Sawubona, bangane abathandekayo! Namuhla ngithanda ukukutshela, futhi okubaluleke kakhulu, ngikubonise ukuthi umsebenzi wokufaka i-implant wenziwa kanjani - ngawo wonke amathuluzi nokunye. Uma mayelana , ngokuqondene - Sengikutshelile kakade, sekuyisikhathi sokukhuluma ngokuthile okungathí sina.
QAPHELA!-Uwaga!-Pažnju!-Qaphela!-Achtung!-Attenzione!-NAKELA!-Uwaga!-Pažnju!
Ngezansi kunezithombe ezithathwe ngesikhathi sokuhlinzwa! Ngokubuka kwamazinyo, izinsini, igazi nokunqunywa. Uma unenhliziyo ebuthakathaka, sicela uyeke ukufunda lesi sihloko.
Ingabe usekhona? Bese sihamba!
Ukubonisana nokuhlolwa
Ngaphezu kokuhlolwa okubonakalayo:
Kudingeka senze ukuhlolwa kwe-x-ray. Kulokhu, i-OPTG elula (isithombe se-Panoramic samazinyo) ngeke isanele. Kudingeka I-CBCT (I-cone beam computed tomography).
Uyini umehluko?
I-OPTG (I-Orthopantomogram) - isithombe esifushane sesistimu yamazinyo. Lesi sithombe si- planar, okusho ukuthi imininingwane ngayinye yesithombe ibekwe phezu kwesinye. Ngakho-ke, akunakwenzeka ukuhlola into efundwayo, ikakhulukazi indawo yokufakelwa okuhleliwe, kuzo zonke izindiza, nge-engeli ehlukile noma ngokuqagela okuhlukile.
I-CBCT (I-cone beam computed tomography) - isithombe se-volumetric ye-3D, ngokuphambene nalokho, sisinika leli thuba.
Kulokhu, umthamo wezicubu zethambo wanele ukuzinzisa ukufakwa kosayizi ofanele, futhi ikhwalithi yezinsini yenza kube nokwenzeka ukwakha i-aesthetic contour ngaphandle kwezinqubo ezengeziwe:
Ngemuva kokwenza izivivinyo ezidingekayo, siqhubekela ngqo ekufakweni.
Konke kuqala, yebo, nge-anesthesia. Akekho ofuna ukukhala ngobuhlungu ngesikhathi sokuhlinzwa, akunjalo?
Ukuze unciphise yonke imizwa engathandeki futhi umjovo wenaliti wawungebuhlungu kakhulu, okuthiwa i-anesthesia yendawo
Okulandelayo kuyenziwa ukungena i-anesthetic endaweni yokusebenza okuhleliwe. Isithombe sibonisa isirinji ye-carpule engasetshenziswa kabusha, okuthi, vele, inzalo ngemva kwesiguli ngasinye, njenganoma iyiphi enye insimbi. Amaphilisi okubulala izinzwa amabili alahlwayo nezinaliti ezimbili ezinobude obuhlukene:
Indlela elibukeka ngayo emlonyeni:
Ngemuva kwe-anesthesia, kusetshenziswa i-scalpel, okulandelayo kuyenziwa: ukusikwa, kanye nalokho okubizwa ngokuthi i-raspator - i-bone skeletonization. (ukuhlukaniswa kwe-periosteum kusuka entweni ehlangene yethambo).
Imbobo:
I-Skeletonization yethambo:
Okulandelayo, imbobo yokufakelwa iyalungiswa (ukulungiselela).
Ngezansi kunesethi yesistimu yokufakelwa yaseJalimane engiyisebenzisa ekusebenzeni kwami.
Ngaphezu kwekhithi yokuhlinza, sinethuluzi elikhethekile elibizwa ngokuthi i-physiodispenser:
Ngokungafani ne-drill yamazinyo evamile, ikuvumela ukuthi ungagcini ngokulawula ngokuqondile isivinini futhi upholise ithuluzi lokusika ngesisombululo saline, kodwa futhi ulawule i-torque.
Ukufakelwa kuqala ngokumaka. Lokhu kwenziwa kusetshenziswa i-spherical bur:
Okulandelayo, kusetshenziswa i-pilot cutter enobubanzi obungu-2 mm, i-axis yembobo yokufakelwa kwesikhathi esizayo iyasethwa, elawulwa kusetshenziswa izikhonkwane*
*I-Gizmo yokuqapha indawo yokufakelwa
Okulandelayo, njengoba i-axis yembobo isethwe ngendlela efanele, konke okufanele sikwenze ukuletha imbobo kububanzi obudingekayo. Ngale njongo, kusetshenziswa ama-cutters asebenzayo amakhulu. Eyokuqala yazo ingu-3.0 mm ububanzi:
Ngemuva kwalokho, ukulawula isikhundla usebenzisa izimila ze-analogue ezifakwe kusethi:
Okulandelayo emgqeni isisiki esilandelayo, esinobubanzi obungu-3.4 mm:
Futhi manje kufika isigaba esibaluleke kakhulu - umsiki wokuqeda wokufakelwa kwethu ngobubanzi obungu-3.8 mm. Manje sehlisa isivinini ku-physiodispenser sibe sincane ukuze sigweme ukushisa ngokweqile nokulimala kwezicubu zethambo, ngemva kwalokho sidabula umgodi ngokucophelela kakhulu:
Siphinde sihlole yonke into sisebenzisa ama-analogue okufakelwa. Njengoba besho, linganisa kabili, unamathele kanye:
Silethe umgodi ekujuleni kuka-11 mm nobubanzi obungu-3.8 mm. Kodwa ukulungiswa komgodi akugcini lapho.
Lokhu kungenxa yokuthi izicubu zethambo ziyindlela enwebekayo, futhi ukuze sinciphise ukungezwani okuvela ku-cortical plate (nokuvimbela i-peri-implantitis) sisebenzisa i-cortical cutter ekhethekile:
Lapho sisebenza ngezicubu zamathambo aminyene kakhulu, sisebenzisa futhi umpompi okhethekile:
Manje ungaqala ukufaka i-implant.
Ukufakelwa kosayizi odingekayo (3.8x11 mm) kumiswa kukhiye we-hexagonal bese kufakwa embobeni elungisiwe:
Hlola indawo yokufakelwa futhi:
Okulandelayo, sisusa i-abutment yesikhashana, kulokhu esebenze njengesibambi sokufakelwa:
Isigaba esilandelayo ukufakwa kwe-gum yangaphambili:
Ngokucabangela izimo zomtholampilo, sikhethe i-Slim yangaphambili (ngaphandle kwezandiso) enobude obungu-3 mm ekufakweni okufakiwe:
Siqedela umsebenzi wethu ngokufaka i-suturing:
Futhi isibhamu sokulawula:
Ukuhlanganiswa kokufakwayo kuthatha ngokwesilinganiso izinyanga ezi-4. Ngesikhathi esifanayo, kwakhiwa izicubu ezithambile, ngakho emasontweni angaba ngu-12 sizoba nohlelo olulungele ukufaka umqhele.
Konke okwanamuhla.
Спасибо за внимание!
Ozithobayo, u-Andrey Dashkov
Yini enye ongayifunda mayelana nokufakelwa kwamazinyo?
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Source: www.habr.com