{"id":35480,"date":"2019-10-31T22:04:33","date_gmt":"2019-10-31T19:04:33","guid":{"rendered":"https:\/\/prohoster.info\/blog\/zuby-mudrosti-tyanem-potyanem\/"},"modified":"2019-10-31T22:04:33","modified_gmt":"2019-10-31T19:04:33","slug":"zuby-mudrosti-tyanem-potyanem","status":"publish","type":"post","link":"https:\/\/prohoster.info\/ro\/blog\/news\/zuby-mudrosti-tyanem-potyanem","title":{"rendered":"Din\u021bi \u00een\u021belepciunii: Tregem \u0219i h\u0103r\u021buim","gt_translate_keys":[{"key":"rendered","format":"text"}]},"content":{"rendered":"

\"Din\u021bi
\nDup\u0103 publicarea articolelor anterioare, \u00een special \u201eDin\u021bii minte \u2013 nu pot fi l\u0103sa\u021bi \u00een loc\u201d<\/a><\/noindex>, am primit c\u00e2teva comentarii cu \u00eentrebarea \u2013 \u201eDac\u0103 dintele 7 a fost c\u00e2ndva \u00eendep\u0103rtat, va fi dintele 8 \u00eenlocuit?\u201d sau \u201eSe poate scoate dintele 8 (orizontal) \u0219i s\u0103 fie pus \u00een locul dinelui 7, care lipse\u0219te?\u201d
\n<\/a><\/noindex>
\nA\u0219adar, teoretic este posibil s\u0103 faci asta, dar\u2026 e complicat.<\/p>\n

Desigur, exist\u0103 \u201emae\u0219tri\u201d care se ocup\u0103 activ \u0219i promoveaz\u0103 aceast\u0103 metod\u0103. Dar niciunul dintre ei nu \u00ee\u021bi va oferi garan\u021bii c\u0103, dup\u0103 un an sau chiar doi ani de \u00eencerc\u0103ri de a extrage un astfel de dinte 8 \u0219i de a-l pune laolalt\u0103 cu ceilal\u021bi din\u021bi va avea succes 100%. Exist\u0103 \u0219i metode de replantare a dintelui. La care eu sunt extrem de sceptic. Cu at\u00e2t mai mult \u00een cazul \u00een care \u00een locul din\u021bilor 6 sau 7, care au fost \u00eendep\u0103rta\u021bi demult, se creaz\u0103 o \u201eap\u0103\u201d artificial\u0103 (doar o \u201eg\u0103uric\u0103\u201d \u00een os), \u00een care este a\u0219ezat astfel un dinte de minte horizontal, care la r\u00e2ndul s\u0103u trebuie tratat endodontic (adic\u0103 s\u0103 \u00eei fie \u00eendep\u0103rtat nervul). Nu consideri c\u0103 asta e absurd?<\/p>\n

Din punctul meu de vedere - e pur \u0219i simplu prostesc, dar! O asemenea situa\u021bie exist\u0103. Fiecare \u201elucreaz\u0103\u201d cum vrea sau cum poate, dac\u0103 preferi. Cum se spune - \u201etotul dup\u0103 indica\u021bii\u201d. \u00cemi exprima punctul de vedere, care poate diferi radical de opinia altora.<\/p>\n

Atunci de ce s\u0103 nu extragem dintele de minte?<\/p>\n

Ortodon\u021bii pun bretele, mut\u0103 din\u021bii, trag \u201edin\u021bii ascun\u0219i\u201d reten\u021biona\u021bi (ne-erup\u021bi) care se afl\u0103 orizontal \u00een maxilar. Hai s\u0103 \u201escoatem\u201d \u0219i dintele 8! Vei spune.<\/p>\n

Problema este c\u0103 zona din\u021bilor de minte, \u0219i \u00een special inferiorii<\/b> dintelor 8 este destul de specific\u0103. \u021aesutul osos din acest loc este foarte dens, iar zona \u00een sine este, de regul\u0103, larg\u0103. Aceast\u0103 zon\u0103 este utilizat\u0103 chiar ca donor \u00een timpul opera\u021biunilor de plastie osoas\u0103.<\/p>\n

