Bangane abathandekayo, ezihlokweni ezedlule, sixoxe nawe - и . Namuhla ngithanda ukuhlehlisa kancane futhi ngikhulume ngokufakwa, futhi ikakhulukazi ukufakelwa kanyekanye, lapho ukufakelwa kufakwa ngqo esokhethini lezinyo elikhishiwe futhi mayelana nokuphakanyiswa kwe-sinus, okwandisa umthamo wezicubu zethambo ukuphakama. Lokhu kuyadingeka lapho ufaka izimila endaweni engu-6, 7, amazinyo angaphansi kwama-5 emhlathini ongaphezulu. Ukwandiswa kwamathambo kuyadingeka ngoba kukhona imbobo emhlathini ongenhla - i-maxillary sinus. Ngokuvamile, ithatha ingxenye enkulu yomhlathi ongenhla, futhi ibanga ukusuka emaphethelweni ethambo kuya phansi kwalesi sinus akwanele ukufaka ukufakelwa kobude obufunayo.
I-tomography ehlanganisiwe ibonisa ngokucacile ukuthi kukhona igebe endaweni yezinyo elilahlekile.
Ngiye ngizwe odokotela bethi, “Cha, cha, cha, awukwazi ukufaka isimila ngokushesha! Okokuqala, sizosusa izinyo, futhi ngokushesha nje lapho konke kuphulukiswa, sizobe sesiyifaka! Umbuzo onengqondo - kungani? Yebo, ngubani owaziyo. Okuthakazelisa kakhulu. Kungakhathaliseki ukuthi ngenxa yokungaqiniseki ekubikezelweni, noma ngenxa yokwesaba izinkinga, empeleni, ezingekho ngaphezu kokusebenza kwe-classical. Yiqiniso, ngesimo sokuthi konke kwenziwa ngendlela efanele. Emsebenzini wami, iphesenti lokufakelwa kanyekanye okuhlobene nendlela yakudala cishe i-85% kuya ku-15%. Vuma, hhayi kakhulu. Lapho cishe yonke imisebenzi lapho kukhishwa khona izinyo iphetha ngokufakwa. Okuhlukile kungaba ukuvuvukala okunamandla endaweni yezinyo le-causative, lapho ubomvu bugeleza buhlanganiswe ne-snot. Noma, lapho ukufakwa kungagxili nhlobo futhi kulenga emgodini njengepensela engilazini. Amathuba ezezimali nawo adlala indima ebalulekile. Noma ubani uzosebenzisa imali ngokuzithandela kunoma yini ngaphandle kwamazinyo. Ngeke uphikisane nalokho. Kodwa kukhona oyedwa "Kodwa"! Kufanele uqonde ukuthi lapho kudlula isikhathi esiningi kusukela lapho izinyo likhishwa kuze kube sekuqaleni kwe-prosthetics, izimo ezimbi kakhulu zokubeka lokhu kufakelwa. Njengoba isisho sithi: "Indawo engcwele ayinalutho." Ngokuhamba kwesikhathi, kuvela izinkinga eziningi kakhulu, nazo okufanele zixazululwe. Futhi lokhu kubiza njalo, futhi ngokuvamile kuyabiza. Uyayidinga?
Awu! Ake siqhubekele ezibonelweni.
Icala elilula kakhulu lokufakelwa kanyekanye izinyo elinezimpande eyodwa. Noma ngabe umhlathi ongenhla noma ongezansi.
Le CT scan yathathwa ngaphambi kokuba izinyo lihlukane ngokuphelele.
Sibonani?
Ingaphezulu kwesokunxele 5 alikho ngaphansi kokwelashwa noma ukwelashwa kwamathambo. Senzani? Kulungile - khipha izinyo bese ugoqa ibhawodi.
Ngakhipha amazinyo athambile kakhulu futhi ashubile futhi ngafaka i-gum ngaphambili.
