Trauma of primary teeth 乳牙外伤 Tooth fracture Crown fracture 冠折 Enamel fracture: no need treatment Dentine fracture without pulp exposure: indirect pulp.

Presentation on theme: "Trauma of primary teeth 乳牙外伤 Tooth fracture Crown fracture 冠折 Enamel fracture: no need treatment Dentine fracture without pulp exposure: indirect pulp."— Presentation transcript:

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2 Trauma of primary teeth 乳牙外伤

3 Tooth fracture Crown fracture 冠折 Enamel fracture: no need treatment Dentine fracture without pulp exposure: indirect pulp capping 间接盖髓术 Dentine fracture with pulp exposure : direct pulp capping 直接盖髓术 pulpectomy with endodontic treatment 牙髓摘除术（根管治疗） Root fracture: 根折 surgical removal

4 Displacement 移位  Intrusion 挫入  Lateral luxation 侧向移位 reeruption or removal

5 恒牙胚受损伤可能发生： 萌出异常 牙冠形成异常 牙根形成异常 恒牙胚发育停止

6 Total extrusion 完全脱位

7 Dental caries in the child 乳牙龋病

8 Risk factor 乳牙易患龋的因素 形态结构特点 饮食结构

9 Characteristics of dental caries in the child 乳牙龋病的特点  患龋率高，发病早  龋齿多发，龋坏范围广  龋蚀发展速度快  自觉症状不明显  修复性牙本质的形成活跃

10 Harm 局部影响：  chewing function  permanent teeth  mucous membrane of mouth and soft tissues 全身影响：  nutrition intake  focal infection  Phonation  beauty  psyche

11 Clinical exhibition 乳牙龋蚀常见类型及临床表现 奶瓶龋 环状龋 猖獗性龋

12 奶瓶龋 milk bottle caries nursing bottle caries bottle feeding caries BBTD Baby bottle tooth decay ECC Early childhood careis

13 环状龋 circular caries

14 猖獗性龋 rampant caries “ Suddenly appearing,widespread,rapidly burrowing type of caries,resulting in early involvement of the pulp and affecting those teeth usually regarded as immune to ordinary decay,such as the mandibular anteriors ” -----Massler

15 Therapy 治疗 Stop and protect 终止龋蚀进展，保护牙髓活力 Avoid 避免并发症 Restore 恢复外形和功能

16 Medication 药物治疗 Indication 适应证： 广泛浅龋，环状龋，不易制备洞形者 Commonly used drug 常用药物 ： Ammonia silver nitrate 氨硝酸银 Fluoride 氟化物类

17 Mechanism ：  堵塞牙本质小管  抑制细菌生长繁殖  增加抗酸性

18  修整外形  清洁干燥牙面、隔湿  涂药 procedure 操作步骤

19 注意事项 ：  征得患者家属同意  注意保护口腔软组织  定期复查  不能恢复牙体外形，仅能 控制龋蚀进展

20 Restoration 充填治疗

21 治疗特点：  钻针切削会使釉面龟裂多发，走向复杂  硬组织薄，易切削，易穿髓  牙髓组织对切削反应敏感，且出现变化早  生理间隙特点决定不必勉强恢复接触点  洞形制备要求不如恒牙严格

22 Class Ⅰ cavity

23 Class Ⅱ cavity

24 Class Ⅲ cavity Class Ⅳ cavity Class Ⅴ cavity

25 Management of deep caries of primary teeth 乳牙深龋治疗

26 两种观点：  保存活髓 Indirect pulp capping 间接盖髓术  不保髓 Treatment principle 治疗原则 保牙不保髓 Pulp mummufication 干髓术

27 Restoration of proximal-incisal caries in primary anterior teeth 乳前牙近切端缺损  Preformed stainless steel bands 预成不锈钢带环  Esthetic resin restoration 树脂  Stainless steel crowns 不锈钢成品冠  Inlay 嵌体

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29 Endodontics of primary teeth 乳牙牙髓根尖周病治疗

30 Clinical characteristic 牙髓病特点  诊断困难  症状与疾病进展程度不一致  多呈慢性炎症过程  牙髓炎常伴发根尖周症状  牙髓炎症常引起根管内吸收  可引起牙根病理性吸收，致牙齿过早脱落

31 症状： toothache ， cavity ， pustule 脓包 检查：  深龋穿髓或未穿髓  温度试验不可靠  可同时伴随根分叉脓肿或根尖区红肿  叩痛和轻度松动  X － ray

32 Brief summary 1. Management of trauma to primary teeth  Tooth fracture  Displacement  Total extrusion 2. Characteristics and management of dental caries in the child 3. Endodontics  Characteristics

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