ndlela ithumba elincane elikhiwa ngayo. Iziguli zingase zibone isigaxa ku-gum ene-apex emhlophe.
Eminye imicimbi ingahamba ngokwezimo ezimbili.
Uma ngasizathu simbe, ubomvu bungakwazi ukuzitholela indlela yokuphuma futhi bugqekeze i-periosteum kanye nolwelwesi lwamafinyila, khona-ke i-periostitis iyakhula, eyaziwa kangcono ngokuthi "i-flux". Izimpawu ezifanele zivela: ubuhlungu obunzima, i-edema ebizwa ngokuthi, ephula ukulinganisa kobuso, inhlalakahle evamile ingase ibe yimbi, futhi izinga lokushisa lingakhuphuka.
Uma ubomvu buthola indlela yokuphuma, iziguli zibona i-fistula. Uma ucindezela kule ndawo, ubomvu buphuma - futhi ngalesi sikhathi zonke izimpawu ziyanyamalala. Ngokuhamba kwesikhathi, lapho ukuvuvukala kwe-purulent kuncipha, i-fistula ingabambezeleka, noma kunjalo, uma imbangela eyinhloko yokubunjwa kwayo ingelashwa, khona-ke ingabuye ibuye ngesikhathi sokukhushulwa.
Izimbangela ze-fistula ezinsinini kubantu abadala
Isizathu esiyinhloko nesivame kakhulu ukuvuvukala kwe-purulent okwakheke phezulu kwempande yezinyo, okungukuthi, i-apical periodontitis. Ngakolunye uhlangothi, i-periodontitis iyinkinga ye-caries, engazange ilapheke ngesikhathi. Noma kunjalo, kunezinye izizathu eziningi ezingaholela ekwakhekeni kokuvuvukala kwe-purulent:
- izinga eliphansi lokwelashwa komsele wempande mayelana nepulpiti, lapho zingavalwanga ngokuphelele, zingacutshungulwa ngokucophelela futhi ukutheleleka kwahlala kuzo, noma enye yeziteshi iphuthelwe, ngakho-ke ngisho nokwelashwa kwangaphambilini akubandakanyi ukwakheka kokuvuvukala esikhathini esizayo.
- ukuhlukumezeka okukhulu esikhathini esidlule, isibonelo, ukuphuka kwezimpande noma ukubhoboza, njengenkinga yokugcwalisa umsele wezimpande - ukulimala okunjalo kuvula indlela yokutheleleka futhi kubangele ukwakheka kwenqubo yokuvuvukala.
Izimpawu ze-fistula ezinsinini kubantu abadala
Izimpawu ze-fistula ezinsini kubantu abadala zincishiswa ekwakheni "i-tubercle", "i-pimple" njengoba iziguli zibiza kanjalo, iphunga elimnandi nokunambitha emlonyeni kuyisici. Ubuhlungu bungase bungabi khona, njengoba ubomvu buthole indlela yokuphuma futhi alucindezeli inethiwekhi eminyene yemikhumbi yezinzwa. Nokho, ezinye iziguli zibona ukubukeka kobuhlungu obuncane lapho ziluma.
Kubaluleke kakhulu ukukhuluma ngezimpawu ezandulela i-fistula ezinsinini kubantu abadala. Njengoba kunikezwe ukuthi ngokwezibalo kaningi, imbangela i-apical periodontitis, izimpawu ezilandelayo zivela:
- amazinyo abuhlungu kakhulu, abhebhetheka ngokuluma;
- ukwanda kanye nobuhlungu be-lymph nodes e-submandibular;
- ukuvuvukala nobuhlungu ekuqageleni kwempande yezinyo le-causative;
- ukubonakala kokunambitheka okungemnandi kanye nephunga elivela emlonyeni.
Izimpawu ezinjalo zingase zivele ngisho noma izinyo liye laphathwa ngaphambili, kukhona ukugcwaliswa okubanzi noma ngisho nomqhele. Kodwa ngokushesha nje lapho i-fistula yakha, isithombe somtholampilo siyasuswa: ubuhlungu buyanyamalala, ubuhlungu obuncane kuphela obuqhubekayo lapho kuluma, futhi hhayi njalo.
Ukwelashwa kwe-fistula ezinsinini kubantu abadala
Lapho udweba amaqhinga okwelapha, kucatshangelwa ama-nuances amaningi: kungakhathaliseki ukuthi izinyo belashwa ngaphambili, siyini isimo sezimpande, ukuthi izinyo lonakele kangakanani, nokunye okuningi, kanye nezizathu zokwakheka kwe-fistula. ezinsinini kubantu abadala.
