Ndizodziwika bwino kuti matenda a periodontal ndi periodontal tissues (chingamu ndi zida zamano), matenda a mucous nembanemba ndi zofewa zam'kamwa sizingachiritsidwe. Koma iwo amakhazikika ndi kutsika ku chikhululukiro. Nthawi zina kukhazikika, nthawi zina kuchulukirachulukira. Odziwika bwino periodontitis, periodontitis ndi gingivitis ndi matenda ambiri. Ku Russia, periodontics inayamba kukula zaka 10-12 zapitazo, ndipo ambiri, anthu sali okonzeka kuthetsa mavutowa.
Choyamba muyenera kuthana ndi mawu osavuta kuti pasakhale zolemba ndi zotsatsa zomwe zikusocheretsa. Matenda a periodontal amagawidwa kukhala dystrophic (yomwe imagwirizanitsidwa ndi njira za dystrophic mu minofu) - PARODONTOSIS, ndi matenda oyambitsa kutupa - PERIODENTITIS. Nthawi zambiri, mwatsoka, malonda ndi mabuku amaika chirichonse mu gulu limodzi, koma izi ndizolakwika zomwezo monga kusokoneza ndi kugawa matenda monga ARTHRITIS ndi ARTHRITIS mu gulu limodzi. Ngati mumakumbukira nthawi zonse chitsanzo cha nyamakazi ndi arthrosis, ndiye kuti simungasokoneze periodontitis ndi periodontal matenda.
Nthawi zambiri, ndithudi, pali matenda a kutupa etiology - periodontitis. Pafupifupi 3-4 aliyense wokhala ku megacities, makamaka Russia, pambuyo 35-37 zaka anakumana kale vutoli. "Makamaka ku Russia" - chifukwa mayunivesite athu azachipatala zaka 6-8 zapitazo adasankha dipatimenti yosiyana ya periodontology ndikuyamba kuphunzira vutoli mwachangu. Pafupifupi wodwala aliyense wotere amadziwa bwino kutulutsa magazi m'kamwa, kusapeza bwino mukamaluma chakudya cholimba, nthawi zina pafupifupi kukana kwathunthu chakudya cholimba pazifukwa izi, kuyenda kwa dzino limodzi ndi zomverera zowawa komanso zosasangalatsa, mpweya woipa komanso kuchuluka kwa zolembera zofewa ndi mineralized (tartar) . ).
Mwachidule ponena za etiology ndi pathogenesis wa periodontitis, zifukwa zazikulu zomwe zimachitika ndi majini, moyo, ukhondo wamkamwa ndi zakudya za wodwalayo. The pathogenesis ya matendawa ndi kutupa kwapang'onopang'ono komanso kosalekeza mu zida za ligamentous za dzino, chifukwa chake kusuntha kwa dzino kumawonjezeka, kutupa kosalekeza kumachitika chifukwa cha kukhalapo kwa microflora yosalekeza (Str Mutans, Str.Mitis). ndi ena), wodwalayo sathanso kupirira kudziyeretsa mano ndi kukhala aukhondo wokwanira. Pathological dentogingival matumba (PGD) amawonekera.
Zizindikiro zonsezi ndi mawonetseredwe a periodontitis amagwirizana ndi chilema mu periodontal ndi periodontal connective minofu, ndiko kuti, ndi pang`onopang`ono kukula ndi kuwonjezeka kutupa, maselo akuluakulu a connective minofu, fibroblasts, sangathenso kupirira synthesis latsopano connective. minofu, motero, kuyenda kwa dzino kumawonekera. Ukhondo, ndiko kuti, mikhalidwe ya wodwala kutsuka mano, ndi chinthu chofunikiranso. Chifukwa chake, ndi kuyeretsa koyenera m'kamwa, sikuti ma microflora okhazikika amapangidwa, zolembera za mano ndi ma depositi olimba a mano zimachotsedwa, koma kutuluka kwa magazi kumakhalanso kolimbikitsa. Kukhazikika kwa kukhazikika kwa zida zamano kumakhudzidwa ndi kugwiritsa ntchito chakudya cholimba, chaiwisi komanso chosasinthika. Izi ndi zachilengedwe komanso zakuthupi. Sikoyenera kukhala ndi chidziwitso chapamwamba pazachipatala cha mano kuti mumvetsetse kuti chiwalo chilichonse chimagwira ntchito bwino komanso molondola ndi katundu wolondola (mkati mwa physiology). Choncho, incisors ndi canines ndi gulu lakutsogolo la mano opangidwa kuti agwire ndi kuluma chakudya. Gulu lotafuna - pogaya mtanda wa chakudya.