\"Din\u021bi
\n
\nA\u0219adar, \u00een acest loc, folosind instrumente speciale, se poate extrage un fragment osos (bloc) \u0219i transplanta acolo unde \u021besutul osos este insuficient pentru a plasa un implant. Iar aceast\u0103 zon\u0103 (de unde a fost extras fragmentul osos) se va recupera \u00een timp \u0219i, dac\u0103 este necesar, procedura poate fi repetat\u0103.<\/p>\n

\"Din\u021bi
\n
\nDar plastia osoas\u0103 este un subiect pentru articole separate, pe care le vom analiza cu siguran\u021b\u0103 mai t\u00e2rziu.<\/p>\n

Iat\u0103. Osul este dens \u0219i lat. Dac\u0103 \u00eencerci s\u0103 \u00eendep\u0103rtezi molarul de 8 ani, se va forma o cavitate osoas\u0103 profund\u0103 \u00een spatele lui, iar orice dinte respectabil trebuie s\u0103 fie \u00eenconjurat de \u021besut osos din toate p\u0103r\u021bile. Un mic exemplu - ia o b\u0103taie \u0219i \u00eempinge-o \u00een nisip, mi\u0219c\u00e2nd-o, ce se va \u00eent\u00e2mpla? \u00cen nisip va ap\u0103rea o \u201ecanal\u201d. La fel va fi \u0219i cu osul; a scoate un dinte orizontal \u0219i s\u0103 fie \u00eenconjurat de os din toate p\u0103r\u021bile este extrem de \u00eendoielnic.<\/p>\n

\"Din\u021bi
\n
\nVei spune: \u201eBine, dar ce se \u00eent\u00e2mpl\u0103 cu un dinte vertical?\u201d<\/p>\n

R\u0103spund, situa\u021bia cu un dinte vertical este pu\u021bin diferit\u0103, nu va trebui s\u0103 facem muta\u021bii at\u00e2t de serioase. Dar problema va fi aceea\u0219i, a muta un dinte \u201e\u00een corp\u201d este destul de complicat. To\u021bi \u0219tim c\u0103, pe m\u0103sur\u0103 ce o persoan\u0103 \u00eemb\u0103tr\u00e2ne\u0219te, procesele de vindecare din organism decurg mai lent comparativ cu cei tineri. Fie c\u0103 este vorba de o fractur\u0103, de exemplu. \u0218i asta pentru c\u0103 \u00een oasele unui copil sunt mult mai multe substan\u021be organice dec\u00e2t \u00een cele ale adul\u021bilor. \u00cenveli\u0219ul care acoper\u0103 osul din exterior (periostul) este gros \u0219i bine vascularizat. \u0218i a\u0219a mai departe. Pe m\u0103sur\u0103 ce omul \u00eemb\u0103tr\u00e2ne\u0219te, procesele de recuperare dureaz\u0103 mai mult \u0219i sunt mai complicate. Acelea\u0219i lucruri sunt valabile \u0219i pentru din\u021bi. Dac\u0103 ai 14 ani, toate mut\u0103rile de din\u021bi pe care le-a planificat ortodontul se vor desf\u0103\u0219ura mult mai repede \u0219i mai u\u0219or dec\u00e2t dac\u0103 ai avea 40 de ani. Aceea\u0219i poveste cu \u201e\u00eendep\u0103rtarea\u201d caninilor, despre care am vorbit mai devreme - dac\u0103 te ocupi de asta la 14 ani, atunci succesul acestei proceduri este maxim.<\/p>\n

