牙体硬组织非龋性疾病牙体慢性损伤_温医《牙体牙髓病学》课件.ppt

牙体硬组织非龋性疾病 --牙体慢性损伤 This 33-year-old male with GERD had severe asymptomatic erosion. Note the amalgams rising above the adjacent eroded occlusal surfaces. Citric acid from lemons absolutely destroys teeth at an early age.? I have seen cases of teen-agers that have ruined their front teeth from sucking on lemons all the time. 减少紧张（stress reduction ） 自身调节 生物反馈机制 保护牙齿（tooth care） 合垫mouth guard or night guard 粘接bonding 全冠crown 治 疗 （treatment ） Common Acrylic Splint safe?liquid (e.g., sea water), is inserted into, and sealed in,small ?plastic capsules. Whenever bruxism is attempted, the capsule(s) rupture and the liquid is released into the mouth. The liquid then draws the bruxers conscious attention to, and forestalls, any attempt of teeth clenching or grinding.? GrindAlert is a battery-powered device worn on the forehead during sleep. Applying the well documented principles of biofeedback, it emits a gentle tone that alerts you when you grind, and triggers you to stop. You relax your tight, clenched muscles naturally. No more headaches. No more sore jaw. -- GrindAlert customer L. Russell. Bonding Before Surgery Restored YES: Try taking a warm bath before bedtime Relaxing muscles, especially on the neck area Exercise regularly by walking, cycling or swimming Tips NO: Do not eat sugar before going to bed Drink less alcohol and caffeine Tips -This cervical abrasion is caused by tooth brush -What are some other causes of ‘abrasion’? -What tooth surfaces are affected? 概念 牙唇、颊侧颈部硬组织发生缓慢消耗所致的缺损，由于这种缺损常呈楔形 楔 状 缺 损(wedge-shaped defect) 其它因素： 牙颈部的结构 酸的作用 牙体组织的疲劳 刷牙 Cause 刷 牙 唇颊侧牙面横刷法导致了楔状缺损的发生 根据：动物不患此病，不刷牙的人很少发生 大多数发生在牙齿的唇颊面，很少在舌面 唇向错位的牙比较严重 常伴有牙龈退缩 离体实验横刷牙颈部可以造成楔状缺损 酸 的 作 用 龈沟内的酸性环境 涎腺的酸性分泌 喜食酸食 唾液PH值变化 牙 颈 部 组 织 脱 矿 受 磨 擦 后 易 缺 损 牙 颈 部 结 构 釉牙骨质界是牙釉质 和骨质覆盖量最少或 无覆盖的部位 牙龈的炎症和萎缩 导致根面的暴露 牙颈部耐磨损 能力低 A B C A、牙骨质覆盖牙釉质（60％） B、牙骨质和牙釉质端端相接（30％） C、牙骨质和