牙体硬组织非龋性疾病牙发育异常温医《牙体牙髓病学》课件.ppt

概 述 病 理 临床分类——陷入深度 临床表现 治 疗 Hot Tip CASE 1 CASE 1 CASE 1 CASE 1 CASE 1 CASE 1 CASE 1 CASE 1 CASE 2 CASE 2 CASE 2 本节重点内容 釉质发育不全的病因，临床表现 釉质发育不全、氟斑牙和浅龋的鉴别 融合牙，双生牙，结合牙的鉴别 畸形中央尖的病因，临床表现，处理原则 牙内陷的临床表现 Figure 3. The dark-stained dentin that provided clues to the location of the distal canal space (arrow). Figure 4. The access opening prior to removal of the central hard-tissue core (note alternate openings). Figure 5. Length determination demonstrating the main and lateral canal spaces. Figure 6. Radiograph taken after the complete removal of the invaginatus or hard tissue core. Figure 7. Immediate posoperative periapical radiograph taken after final canal obturation and placement of a coronal seal. Figure 8. Nine-month follow-up radiograph demonstrating advanced apical bone healing. Figure 1.? The mandibular anterior teeth with a large crown on the left incisor with a notch in the incisal edge.? The adjacent gingiva is hyperemic and edematous. A 13-year-old girl presented with spontaneous pain in the mandibular left lateral incisor tooth. Figure 2.? A panoramic radiograph indicating a normal tooth count; a mandibular left lateral incisor with a large crown and root; a single pulp chamber and multiple periapical radiolucencies. ??????????????????????????????????????????????????????????????????????????????????????? Figure 3.? Periapical radiographs indicating a invaginated mandibular left lateral incisor and a radiolucency around the apices. ??????????????????? 病 因 位 置 后 果 治 疗 定 义 牢固附着于牙骨质表面的釉质小块，大小似粟粒，呈球形 错位的成釉细胞，或上皮根鞘的异常分化，再度出现成釉功能 磨牙根分叉内或其附近，或釉牙骨质界附近的根面上 影响牙体与牙龈之间的附着关系，造成龈炎 一般不必处理，必要时磨去 釉 珠 Hutchinson teeth Mulberry molars 过小牙、过大牙、锥形牙 融合牙、双生牙、结合牙 畸形中央尖 牙内陷 釉 珠 形 态 过小牙、过大牙、锥形牙 锥形牙： 过小牙牙的形态呈锥形，即牙的切端比颈部狭窄 过小牙或过大牙： 个别牙若偏离了解剖上正常值的范围，且与牙列中其他牙明显不相称时 . 定义 定义 好发牙位 好发牙位 过小牙多见于上颌侧切牙、第三磨牙、额外牙 过大牙可见于上颌中切牙 microdontia microdontia macrodontia 定 义 特 点 好发牙位 由两个正常牙胚融合而成， 可以是完全或不完全融合 引起融合的原因认为是压力所致 正常牙列中缺少一个牙 牙冠或牙根部分融合