Tanamedrove endodontiuri mkurnalobis zogierTi aspeqti

 

 

 

m.m.k.nino vadaWkoria, m.m.k.mzia baqraZe, m.m.k.nana melqaZe

 

Tbilisis saxelmwifo samedicino akademiis Terapiuli stomatologiis kaTedra

 

 

 

 

Terapiul stomatologiaSi gadamwyveti mniSvneloba aqvs fesvis arxis srulfasovan dabJenas. Tanamedrove endodonturi instrumentebi da maTi sworad gamoyeneba am rTuli problemis gadaWris saSualebas iZleva.

anesTeziis qveS kariesuli Rrus preparireba, koferdamis moTavseba, pulpuri Rrus gaxsna, amputacia, arxebis Sesasvlelebis povna, eqstirpacia, arxis samuSao sigrZis dadgena, arxebis preparireba, irigacia, gamoSroba, “master-Stiftis” SerCeva, arxis obturacia da mudmivi bJeni-es aris is klinikuri etapebi, romelTa Tanamimdevruli Sesrulebac ganapirobebs garTulebuli kariesis mkurnalobis karg Sedegebs.

Tanamedrove stomatologiuri teqnikis maRali done gvexmareba eqimebs gavimartivoT klinikaSi muSaoba. am mxriv aRsaniSnavia apeqs-lokatorebis gamoyeneba arxis sigrZis gansazRvrisaTvis, endodonturi bunikebi, profailebi, niti-failebi. aseve aucilebelia fesvis konfiguraciisa da arxis obturaciis Sesamowmeblad rentgenis Tanamedrove aparatura da viziografebi.

miuxedavad yvelafrisa, klinikuri masalis analizi ar gvaZlevs saSualebas gadawyvetilad CavTvaloT endodonturi problemebi. Cvens mier gaanalizebuli iqna 15-60 wlis asakSi myofi 60 avadmyofis orTopantomograma. aRmoCnda, rom 22 suraTze aRiniSneboda arxebis arasrulfasovani obturacia da Sedegad cvlilebebi kbilis periapikalur qsovilSi. iyo SemTxvevebi, rodesac avadmyofebi mogvmarTavdnen mwvervalovani periodontitis CivilebiT an xvrel-arxis arsebobiT dabJenili kbilis areSi. pacientebs vuRebdiT rentgenis suraTs da suraTze Canda fiziologiur apeqsamde dabJenili arxi. am movlenas xSirad hqonda adgili 33; 34; 35; 43; 44; 45; 15; 25 kbilebis SemTxvevaSi. klinikaSi kbilis gaxsnis Semdeg ki, rogorc wesi, aRmovaCendiT, rom ar iyo moZebnili da dabJenili fesvis meore arxi. e.i. saqme gvqonda arsebuli me-2 arxis ignorirebasTan.

Cveni praqtikuli muSaobis analizma dagvarwmuna, rom savaldebuloa im Teoriul monacemebze dayrdnoba, romelic Tanamedrove stomatologiur literaturaSia da asaxavs kbilTa fesvebSi arxebis raodenobis % maCveneblebs. “ignorirebuli” arxi gansakuTrebiT xSiria erTfesvian kbilebSi, rodesac eqimi fsiqologiurad ganwyobilia standartuli 1 arxis arsebobaze da aRar eZebs meore arxs. Teoriul-praqtikul monacemebze dayrdnobiT unda gvaxsovdes, rom zeda ybis me-2 premolarSi 2 arxi aRiniSneba SemTxvevaTa 48%-Si, qveda ybis eSvSi 2 arxia 15%-Si, qveda ybis pirvel premolarSi 2 arxia 20%-Si, qveda ybis saWrelebSi 2 arxia 35-43%-Si, zeda ybis pirvel molarSi 4 arxia SemTxvevaTa 30%-Si, zeda ybis me-2 molarSi 4 arxia 13%-Si (zeda ybis molarebSi me-4 damatebiTi arxi mdebareobs loyiskena mezialur fesvSi). qveda ybis molarebSi damatebiTi me-4 arxi mdebareobs distalur fesvSi da igi gvxvdeba SemTxvevaTa 10%-Si.                                                

endodonturi mkurnalobis I etapze garTulebebis Tavidan acilebis TvalsazrisiT saintereso Sedegebs iZleva da Sesasrulebladac martivia iseTi meTodi, rogoricaa SeRebviT kbilis fskerze arxebis Sesasvlelebis moZebna.

