牙髓病与根尖周病.ppt.pptVIP

牙髓病与根尖周病 Pulpal DiseasePeriapical Disease 【病因Causes 】 细菌因素Bacterial factors 物理因素Physical factors 化学因素Chemical factors 免疫因素Immune factors 牙髓病 Pulpal Disease 一、髓腔解剖特点 Pulp cavity anatomical characteristics 牙髓病 髓腔解剖与牙髓病和根尖周病的症状和治疗关系紧密。 Pulp cavity anatomy is related to pulpal and periapical disease. 髓腔由坚硬的牙本质壁包围 pulp cavity surrounded by dentin 髓腔通过根尖孔与外界相连通 the?apical foramen?is the opening at the apex of the?root?of a?tooth, through which the?nerveand?blood vessels?that supply the?dental pulp?pass. Thus it represents the junction of the pulp and theperiodontal?tissue. 牙髓病 二、牙髓的特点和功能 pulp features and functions 牙髓病 Structural features The central region : large nerve trunks and blood vessels. three layers (from innermost to outermost) 1. Cell rich zone (zone of Rinaggio): innermost pulp layer which contains fibroblasts and undifferentiated mesenchymal cells. Cell free zone (zone of Weil): rich in both capillaries and nerve networks. Odontoblastic layer: outermost layer which contains odontoblasts and lies next to the predentin and mature dentin Cells found in the dental pulp include fibroblasts (the principal cell), odontoblasts, defence cells like histiocytes, macrophage, granulocytes, mast cells and plasma cells. The nerve plexus of Raschkow is located central to the cell-free zone. 牙髓的功能：The primary function of the dental pulp 形成功能——成牙本质细胞形成牙本质 to form dentin (by the odontoblasts) Formative:cells of the pulp organ produce dentin which surrounds and protects the pulpal tissue. 营养功能——血管系统向牙髓牙本质复合体提供营养成分 Nutritive: the pulp keeps the organic components of the surrounding mineralized tissue supplied with moisture and nutrients; 感觉功能——疼痛 Sensory: extremes in temperature, pressure, or trauma to the dentin or pulp are perceived as pain; 防御功能——修复性牙本质形成 Protective: the formation of reparative or secondary dentin (by the odontoblasts). 三、临床病理 牙髓的防御机制 1）牙本质硬化 Dentin sclerosis 2）第三期牙本质形成 The formation of reparative dentin 第一