牙体牙髓学龋病的治疗课件.ppt

填充材料：少量分次，层层加压 雕刻成形 调整咬合 打磨抛光：24小时完全硬固 并发症 意外穿髓 疼痛 牙髓性 牙周性 充填体折断 牙齿折裂 继发龋 患者，男，2１岁， 主诉：右下后牙冷刺激痛2周，无自发痛 体检：４６颌面颊沟深龋，探诊（＋），质较硬，冷诊（＋），冷刺激去除疼痛快速缓解，叩诊（－）。 窝洞预备基本步骤 The design of the cavity preparation for either a tooth with initial caries or replacement restoration is based on the location of the caries, the amount and extent of the caries, the amount of lost tooth structure, and the restorative material to be used. 一、预备洞形 1、开阔洞口及进入病变区：不同窝洞进入通道的选择 2、设计预备洞的外形 以病变为基础 扩展 避开承受咬合力的部位 圆滑曲线 The dentist must establish an outline form, which determines the overall shape of the preparation along the cavity margins of the restoration and the tooth surfaces. The outline form is determined by the size and shape of the carious lesion and by the need for a suitable design that will hold a restoration firmly in place. 邻面的颊舌洞缘位置 在规定的深度扩展洞形 3、抗力形和固位形 4、Finishing the Enamel Walls and Margins This is a process of angling, beveling, and smoothing the walls of the cavity preparation to achieve the best marginal seal possible between the restorative material and tooth structure. The dentist may use burs, diamond stones, or hand-cutting instruments (chisels, hoes, hatchets, and gingival margin trimmers) to complete the walls by removing loose or unsupported enamel to create the strongest possible enamel wall. 5、无痛制洞法 锋利器械，正确手法 局部麻醉 anesthesia 化学机械去龋 二、术区隔离 棉卷隔离 Reasons for use of rubber dam Protection aspiration or swallowing of instruments or irrigants Soft tissue injury caused by instruments Efficiency Improve visibility (dry field and reduced mirror fogging) Minimize patient conversation Minimize the need for frequent rinsing Reduced risk of cross-contamination Legal considerations Four-handed dentistry Close support 四手操作 选择性辅助隔离法： refraction cord mouth prop 三、窝洞消毒 CAVITY LINERS AND BASES are used primarily to protect the pulp and to aid the pulp in recovering from irritation re