\"Din\u021bi
\n
\nDac\u0103, \u00eens\u0103, la 40 de ani ai f\u0103cut pentru prima dat\u0103 o radiografie panoramic\u0103 a din\u021bilor \u0219i medicul a descoperit acolo un canin retinut orizontal, \u0219ansele de succes sunt mult mai mici. La fel \u0219i cu molarul de 8 ani; dac\u0103 ai fi avut 14 ani, atunci, teoretic, o astfel de manipulare ar fi posibil\u0103, pot chiar s\u0103 presupun c\u0103 ar fi avut succes. Dar exist\u0103 un mare DAR! La acea v\u00e2rst\u0103, r\u0103d\u0103cinile molarilor de 8 ani nu sunt \u00eenc\u0103 formate; pe radiografia panoramic\u0103, putem vedea doar partea coronar\u0103 format\u0103 a din\u021bilor, aflat\u0103 \u00een folicul (capsula care \u00eenconjoar\u0103 germenul dintelui), ce s\u0103 \u201e\u00eendep\u0103rtem\u201d atunci?<\/p>\n

\"Din\u021bi
\n
\n\u00cen acest caz, se poate deteriora germenul \u0219i dintele tot va trebui s\u0103 fie \u00eendep\u0103rtat. Da, \u0219i dac\u0103, la 14 ani, ai ajuns s\u0103 \u00eendep\u0103rtezi vreun dinte... Este, s\u0103 spunem, trist. Ce se va \u00eent\u00e2mpla atunci cu din\u021bii la 40 de ani?<\/p>\n

\u0218i \u00eenc\u0103 un aspect, nu at\u00e2t de important, dar care merit\u0103 men\u021bionat. Este anatomia formei \u0219i dimensiunii coroanei molarilor de 7 \u0219i 8. Acestea sunt diferite. Se poate crea un contact complet \u00een acest caz, dar va fi corect?<\/p>\n

\u201eDac\u0103 dintele 6 a fost extras de mult, se poate ca dintele 7 s\u0103 se mute \u00een locul dintelui 6, iar dintele 8 \u00een locul dintelui 7?\u201d<\/p>\n

Nu\u2026 Va fi ceva de genul acestuia \u2014 \"Din\u021bi
\n
\n\u201eLocul sf\u00e2nt nu r\u0103m\u00e2ne gol\u201d. \u00cen absen\u021ba prelungit\u0103 a unui dinte, din\u021bii adiacen\u021bi \u00eencep s\u0103 se deplaseze treptat spre acea direc\u021bie. Astfel de mi\u0219c\u0103ri au loc doar \u00eenainte. Adic\u0103, dac\u0103 se extrage dintele 8<\/a><\/noindex>, dintele 7 nu se va \u00eenclina \u00eenapoi, a\u0219a cum este prezentat \u00een imagine. Dac\u0103 nu exist\u0103 probleme cu mu\u0219c\u0103tura. (\u00eembinarea din\u021bilor).<\/p>\n

\u201ePot extrage doar dintele de minte inferior, iar pe cel superior s\u0103-l las (sau invers), c\u0103ci nu m\u0103 deranjeaz\u0103?\u201d<\/p>\n

Din p\u0103cate, nici asta nu este posibil.<\/p>\n

Mai jos este un exemplu, de\u0219i nu cu dintele 8, dar principiul este acela\u0219i. \u00cen absen\u021ba oric\u0103rui dinte, antagonistul s\u0103u (dinte cu care se \u00eembin\u0103) \u00eencepe s\u0103 se \u00eemping\u0103 treptat spre gol, \u201e\u00eencerc\u00e2nd\u201d s\u0103-\u0219i reg\u0103seasc\u0103 contactul.<\/p>\n

\"Din\u021bi
\n
\nPlasarea unui implant \u00een zona dintelui 7 nu este o problem\u0103, dar protezarea (instalarea unei coroane) unui astfel de dinte va fi imposibil de realizat corect. De ce? Pentru c\u0103, \u00een acest caz, coroana va fi de dou\u0103 ori mai scurt\u0103. \u0218i se va forma ceea ce se nume\u0219te \u201ebloc\u201d, la mi\u0219carea mandibulei, despre care am men\u021bionat \u00een acest articol<\/a><\/noindex>.<\/p>\n

O \u00eentrebare logic\u0103 \u2014 \u201eCum ar trebui s\u0103 proced\u0103m? Ce s\u0103 facem \u00een aceast\u0103 situa\u021bie?\u201d<\/p>\n

