牙髓病与根尖周病_1课件

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1、牙髓病与根尖周病PulpalDisease&PeriapicalDisease【病因Causes】细菌因素Bacterialfactors物理因素Physicalfactors化学因素Chemicalfactors免疫因素Immunefactors牙髓病PulpalDisease一、髓腔解剖特点Pulpcavityanatomicalcharacteristics牙髓病髓腔解剖与牙髓病和根尖周病的症状和治疗关系紧密。Pulpcavityanatomyisrelatedtopulpalandperiapica

2、ldisease.髓腔由坚硬的牙本质壁包围pulpcavitysurroundedbydentin髓腔通过根尖孔与外界相连通theapicalforamenistheopeningattheapexoftherootofatooth,throughwhichthenerveandbloodvesselsthatsupplythedentalpulppass.Thusitrepresentsthejunctionofthepulpandtheperiodontaltissue.牙髓病二、牙髓的特点和功能pulpf

3、eaturesandfunctions牙髓病StructuralfeaturesThecentralregion:largenervetrunksandbloodvessels.threelayers(frominnermosttooutermost)1.Cellrichzone(zoneofRinaggio):innermostpulplayerwhichcontainsfibroblastsandundifferentiatedmesenchymalcells.Cellfreezone(zoneofWeil

4、):richinbothcapillariesandnervenetworks.Odontoblasticlayer:outermostlayerwhichcontainsodontoblastsandliesnexttothepredentinandmaturedentinCellsfoundinthedentalpulpincludefibroblasts(theprincipalcell),odontoblasts,defencecellslikehistiocytes,macrophage,granul

5、ocytes,mastcellsandplasmacells.ThenerveplexusofRaschkowislocatedcentraltothecell-freezone.牙髓的功能：Theprimaryfunctionofthedentalpulp形成功能——成牙本质细胞形成牙本质toformdentin(bytheodontoblasts)Formative:cellsofthepulporganproducedentinwhichsurroundsandprotectsthepulpaltissu

6、e.营养功能——血管系统向牙髓牙本质复合体提供营养成分Nutritive:thepulpkeepstheorganiccomponentsofthesurroundingmineralizedtissuesuppliedwithmoistureandnutrients;感觉功能——疼痛Sensory:extremesintemperature,pressure,ortraumatothedentinorpulpareperceivedaspain;防御功能——修复性牙本质形成Protective:theform

7、ationofreparativeorsecondarydentin(bytheodontoblasts).三、临床病理牙髓的防御机制1）牙本质硬化Dentinsclerosis2）第三期牙本质形成Theformationofreparativedentin第一期牙本质Primarydentin:Themostprominentdentininthetooth,liesbetweentheenamelandthepulpchamber.Theouterlayerclosesttoenamelisknownasm

8、antledentin.第二期牙本质Secondarydentin(RegularSecondaryDentin):Formedafterrootformationiscomplete,normallyafterthetoothhaseruptedandisfunctional.第三期牙本质Tertiarydentin（reparativedentin）：Formedasareacti