Ukwelashwa ngezikhathi ezithile. Umgomo oyinhloko wokwelashwa ukumisa ukugxila kokuvuvukala ngemuva kwe-apex yezimpande, ukususa izicubu ezithelelekile emgodini wezimpande, ukukhipha amagciwane kanye nokugcwaliswa komsele ophezulu, futhi, yiqiniso, ukubuyisela ukuma kwe-anatomical nobuqotho bezinyo. Ukwelashwa okunjalo kungathatha isikhathi esingaphezu kosuku olulodwa, ngisho nenyanga.
Uma uke waba nokwelashwa kwe-endodontic ngaphambilini. Izinkinga ngesikhathi sokugcwaliswa komsele wezimpande, ngeshwa, azivamile: ngezinye izikhathi izinto zokugcwalisa azikwazi ukulethwa esiqongweni sezimpande ngenxa ye-anatomy eyinkimbinkimbi yemisele, ukuvinjelwa kwabo okuyingxenye, njll. Lokhu kuyimbangela yezinkinga - ukuthuthukiswa kokutheleleka. .
Akuvamile ukuthi udokotela ahluleke ukuqaphela omunye wemisele noma amagatsha awo ngesikhathi sokwelashwa kwe-endodontic, noma angakususi ukutheleleka ngokuphelele ngenxa yobunzima babo.
Kulesi simo, ukwelashwa kuhlanganisa ukuvula imisele, ukucubungula kwabo okulandelayo nokugcwalisa izinga eliphezulu, okokuqala ngesikhashana, bese kuba nezinto ezihlala njalo. Inqubo enjalo iyinkimbinkimbi, isikhathi eside futhi ukwelashwa okulandelayo kubambezeleka izinyanga.
Lapho izinyo libhobozwa ngesikhathi sokwelashwa. Ukubhoboza imbobo eyenziwe udokotela wamazinyo ngesikhathi sokwelashwa. Izimbobo ezinjalo, uma izinyathelo ezifanele zingathathwanga, zingenye yezizathu zokuthuthukiswa kokuvuvukala kwe-purulent. Ukubhoboza kungase kwenzeke ngesikhathi sokwelashwa komsele wempande, noma uma iphinifa lifakwa lapho lingalingani nesimo somsele. I-Radiography izovumela ukukhomba ukuvuvukala, kodwa kaningi le nkinga iboniswa ukubonakala kwezimpawu ezihambisanayo.
Ukwelashwa kuleli cala kunzima kakhulu, kodwa konke kuncike ekufikeni kwesikhathi kokwelashwa. Uma i-perforation ibonakala ngesikhathi esifanele, khona-ke izinto zokugcwalisa zingavala i-perforation ngaphandle kwezinkinga, kodwa lesi simo sidinga ukuqapha njalo udokotela.
Diagnostics
Izimpawu ze-fistula ezinsini kubantu abadala ziqondile, kodwa zonke izinyathelo zokuxilonga zihloselwe ukukhomba imbangela eyinhloko yokubunjwa kwayo. Lokhu kuzosiza izindlela ezibonwayo nezisetshenziswayo zokuhlola.
Konke kuqala ngocwaningo kanye nokucaciswa kwezikhalo. Ngokwezinye izici zobuhlungu, udokotela wamazinyo angenza ukuxilongwa kokuqala, kodwa izindlela zokuhlola ezengeziwe ziyadingeka ukuze ziqinisekise.
Ngemuva kwalokho, udokotela wamazinyo uqhubeka ezindleleni zokuhlola: izinyo ngalinye liyaphenywa, ukushaywa (ukushaya), ukuhlolwa kwezinga lokushisa nakho kwenziwa.
Isimo sezinsini sidinga ukunakwa okukhethekile. Idatha etholiwe yenza kube nokwenzeka ukufeza ukuxilongwa okuhlukile, okungukuthi, ukuhlukanisa isifo esisodwa kwesinye uma izimpawu zabo zifana.
Kungenzeka ukwenza ukuxilongwa kokugcina futhi uqinisekise kuphela ngemuva kwe-X-ray noma i-CT scan. Lezi zindlela zocwaningo zibona ngeso lengqondo isithombe esifihliwe emehlweni, zikuvumela ukuthi uhlole usayizi wesilonda esivuthayo futhi ubone ngisho nepheshana le-fistulous uma impahla ye-radiopaque yethulwa kuyo ngaphambi kwesithombe (isibonelo, i-gutta-percha).
Ngemva kokunquma imbangela yokwakheka kwe-fistula, ezinye izici zomuntu ngamunye kanye nohlelo lokwelapha luyakhiwa.
