开髓术_课件的.pptVIP

开髓术 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 开髓术窝洞制备的原则 开髓术窝洞制备的形状、大小和方向应与牙髓腔解剖形状相同 既要将髓室顶揭除干净，又不能过大破坏健康牙体组织，要保留髓壁、髓室底和个根管口的自然形态 形成用根管治疗器械经开髓窝洞进入根管口达到根尖的直线通路 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 基本步骤 1、术前X线片：髓腔形态，根管长度、数目 2、去除所有龋坏组织 3、形成开髓洞形：用裂钻磨除开髓窝洞的釉质和牙本质，达牙本质深层 4、穿通髓腔，揭净髓室顶：在最高的髓角处穿透髓室顶，瞬间“落空感”，换球钻“提拉”式动作揭净髓室顶。 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 5、修整开髓洞型：用探针双弯小钩检查髓角部位的髓室顶是否去净，用裂钻修整洞形，保证根管器械能直线进入根管 6、探针检查根管口的分布：探及根管口时有“嵌入感” 7、扩锉探查根管，检查是否可以直线进入根管 基本步骤 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 上颌前牙 圆三角形，舌面窝的中央，近远中边缘嵴之间 顶在舌隆突处，两边分别与近远中边缘嵴平行 尖牙：近似椭圆形 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 舌面窝的中央下钻，与舌面垂直 达釉牙本质界钻与牙长轴平行，向深层钻入 明显“落空感” 根据髓腔大小揭净髓室顶 上颌前牙 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 注意事项 钻到釉牙本质界时立即改变钻针方向，否则形成唇侧台阶或出现颈部侧穿 开髓口的洞形不宜过小，以免近远中髓角的暴露不充分，而遗留牙髓 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 下颌前牙 椭圆形，位于舌面窝中央 舌面窝的中央下钻，与舌面垂直 达釉牙本质界钻与牙长轴平行，向深层钻入 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 明显“落空感” 揭去髓顶，修整洞形 下颌前牙 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 下颌前磨牙 椭圆形，颊三角嵴中下部 咬合面近中颊尖下钻，钻针与牙体长轴一致 穿通髓腔，揭去髓顶，修整洞形 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 上颌前磨牙 长椭圆形，外形与颈部横断面处的髓室外形相似 颊舌颈径为颊舌三角嵴中点之间的距离，近远中径为咬合面近远中的1/3 咬合面中央下钻，向颊舌向 扩展 颊角或舌角开髓 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. C