I-gum shaper into efana nephansi (isilinganiso esingu-3 mm ukuphakama), isiphunzi sensimbi esiphumela ngaphandle kancane ngaphezu kwezinga le-gum, ngaleyo ndlela sakhe ikhonco ngaphambi kokufaka umqhele. Kubukeka kanjena:
Nansi indlela i-implant ebukeka ngayo:
Ingxenye empunga wukufakelwa ngokwayo. Ingxenye eluhlaza okwesibhakabhaka yilokho okubizwa ngokuthi i-abutment yesikhashana, lapho umqhele wesikhashana ungaxhunywa khona uma ukufakwa kuhambisana nokulayisha ngokushesha. Ngokuyisisekelo, lokhu kuhlanganiswa kusebenza njengesibambi sokufakelwa. Ngemuva kokufakwa kokufakelwa, i-abutment ivuliwe, njengomklami - nge-screwdriver ekhethekile, futhi ipulaki ifakwe endaweni yayo. Ifakwe uma kwenzeka kungenakwenzeka ukufaka ngokushesha i-gingiva yangaphambili. Khona-ke i-implant kanye nazo zonke izingxenye zayo eziyinhloko zingaphansi kwe-gum ngokuphelele, okusho ukuthi ngeke sibone lutho emgodini womlomo ngemva kokuhlinzwa. Hhayi-ke, ngaphandle kwemithungo kanye ... namazinyo asele, uma kukhona asele. Kulesi simo, i-shaper ifakwa ngemuva kokuthi isifakelo sithathe izimpande.
Okulandelayo, sikhetha izinga elilandelayo lobunzima, lapho kufanele sisuse izinyo lesi-6 emhlathini ophansi. Lezi zinyo zinezimpande ezimbili. Vele, ngeke sibeke isigxivizo endaweni yempande ngayinye, njengoba omunye umuntu engase acabange. Nakuba ngiwabonile amacala afanayo. Udokotela ngokusobala wayenemali ebolekiwe.
Ngakho-ke, sidinga ukufaka i-implant eyodwa, kodwa ngokucacile phakathi nendawo. Sizogxila ku-septum yamathambo phakathi kwezimpande ezimbili.
Sifaka i-implant. Ngakwesobunxele nangakwesokudla kuso esithombeni, izimbobo ezivela ezinyo elisanda kukhishwa zibonakala ngokucacile, okuthi, njengoba ziphulukisa, zizoqiniswa.
Nokho, sekuyisikhathi sokucabangela icala lapho udinga ukususa izinyo, ufake i-implant futhi wakhe izicubu zethambo emhlathini ongenhla - i-sinus lift. Futhi izinga lobunzima, okwamanje, liyakhula. Akuyona i-mission enezindiza ezinophephela emhlane ezivela eVice City, kunjalo, kodwa kufanele uqaphele kancane kunasesimeni sangaphambilini.
Uyakhumbula lapho ngithi ukufakelwa kufanele kugxiliswe phakathi? Ngakho-ke izinyo le-3-root nalo lihlukile. Ukufakelwa kufakwe, njengasekuqaleni, ku-septum, kodwa kakade izinyo elinezimpande ezintathu. Njengoba sibona, ukuphakama kwethambo kule ndawo cishe ku-3mm. Le volumu ayanele ukubeka ukufakelwa kobude obufanele, ngakho-ke, ivolumu kufanele inyuswe. Ukukhwabanisa kwenziwa kusetshenziswa "i-bone material" ekhethekile. Omunye uyibiza ngokuthi "impushana yamathambo", akufanele idideke "impushana emhlophe", nakuba imhlophe, isavezwa ngendlela yama-granules. Ikhiqizwe ngendlela elula ezitsheni zengilazi,
futhi ngendlela elula kakhulu - ama-syringe akhethekile, ngosizo olulula kakhulu ukusebenza nokuletha izinto endaweni yokuhlinza.