Iat\u0103 cum stau lucrurile. Apel\u0103m la ajutorul ortodon\u021bilor, foarte iubi\u021bi, \u0219i cu ajutorul unor construc\u021bii speciale \u0219i a unor benzi \u00eencerc\u0103m s\u0103 a\u0219ez\u0103m din\u021bii \u00een pozi\u021bia corect\u0103, a\u0219a cum a fost g\u00e2ndit\u0103 de natur\u0103. Consider c\u0103 ortodon\u021bii sunt cei mai importan\u021bi denti\u0219ti. De ce? Dac\u0103 stai s\u0103 te g\u00e2nde\u0219ti, toate problemele cu din\u021bii de unde vin? \u2014 Din pozi\u021bia lor. Dac\u0103 \u201edin\u021bii sunt str\u00e2mbi\u201d, resturile alimentare se blocheaz\u0103 mai u\u0219or \u00eentre din\u021bi, de aici sufer\u0103 igiena, de aici apare caria \u0219i toate complica\u021biile asociate. \u00cen plus, din\u021bii sunt supra\u00eenc\u0103rca\u021bi din cauza \u00eenchiderii incorecte. Bun venit uzurii, ciobirii din\u021bilor \u0219i diferitelor defecte \u00een form\u0103 de clin (afectiuni non-carioase care apar \u00een zona g\u00e2tului din\u021bilor sub form\u0103 de defecte de form\u0103 clinal\u0103). De asemenea, sufer\u0103 A\u021aMC (articulatia temporomandibular\u0103), pot ap\u0103rea trosnituri, clicuri, dureri etc. Iar dac\u0103 nu ai probleme cu mu\u0219c\u0103tura \u2014 nu ai dec\u00e2t s\u0103-\u021bi speli din\u021bii \u0219i fericirea va fi a ta. Dar, c\u00e2t de amuzant ar p\u0103rea, trebuie s\u0103 o faci corect. Po\u021bi s\u0103 \u00ee\u021bi periezi din\u021bii timp de 20 de minute, dar nu va avea niciun efect.<\/p>\n

Ne-am ab\u0103tut. Iat\u0103 un caz clinic mic.<\/p>\n

\"Din\u021bi
\n
\nS-a instalat un implant \u0219i, \u00een paralel, a \u00eenceput tratamentul cu ortodontul. A\u0219a cum vedem, dintele 7 inferior drept este \u00eenclinat, iar dintele 6 superior drept s-a deplasat u\u0219or \u00een jos.<\/p>\n

Observa\u021bi, nu este neap\u0103rat necesar s\u0103 instala\u021bi un sistem de brackets complet pentru a rezolva aceast\u0103 problem\u0103. Este suficient s\u0103 lipi\u021bi 3 brackets pe din\u021bii 4, 5 \u0219i 7, iar cu ajutorul unei arcuri speciale s\u0103 \u00eempinge\u021bi dintele problematic la locul s\u0103u. \u00cen maxilarul superior, situa\u021bia este pu\u021bin diferit\u0103. Pentru a rezolva problema, se instaleaz\u0103 dou\u0103 \u0219uruburi ortodontice. Unul dinspre obraz, iar cel\u0103lalt dinspre cerul gurii. Se lipesc dou\u0103 butoane pe din\u021bi \u0219i se adaug\u0103 o tr\u0103g\u0103toare (benzi speciale). Acestea sunt cele care \u201etrag\u201d dintele la loc.<\/p>\n

\"Din\u021bi
\n
\n\u0218i dintr-un alt unghi \u2014 \"Din\u021bi
\n
\n\u0218i acum \u00eentrebarea mea este, de ce ave\u021bi nevoie de aceasta? Vorbesc despre \u201e\u00eendreptarea\u201d de 8.<\/p>\n