erT-erTi aseTi saRebavia Canal Blue. igi aris lurji feris siTxe. misi gamoyenebis teqnika aseTia: siTxe Tavsdeba pulpuri Rrus fskerze ramodenime wamiT (3-5 wm), Semdeg bambis burTuliT vaSorebT Warb saRebavs Rrudan. arxebis Sesasvlelebi iRebeba intensiur lurj ferad (sur. 1) da Semdgomi maTi lokalizaciisaTvis gamoviyenebT wvril arxovan zonds, rogoricaa mag. Micro-Opener-i. saRebavis mier aRmoCenili arxebis Sesasvlelis suraTi gansakuTrebiT efeqturia qr.pulpitebis da qr.periodontitebis dros darbilebuli da inficirebuli dentinis siWarbis gamo. am meTodiT arxebis Sesasvlelebis aRmosaCenad SevRebeT 100 kbilis Rru da 56 SemTxvevaSi aRmovaCineT arxebis arastandartuli raodenoba, rac SemdgomSi dadasturda dentaluri rentgenologiuri gamokvleviT (suraTs viRebdiT endodontur instrumentTan erTad). sur. 2-3

 

 

 

 

 

 

 

 

 

 

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arxebis SesasvlelTa mosaZieblad Zalian efeqturia iseTi modificirebuli zondebi, rogoricaa: DG 16 da TiTistarismagvari zondebi PCE-1 da  PCE-2, aseve Micro-Opener-i. es instrumentebi gansakuTrebiT kargia wvrili arxebis SesasvlelTa zondirebisaTvis. maTi gamoyenebiT gamoricxulia rotacia, radganac aqvT tari. swored taris arseboba ganapirobebs pulpuri Rrus fskeris optimalur gamokvleva-danaxvas, radganac eqimis xeli ar faravs saoperacio vels. am instrumentTa maRali konusuroba da tradiciuli zondebisagan gansxvavebiT maRali simtkice uzrunvelyofs: 1) arxebis Sesasvlelis swrafad povnas, 2) arxebis SesasvlelTa gafarToebis gamartivebas, 3) gvirgvinovan nawilSi da arxovan nawilSi arxis sigrZis 1/3-dan 2/3-mde.

arxebis SesasvlelTa moZebna ki, Tavis mxriv ganapirobebs preparirebis dros maqsimalurad gavufrTxildeT da davzogoT kbilis janmrTeli magari qsovili.

daskvna: Cvens mier endodontur muSaobaSi gamoyenebuli axali meTodebi xels Seuwyobs praqtikos eqimebs da gansakuTrebiT damwyeb specialistebs klinikuri etapebis Catarebis gamartivebaSi, drois ekonomiaSi arxebis Sesasvlelebis Zebnisas da mkurnalobis xarisxian CatarebaSi. zog SemTxvevaSi ki Tavidan agvaSorebs endodonturi mkurnalobis iseT warumateblobas, rogoricaa, ignorirebuli arxi.      

 

 

literatura

 

1.        А.Ж.Петрикас – "Пульпэктомия"  Тверь  2000 г

2.       Бенджамин Бризено, Бритта Виллесхаузен-Ценхен "Препарирование доступной полости: вспомогательные средства для нахождения входов в корневой канал" Клиническая стоматология №4 2001г.

 

 

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SUMMARY

 

In therapeutical stomatology providing of correct endodontical treatment  is highly important during the therapy of complicated cariesis.

In this article are discussed some new endodontical treatment methods.

In order to find the root canal ostium it is offered the method of colouring with Canal Blue and modern endodontical probes as Micro Opener, PCE-1 and PCE-2 are offered for localization of the canals.

In the article is also analysed literary information about non-typical quantity of root canals.

The article is very useful  for practical dentists  and especially for beginners.