Kuyiphutha ukukholelwa ukuthi i-sinus lift iwumsebenzi "B" we-maxillary (maxillary) sinus. Eqinisweni, ukukhohlisa kwenziwa "NGANSI" kwakho. Njengoba sesivele sitholile, i-sinus iyisikhala emhlathini ongenhla, i-void, uma uthanda, efakwe ngaphakathi nge-membrane encane yamafinyila ene-ciliated epithelium. Ngakho-ke, ukuze ukuhlinzwa kuphumelele, ulwelwesi lwamafinyila lukhishwa endaweni endaweni yamathambo futhi “ithambo lempahla” lifakwa endaweni eyakhiwe phakathi kwephansi le-sinus kanye nolwelwesi lwamafinyila, njengasemvilophini. Kulokhu, ngokufakwa okufanayo kokufakelwa.
Futhi manje isibonelo sokuphakanyiswa kwe-sinus nokufakwa, kodwa ezinyangeni ezi-2 ngemuva kokuba izinyo lesi-6 emhlathini ongenhla likhishwe. Lesi siguli sakhishwa ezingu-6 esikhathini esingangesonto eledlule komunye umtholampilo. Umsizi wenze i-CT scan.
Ngenxa yokuthi sekudlule isonto kuphela kusukela ekususweni, sibona futhi "umgodi omnyama" esithombeni, njengalowo owashiya enhliziyweni yakho. Lapho izinyo lalikhona. Okusho ukuthi, azikho izicubu zamathambo kule ndawo. Ngaqala ukuhlinzwa ngemva kwezinyanga ezi-2. Abazange benze i-CT scan yesibili ngemva kokuphulukiswa komgodi, kodwa kholwani mina, konke kuphuluke ngokwanele ukuze kwenziwe ukuhlinzwa. Ngesikhathi sokusebenza, kwakungenakwenzeka ukufeza ukuqiniswa okuqinile kokufakelwa, ngakho-ke nganquma ukufaka ipulaki esikhundleni se-gingiva yangaphambili. Kungani? Futhi ngenxa yokuthi uma isiguli siqala ukuququda ama-crackers, khona-ke ingcindezi eqinile ingafakwa ku-implant, ikakhulukazi i-shapper, ngakho-ke ukufakelwa kungase kukhululeke noma "kundize" ku-sinus. Ngesikhathi esifanayo, abangu-8 baya ku-scrap.
Hhayi-ke, isibonelo sokugcina sanamuhla ukususwa kwamazinyo ama-2, ukufakwa kwezimila ezi-2 kanye nokuphakanyiswa kwe-sinus.
Njengoba sibona, izimo kuleli cala zimbi kakhulu, cishe 2 mm. Kodwa lokhu akuzange kusivimbele ekwenzeni ukuhlinzwa ngokugcwele.
Ungase ubuze: - "Kungani kukhona izimila ezi-2, hhayi ezi-3?" “Yini, lizoba khona ibhuloho?” “Kodwa kuthiwani ngokusatshalaliswa komthwalo”, njll.?
Eqinisweni, inkinga yokugcwala okuhambisana namabhuloho ithinta amazinyo awo kuphela. Njengoba amazinyo ane-ligamentous apparatus. Okusho ukuthi, izinyo alihlanganiswa ngokuqinile nethambo, kodwa, njengokungathi, liphuma kulo. Nawu umdwebo:
Lapho kukhona ibhuloho, amazinyo asekelayo athatha kokubili umthwalo wawo kanye nomthwalo wezinyo elingekho. Ngakho-ke, ukugcwala kwamazinyo kukhula, bese kuba nenganekwane yezinyo. I-implant ayinawo umsipha onjalo. Ikhula ngokuqinile kanye nezicubu ezizungezile, ngakho-ke azikho izinkinga ezinjalo, njengalapho kwenzeka amazinyo akho. Kodwa lokhu akusho ukuthi ibhuloho elikhulu lomhlathi wonke lingafakwa kuma-implants amabili. Okuwukuphela kwento ehluphekayo phambi kwamabhuloho yinhlanzeko, okuzodinga ukugadwa ikakhulukazi ngokucophelela. Ngoba kulula kakhulu ukunakekela amazinyo amile mahhala kunama-prostheses afanayo.
Lokho, empeleni, kungokwanamuhla. Ngizojabula ukuphendula imibuzo yakho!
Hlala ubukele!
Ozithobayo, u-Andrey Dashkov.
Source: www.habr.com