牙髓根尖周病.pptVIP

牙髓根尖周病 牙髓根尖周病学是研究牙髓及根尖周组织疾病损害及其诊断、治疗技术的一门学科。 牙髓形态及生理学特点 牙髓的功能 形成功能 营养功能 感觉功能 神经分布 感觉功能  闸门控制学说 牙髓增龄性变化  体积变化、结构变化、功能变化 牙骨质的增龄性变化 牙髓炎症的疼痛机制 组织压升高 炎性介质释放 恶性循环理论 牙髓炎的病因 1 细菌因素 感染途径： 牙本质小管 牙髓暴露 牙周途径 牙周途径  血源感染 引菌作用 2 物理因素 创伤 急性创伤、 慢性创伤 温度 备洞产热、充填材料导热、抛光产热 电流 异种金属修复体、检查治疗 激光 3 化学因素 充填材料 酸蚀剂、粘结剂 消毒药物 4 免疫因素 PULP AND JAW INFECTION Bacteria are the most common causes of inflammation and infection of the pulp. They usually enter the pulp through tooth decay (caries). Toxins (poisons) from the bacteria that have destroyed the pulp can leak out through the apex into the jawbone. The jawbone, like all bones, is a living tissue which has arteries, veins, and nerves. Therefore, it can become inflamed and infected by the presence of bacteria and their toxins. If untreated, infection in jawbone can erode through the side of the bone into the mouth, or even into the face or neck, and cause sudden, serious, and painful swelling. * * 刘卫国 1930’s前，牙髓根尖周病的结局就是拔牙。 根尖周炎与牙髓炎症过程没有别，只是解剖环境不同而已 ? Invading bacteria first overwhelm the natural defences in the pulp chamber. Then they destroy the tissues in the root canal(s).