【口腔PPT课件】牙体硬组织非龋性疾病.pptVIP

2ed sectionFused teeth Two teeth united during development by the union of their tooth germs; the teeth may be joined by the enamel of their crowns, by their root dentin, or by both A developmental anomaly arising from the attempted division of one tooth bud, resulting in incomplete formation of two teeth and usually manifest as a bifid crown upon a single root Geminated teeth 2ed sectionConcrescence of teeth Union of the roots of two or more normal teeth caused by confluence of their cemental surfaces 在牙齿发育期内，由于牙乳头组织向造釉器突起，造成在牙齿在牙合面形成额外的牙尖，因多见于下颌双尖牙合面中央窝处，故称畸形中央尖。 Abnormal central cusp Abnormal central cusp 1. 好发牙位：下颌54,一般对称出现 2. 临床表现：根据畸形中央尖磨耗程度不同，可出现不同的症状和体征 未露髓 症状：双尖牙区牙本质过敏症状——酸甜、冷热、刺激痛、无自发痛 体征： a. 额外尖 b. 因磨耗不同，有环形褐色牙本质环 c.用探针探，病人可觉敏感，酸痛 露髓： 症状： 急性/慢性牙髓炎症状 体征：a. 额外尖 b. 因磨耗不同，有环形褐色牙本质环 c. 环中央有黑色小点——为穿髓角处 d.探痛 已为根尖周炎 症状：急性/慢性根尖周炎症状 体征：d. 有的可见双尖牙区龈瘘 f . x-ray：若牙髓感染坏死发生在年轻恒牙期， 根尖孔停止发育成形，仍呈喇叭状 Chronic Apical Periodontitis 3. 治疗 未露髓：①一次-刚萌出、尖而长畸形尖可在局麻和 严格消毒下，一次磨去，作直接盖髓治疗。 ②分次、间隔半月/一月，少量、避免折断或 过度磨耗，且可在髓角处形成足够的修复 性牙本质而不至露髓，注意每次脱敏。 露髓/尖周炎：按牙髓根尖病治疗 若患牙根尖尚未发育完成：按年轻恒牙的治疗原则和方法治疗，如根尖发育成形术、根尖诱导成形术 Anomaly of the tooth, found chiefly in upper lateral incisors. It is characterized by invagination of the enamel at the incisal edge Dens invaginatus Etiology ? Developmental disorder Clinical Features rare in primary teeth most often permanent maxillary lateral incisors, central incisors, premolars, canines and molars various severity （舌侧窝、根面沟、舌侧尖、牙中牙） Restoration of the opening to prevent caries, indirect pulp capping and filling? Endodontic therapy Periondontal treatment Extraction Treatment Ectopic nodular deposits of enamel that primarily occur in the bifurcation or trifurcation areas on the roots of molars. Enamel pearl Etiology ? Ectopic enamel formation Clinical Feature