Okondedwa, m'nkhani zam'mbuyomu, tidakambirana - ΠΈ . Lero ndikufuna kuti ndidutse pang'ono ndikulankhula za kukhazikitsidwa, makamaka kukhazikitsidwa kwa gawo limodzi, pamene implantation imayikidwa mwachindunji muzitsulo za dzino lochotsedwa, komanso za kukweza kwa sinus, kuwonjezeka kwa minofu ya mafupa mu msinkhu. . Izi zimafunika pakuyika ma implants m'dera la 6, 7, kapena nthawi zambiri mano 5 pansagwada zapamwamba. Kuwonjezeka kwa fupa kumafunika chifukwa pali mphuno pamwamba pa nsagwada - maxillary sinus. Nthawi zambiri, imatenga nsagwada zambiri zakumtunda, ndipo mtunda kuchokera pamphepete mwa fupa mpaka pansi pa sinus iyi sikokwanira kukhazikitsa implant ya kutalika kofunikira.
Kujambula kwa CT kumasonyeza bwino kuti pali kusiyana pakati pa dzino losowa.
Nthawi zambiri ndimamva madokotala akunena kuti, βAyi, ayi, ayi, simungathe kuyika implant nthawi yomweyo! Choyamba, tichotsa dzino, ndipo chilichonse chikachira, ndiye kuti tiyiyika! Funso lomveka ndilakuti chifukwa chiyani? Angadziwe ndani? Zosangalatsa ndekha. Mwina chifukwa cha kusatsimikizika m'malingaliro, kapena chifukwa choopa zovuta, zomwe, kwenikweni, sizili zambiri kuposa opaleshoni yachikale. Inde, malinga ngati zonse zachitika molondola. M'zochita zanga, kuchuluka kwa implantation panthawi imodzi ndi njira yachikale ndi pafupifupi 85% mpaka 15%. Gwirizanani, osati pang'ono. Kumene pafupifupi opaleshoni iliyonse yomwe imasonyezedwa m'mano imathera ndi kuika. Kupatulapo ndi kutupa pachimake m'dera la causative dzino, pamene mafinya umayenda wosakanikirana ndi snot. Kapena pamene implant siikhazikika ndipo imalendewera mu dzenje ngati pensulo mu galasi. Maluso azachuma amathandizanso kwambiri. Aliyense amawononga ndalama mofunitsitsa pa chilichonse, koma osati pa mano. Simungatsutse zimenezo. Koma pali mmodzi "Koma"! Muyenera kumvetsetsa kuti nthawi yochulukirapo ikadutsa kuyambira nthawi yochotsa dzino mpaka kuyamba kwa ma prosthetics, mikhalidwe yoyikirayi imayipitsitsa. Monga akunena kuti: βmalo opatulika sakhala opanda kanthu.β M'kupita kwa nthawi, zovuta zambiri zakutchire zimawonekera zomwe ziyenera kuthetsedwa. Ndipo izi nthawi zonse zimakhala zowonjezera, ndipo nthawi zambiri zimakhala zodula. Kodi mukuzifuna?
Chabwino! Tiyeni tipitirire ku zitsanzo.
Mlandu wosavuta wa kuyika kwa gawo limodzi ndi dzino lozika mizu. Zikhale nsagwada zakumtunda kapena zapansi.
CT scan imeneyi inkachitika dzinolo lisanangβambe kotheratu.
Kodi tikuwona chiyani?
Pamwamba kumanzere 5, osapatsidwa chithandizo chamankhwala kapena mafupa. Kodi tikuchita chiyani? Ndiko kulondola - chotsani dzino ndikupukuta mu bawuti.
Ndinachotsa dzino mofatsa komanso modzidzimutsa ndipo ndinaika implant ndi chingamu.
Chingamu choyambirira ndi chinthu chotsika (pafupifupi 3mm kutalika), chitsa chachitsulo chomwe chimatuluka pang'ono pamwamba pa chingamu, potero chimapanga mizere yake musanayike korona. Zikuwoneka motere:
Ndipo izi ndi momwe implant yokhayo imawonekera:
Gawo la imvi ndi choyikapo chokha. Mbali ya buluu ndi yotchedwa abutment yanthawi yochepa, yomwe korona wosakhalitsa akhoza kumangirizidwa ngati implantation ikutsatiridwa ndi kukweza mwamsanga. Kwenikweni, chotengera ichi chimagwira ntchito ngati chosungira. Kuyikako kumayikidwa, chopukutiracho chimachotsedwa ngati womanga - ndi screwdriver yapadera, ndipo pulagi imayikidwa m'malo mwake. Imayikidwa ngati sikungatheke kukhazikitsa kale chingamu. Ndiye implantation ndi zigawo zake zonse zili pansi pa chingamu, zomwe zikutanthauza kuti sitidzawona chilichonse m'kamwa pambuyo pa opaleshoni. Chabwino, kupatula zokometsera ndi ... mano ena onse, ngati pali otsala. Zikatere, choyambiriracho chimayikidwa pambuyo poti implant yazika mizu.
Kenaka, timasankha mlingo wotsatira wa zovuta, pamene tikuyenera kuchotsa dzino lachisanu ndi chimodzi m'nsagwada zapansi. Dzino ili lili ndi mizu iwiri. Ife, ndithudi, sitidzayika implant m'dera la muzu uliwonse, monga momwe wina angaganizire. Ngakhale ndidawonapo milandu yofananira. Zikuoneka kuti dokotalayo anali ndi ngongole yanyumba.
Chifukwa chake, tiyenera kukhazikitsa implant imodzi, koma momveka bwino pakati. Tidzayang'ana pa kugawa mafupa pakati pa mizu iwiri.
