牙周炎的伴发病变和牙周医学-同济口腔医学课件.ppt

早产及低新生儿体重 Preterm Low Weight CASE大学科学家花费三年时间研究,发现低体重早产儿母亲羊水中存在口腔细菌,首次证明了这种关系(J. Clinical Microbiology,第四期: “Transmission of a Uncultivated Bergeyella Strain from the Oral Cavity to the Amniotec Fluid in a Case of Pretem Birth” 失牙与记忆 TOM科技讯　俄罗斯海外新闻网当地时间10月30日8时(北京时间10月30日13时)消息，瑞典科学家最近研究证明，人一旦没有了牙齿，那么其记忆力也会下降。科学家们在动物身上进行的实验证明，如果拔掉牙齿就相当于切断了大脑中的神经。  * 15 牙周炎的其他伴发病变 Other Secondary Lesions of Periodontitis 15-1牙周脓肿 Periodontal Abscesses 牙周炎中\晚期出现深牙周袋后的一个常见的伴发症状, 是位于牙周袋壁或深部牙周组织的局限性化脓性炎症,可引起周围胶原纤维和骨质的破坏 1, 深牙周袋或复杂性牙周袋，内壁的化脓性炎症向深部结缔组织扩展, 无引流通道This abscess formation is usually due to the marginal closure of a deep periodontal pocket and lack of proper drainage. 发病因素 Causal factor 2，不规范的洁治或刮治术后，损伤大，或袋内术后感染物堆积，加上引流不畅Post-scaling periodontal abscess. When these lesionsoccur immediately after scaling or after a routine professional prophylaxis, they are usually related to the presence of small fragments of remaining calculus that obstruct the pocket entrance once the edema in the gingiva has disappeared 临床表现 Clinical feature Acute Periodontal Abscess 发病突然，唇颊或舌腭侧形成半球形突起，炎症早期，张力大，疼痛剧烈，患牙有浮动感，松动明显 Periodontal abscess (arrows) associated with a lower right first molar. Observe the association between the abscess formation and the furcation lesion in this molar. Chronic Periodontal Abscess 急性期治疗不彻底，反复发作所致，一般无症状，可见窦道（fistula) Periodontal abscess associated with a lower left canine. Observe the fistulous tract opening demonstrated with a gutta-percha point. Radiological image of the lower canine The differential diagnosis with a periapical abscess was done by the positive tooth vitality sign and absence of caries or restoration in the tooth, and the presence of a deep periodontal pocket in tooth. 鉴别诊断 Differential diagnosis 与牙龈脓肿gingival abscess 的鉴别 局限于龈乳头或龈缘，无牙周袋，无附着丧失，无牙周炎症状和体征 与尖周脓肿periapical abscess的鉴别 感染来源 牙周袋 牙体龋坏和不良修复体 牙髓活力 脓肿部位 松动度 扣痛 X片 等 治疗原则 Treatment principle The treatment of the periodontal abscess usually includes two stages: the management of the acute les