Dintelui de \u00een\u021belepciune nu este un \u201eroat\u0103 de rezerv\u0103\u201d. Nu po\u021bi s\u0103 \u00eel \u00eenlocuie\u0219ti pur \u0219i simplu pe un dinte pierdut. Pe l\u00e2ng\u0103 faptul c\u0103 procesul de deplasare este foarte lung, mai ales odat\u0103 cu \u00eenaintarea \u00een v\u00e2rst\u0103, nu este nici garantat. Asta \u00eenseamn\u0103 - ai cheltuit aproximativ un an, doi pentru \u201e\u00eendreptarea\u201d de 8. Nimeni nu \u00ee\u021bi va oferi garan\u021bii, iar la final, s-ar putea s\u0103 ajungi oricum s\u0103 \u00eel sco\u021bi. Merit\u0103?<\/p>\n

\u00cens\u0103 este posibil s\u0103 plasa\u021bi la timp un implant singular \u00een zona danturii extrase, iar dup\u0103 aproximativ 3 luni (dac\u0103 vorbim despre maxilarul inferior), ve\u021bi avea garantat o dinte complet func\u021bional, care v\u0103 va servi toat\u0103 via\u021ba. \u0218i f\u0103r\u0103 \u201etiran \u0219i t\u0103r\u0103g\u0103nare\u201d suplimentare. Toate acestea, cu condi\u021bia respect\u0103rii tuturor recomand\u0103rilor \u0219i vizitelor la stomatolog de dou\u0103 ori pe an pentru un control preventiv. Cu implantul, pur \u0219i simplu nu se va \u00eent\u00e2mpla nimic. \u00centreba\u021bi: -\u201eAtunci de ce s\u0103 venim?\u201d Pentru c\u0103, dac\u0103 apar probleme cu din\u021bii vecini, ele pot afecta \u0219i implantul. Fie c\u0103 este vorba despre o problem\u0103 a gingiei sau a \u021besutului osos din jur. Controlurile preventive cu radiografii dentare ajut\u0103 la evitarea unor astfel de probleme. \u0218i, desigur, igiena profesional\u0103 a cavit\u0103\u021bii orale este ideal\u0103, de asemenea, la fiecare \u0219ase luni. Mai ales pentru persoanele cu obiceiuri d\u0103un\u0103toare, cum ar fi fumatul. Cred c\u0103 nu trebuie s\u0103 explic de ce. Toat\u0103 lumea \u00een\u021belege.<\/p>\n

Ve\u021bi spune: - \u201eAceasta este incomensurabil de scump!\u201d sau \u201eDin\u021bii proprii sunt mai buni!\u201d<\/p>\n

Referitor la costuri. Nu vreau s\u0103 v\u0103 \u00eentristez, dar etapa chirurgical\u0103, plus instalarea construc\u021biei ortodontice \u0219i schimbarea elasticelor, \u00een decurs de c\u00e2\u021biva ani la ortodont, \u00een final, va fi practic comparabil\u0103 ca pre\u021b cu instalarea unui implant \u0219i fabricarea unei coroane. Dar \u00een primul caz nu exist\u0103 nicio garan\u021bie, iar \u00een al doilea este pe via\u021b\u0103. Sim\u021bi\u021bi diferen\u021ba?<\/p>\n

Din\u021bii proprii sunt, desigur, cei mai buni. Din cuv\u00e2ntul \u00eentotdeauna. Trebuie s\u0103 lupt\u0103m pentru ei p\u00e2n\u0103 \u00een ultima clip\u0103. Dar \u00een cazul \u00een care ace\u0219ti din\u021bi sunt importan\u021bi. Iar ace\u0219tia nu sunt din\u021bii de minte, de la care, \u00een afar\u0103 de probleme, nu exist\u0103 nimic de a\u0219teptat.<\/p>\n

Asta e tot pentru ast\u0103zi, mul\u021bumesc pentru aten\u021bie!<\/p>\n

R\u0103m\u00e2ne\u021bi conecta\u021bi!<\/p>\n

Cu respect, Andrei Dashkov.
\n
Sursa: habr.com<\/a><\/p>","protected":false,"gt_translate_keys":[{"key":"rendered","format":"html"}]},"excerpt":{"rendered":"

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