Timayika implant. Kumanzere ndi kumanja kwake pachithunzichi mumatha kuona bwino mabowo kuchokera ku dzino lochotsedwa, lomwe lidzachiritsa pamene likuchiritsa.
Chabwino, ndi nthawi yoti muganizire ngati kuli kofunikira kuchotsa dzino, kukhazikitsa implant ndikumanga minofu ya nsagwada kumtunda - kukweza kwa sinus. Panthawiyi, kuchuluka kwa zovuta kumawonjezeka. Osati ntchito yokhala ndi ma helikopita ochokera ku Vice City, ndithudi, koma muyenera kukhala osamala kwambiri kuposa momwe zinalili kale.
Mukukumbukira pamene ndinanena kuti implant iyenera kukhala pakati? Kotero, dzino la 3-mizu ndilosiyana. Kuyikako kumayikidwa, monga momwe zinalili kale, mu septum, koma dzino lokhala ndi mizu itatu. Monga tikuonera, kutalika kwa fupa m'derali ndi pafupifupi 3mm. Voliyumu iyi sikokwanira kukhazikitsa implant ya kutalika koyenera, chifukwa chake voliyumu iyenera kukulitsidwa. Kuwongolera kumachitika pogwiritsa ntchito "fupa" lapadera. Anthu ena amachitcha "fupa la ufa", kuti asasokonezedwe ndi "ufa woyera", ngakhale kuti ndi woyera, amaperekedwabe ngati mawonekedwe a granules. Zimapezeka m'magalasi okha,
ndi mawonekedwe osavuta - ma syringe apadera, omwe ndi osavuta kugwira nawo ntchito ndikuyambitsa zinthu m'munda wa opaleshoni.
Ndi kulakwitsa kukhulupirira kuti kukweza sinus ndi ntchito "Mu" maxillary (Highmore) sinus. M'malo mwake, kuwongolera kumachitika "PASI" izo. Monga taonera kale, nkusani ndi patsekeke pa nsagwada chapamwamba, chopanda kanthu, ngati mukufuna, amene ali alimbane kuchokera mkati ndi woonda mucous nembanemba ndi ciliated epithelium. Chifukwa chake, kuti opareshoniyo ikhale yopambana, kutsekeka kwa mucous nembanemba kuchokera ku fupa kumachitika ndipo "fupa la mafupa" limayikidwa pamalo opangidwa pakati pa pansi pa sinus ndi mucous nembanemba, monga mu envelopu. . Pankhaniyi, ndi kufanana unsembe wa implants.
Ndipo tsopano chitsanzo cha sinus kukweza ndi implantation, koma 2 miyezi pambuyo 6 dzino pa nsagwada chapamwamba anachotsedwa. Wodwala uyu adamuchotsa 6 pafupifupi sabata yapitayo kuchipatala china. Wothandizira adapanga CT scan.
Chifukwa chakuti sabata yokha yadutsa kuchokera kuchotsedwa, pachithunzichi tikuwona "dzenje lakuda", monga lomwe wakale wanu adasiya mu mtima mwanu. Kumalo komwe kunali dzino. Ndiko kuti, palibe minofu ya mafupa m'derali. Ndinayamba opaleshoni patapita miyezi iwiri. Sanachite kubwereza CT scan dzenje litachira, koma ndikhulupirireni, zonse zidachira mokwanira kuti opareshoni ichitike. Panthawi ya opareshoni, sikunali kotheka kukwaniritsa kukhazikika kwa implant, kotero ndidaganiza zoyika pulagi m'malo mochiritsa machiritso. Chifukwa chiyani? Koma chifukwa ngati wodwalayo ayamba kutafuna crackers, ndiye kuti kupanikizika kwamphamvu kungathe kuchitidwa pa implant, makamaka choyambirira, choncho implants ikhoza kukhala yotayirira kapena "kuwulukira" mu sinus. Nthawi yomweyo, 2 adapita kukataya.
Chabwino, chitsanzo chomaliza cha lero ndikuchotsa mano a 2, kuika 2 implants ndi sinus lift.
Monga tikuonera, zinthu mu nkhani iyi ndi penapake woipa, za 2mm. Koma zimenezi sizinatiletse kuchita opaleshoniyo mokwanira.
Mutha kufunsa: - "Chifukwa chiyani pali ma implants awiri osati 2?" "Chani, padzakhala mlatho?" "Nanga bwanji kugawa katundu," ndi zina?
M'malo mwake, vuto lakuchulukirachulukira kokhudzana ndi milatho limakhudza mano anu okha. Popeza mano ali ndi ligamentous zida. Ndiko kuti, dzino silimangirizidwa mwamphamvu ku fupa, koma likuwoneka ngati likutulukira mmenemo. Nachi chithunzi:
Pamaso pa mlatho, mano othandizira amatenga katundu wawo komanso katundu wa dzino losowa. Choncho, amachulukira mano akufotokozera, ndiyeno amathera ndi dzino nthano. Choyikacho sichikhala ndi ligament yotere. Imalumikizana mwamphamvu ndi minyewa yozungulira, kotero palibe zovuta monga momwe zilili ndi mano anu. Koma izi sizikutanthauza kuti ma implants awiri angagwiritsidwe ntchito kukhazikitsa mlatho waukulu pamwamba pa nsagwada zonse. Chinthu chokha chomwe chimavutika pamaso pa milatho ndi ukhondo, womwe udzafunika kuyang'aniridwa makamaka mosamala. Chifukwa kusamalira mano opanda ufulu ndikosavuta kuposa kusamalira mano ofanana.
Ndizo zonse za lero. Ndikhala wokondwa kuyankha mafunso anu!
Dzimvetserani!
Zabwino zonse, Andrey Dashkov.
Source: www.habr.com