最新如何處置孕婦牙科問題教学讲义PPT课件.ppt

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1、如何處置孕婦牙科問題怎麼辦？自己看？轉診？懷孕只是一時，病患是長期的！了解孕程變化了解牙醫師能做什麼了解什麼藥物能使用有關牙科X光照射<5cGy,無先天突變影響預防鉛衣E-speedfilmCollimation懷孕之女性助理人員SourceofradiationAbsorbedexposure(cGy)UpperGIseriesCXRSkullradiographDaily(cosmic)back-groundradiationFullmouthdentalseries(18Dfilmwithleadapron)0.3300.0080.00

2、40.00040.00001該不該用藥？怎麼用？Ideally,nodrugshouldbeadministeredduringpregnancy!!!Erythromycin(exceptestolateform)TakedrugafterbreastfeedingDrugFDAcategory懷孕使用哺乳使用LidocaineMepivacaineIbuprofenPonstanAspirinScanolPenicillinsErythromycinKeflexTetracyclineClindamycinValiumBCBCC/DBBB

3、DD/X○！！！！○○○！○ㄨㄨㄨ○○○ㄨㄨ○○○○ㄨ○ㄨ那些治療計畫需要更改？FullmouthradiographsReconstructionsCrown&bridgeproceduresSignificantsurgery孕婦常見之口腔併發症PregnancygingivitisHormonalchangeHappensat2ndmonthMarginal&interdentalgingiva1%-“pregnancytumor“OHI,removecalculus孕婦常見之口腔併發症“生一個囝仔，落一顆牙齒”Increasingto

4、othmobilityHypersensitivegagreflex–halitosis&enamelerosion如何處置拔牙後之併發症主講人：羅文良陽明牙十一屆常見的拔牙後之併發症AlveolarbonefractureTuberosityfractureMaxillarysinusperforationNervedamageRootsinsinus,submandibularspace&infratemporalspacePost-extractionbleeding併發症最佳的處理方式詳盡的術前告知臨危不亂的處置耐心細心的回診建立良好

5、的轉診AlveolarbonefractureTearing&bleedingintotheperiodontalspaceoftheadjacentteeth–painwithnoetiologyAvascularbonefragment–sequestrumPrevention–routinebonecompressionaftereachextractionAlveolarbonefractureTuberosityfractureConsistentoozing→intobuccalspaceorinfratemporalspace→

6、trismus如何處置牙該拔–將gingiva翻離tooth&bone,以保存較多的softtissue,再用suture緊緊縫住牙不該拔–用rigidwire+light-curedresin作segmentalsplinting6週Coldcompressionfor1day,andhotcompressionfrom3rdday完整的術後告知Prevention–術前X光片及術前告知TuberosityfractureMaxillarysinusperforation那些情況容易產生maxillarysinusperforation齒槽

7、骨薄而且牙齒結構位於sinus內Chronicoracuteinfection,cysts,periapicalgranulomas,tumors,andextrudedrootcanalmaterialSmallperforation(2~4mm)–self-healing>5mm–localflaprepairDiagnosisofsinusperforation將病患的鼻孔捏住,請病患輕輕做鼻孔噴氣的動作.同時將口鏡放到extractionwound處,看鏡面是否有霧氣產生Maxillarysinusperforation–localf

8、laprepairInstrument&material15#bladeandhandlePeriostealelevator4-ODexonPeriodontal