Ukwelashwa kwesimanje
Udokotela Wamazinyo igatsha lezokwelapha elithuthukayo; imishini yesimanje kanye nezinto zakamuva zokugcwalisa zifakwa njalo ekusebenzeni, okuvumela ukulondoloza amazinyo ngisho nasezimweni ezinzima kakhulu.
Impumelelo yokwelashwa kwe-fistula ezinsini kubantu abadala incike kwikhwalithi nokunemba kokuxilongwa. Usizo olubalulekile kulokhu luhlinzekwa yi-CT, i-radiography, ne-visography. Lezi zindlela zokuhlola zinikeza isithombe esiphelele salokho okwenzekayo.
Ukusetshenziswa kwe-microscope yamazinyo futhi kunciphisa amathuba okuba nezinkinga ngesikhathi sokwelashwa kwe-endodontic, okuhlanganisa ukubhoboza.
Ukuvimbela i-fistula ezinsini kubantu abadala ekhaya
Ukuvimbela kufika ekugezeni amazinyo okuvamile nangokuphelele: ekuseni ngemva kokudla kwasekuseni nangaphambi kokulala kusetshenziswa imikhiqizo nezinto zokuhlanzeka ezijwayelekile nezengeziwe, okungamabhulashi, ama-paste, amaflosi kanye nezinto zokunisela.
Ngeshwa, akukho bhulashi elilodwa kanye nokunamathisela okuzohlinzeka ngokukhishwa kwe-100% kwe-plaque, ngakho-ke, okungenani izikhathi ezi-2 ngonyaka, ukuhlolwa kokuvimbela esihlalweni sikadokotela wamazinyo kanye nokuhlanzeka komlomo ochwepheshe kuyadingeka. Inhloso yayo eyinhloko ukususa i-tartar ne-plaque, ngoba lezi yizimbangela eziyinhloko ze-caries, kanye nesifo sofuba esivuthayo.
Ukwelashwa okufika ngesikhathi kwe-caries, lapho kungakabi yizinkinga, kuyindlela ephumelela kakhulu yokuvimbela i-fistula ezinsini. Ngaphezu kwalokho, kuyadingeka ukukhetha udokotela wamazinyo onolwazi ozohlinzeka ngokwelashwa kwe-endodontic ephezulu.
Imibuzo nezimpendulo ezidumile
I-Fistula ezinsini kubantu abadala, ngeshwa, akuyona isikhalazo esingavamile, futhi naphezu kokuthi lokhu kuyisibonakaliso nje, imiphumela ingaba yingozi kakhulu. Ukuze ungasheshisi ukuqala kwabo, udinga ukulandela imithetho ethile. Ngokushesha nje lapho ekhuluma ngakho udokotela wamazinyo, i-implantologist kanye ne-orthopedist, ikhandidethi yesayensi yezokwelapha, uprofesa ohlangene woMnyango Wezamazinyo we-Central State Medical Academy Dina Solodkaya.
Lapho izinyo elide elinokuvuvukala okunjalo lisendaweni yomlomo, izicubu ezincane zamathambo zihlala zizungezile. Ngemuva kokukhishwa kwezinyo elinjalo, umthamo wamathambo ungase unganele ukufaka ukufakelwa kanye nokusebenza kokwandisa amathambo kuyodingeka.
Ezinye izinkinga ezingenzeka zihlanganisa ukwakheka kwethumba kanye ne-phlegmon, futhi lokhu kakade kuyi-pathology yokuhlinzwa eyingozi. Ukwelashwa kwamathumba amakhulu kanye ne-phlegmon kwenziwa ngaphakathi kwezindonga zesibhedlela se-maxillofacial futhi lezi zimo azigcini nje ukubeka usongo empilweni, kodwa futhi nempilo yesiguli.
Ngakho-ke, kubaluleke kakhulu ukufuna ukunakekelwa kwamazinyo ochwepheshe ngesikhathi futhi ukwenze ngokugcwele, ulandela ngokuqinile zonke izincomo zikadokotela.
Noma kunjalo, lapho kuvela izinyo elibuhlungu futhi kukhona i-fistulous tract, udinga ukuthola i-aphoyintimenti nodokotela wamazinyo esikhathini esizayo esiseduze - ukuxilonga nokunquma ukuthi ukwelashwa okulondolozayo kungenzeka yini (ngaphandle kokukhipha izinyo le-causative).
Ukuze uthuthukise ukuphuma kwe-pus, kunconywa ukugeza umlomo ngesisombululo se-soda nosawoti. Hlanza umlomo wakho izikhathi eziningana ngosuku. Uma kungenjalo, ezinye izindlela zokwelapha zingase zingasebenzi futhi zibe yingozi.