Ndizodziwika bwino, zomwe zimaphunzitsidwabe ku Faculty of Dentistry, kuti kugwiritsa ntchito chakudya cholimba (zipatso zaiwisi ndi ndiwo zamasamba) kumathandizira kukhazikika komanso kulimbikitsa zida za ligamentous za dzino. Ana pa nthawi ya kuluma mapangidwe ndi normalize njira kudziyeretsa pakamwa patsekeke (chifukwa cha salivation) tikulimbikitsidwa kudya 5-7 zipatso ndi ndiwo zamasamba, osati grated kapena kudula mu tiziduswa tating'ono ting'ono. Ponena za akuluakulu, njira zodziyeretsa izi ndizodziwikanso kwa iwo. Izi zikugwiranso ntchito pakudya masamba ambiri.
Kusiyana kwa omnivorous ndi vegetarianism (veganism) kwa odwala kumatsimikiziranso njira ya pathological mu periodontal tissue. Mu 1985, dokotala wa mano ndi mano a University of California, AJ Lewis (AJ Luiss) adalemba zomwe adaziwona kwa nthawi yayitali osati za matenda a caries mwa odwala, komanso kukula ndi kupezeka kwa periodontitis kwa anthu omwe sadya masamba ndi omwe sali. -odya zamasamba. Odwala onse anali okhala ku California, anali m'gulu lomwelo lomwe linali ndi moyo womwewo komanso kuchuluka kwa ndalama zomwe amapeza, koma amasiyana m'zakudya (odya zamasamba ndi omnivores). Kwa zaka zambiri akuyang'anitsitsa, Lewis adapeza kuti odyetsera zamasamba, ngakhale okalamba kwambiri kuposa odwala omnivorous, sankadwala matenda a periodontal. Pazamasamba 20, ma pathologies adapezeka mu 4, pomwe ma pathologies adapezeka mwa odwala omnivorous mu 12 mwa 20. Odya zamasamba, ma pathologies sanali ofunikira ndipo nthawi zonse amachepetsedwa kuti akhululukidwe. Panthawi imodzimodziyo, mwa odwala ena, mwa 12, 4-5 inathera mano.
Lewis anafotokoza izi osati kokha ndi kukhazikika ndi kusinthika kwachibadwa kwa zida za ligamentous za mano, njira zabwino zodziyeretsera pakamwa pakamwa komanso kudya mokwanira kwa mavitamini, zomwe zinali ndi zotsatira zabwino pa kaphatikizidwe ka minofu yomweyi. Pambuyo pofufuza microflora ya odwala, adapeza kuti anthu odyetserako zamasamba ali ndi tizilombo toyambitsa matenda timeontopathogenic mu gawo la microflora (lokhazikika) la m'kamwa. Poyang'ana mucosal epithelium, adapezanso kuchuluka kwa maselo oteteza m'kamwa (immunoglobulins A ndi J) mwa odya zamasamba.
Mitundu yambiri ya chakudya imayamba kufufuma m’kamwa. Koma aliyense anali ndi chidwi ndikudabwa ndi ubale womwe ulipo pakati pa njira zowotchera ma carbohydrate ndi ubale womwe odwala amadya mapuloteni a nyama. Chilichonse ndi chomveka bwino komanso chosavuta pano. Njira za chimbudzi ndi nayonso mphamvu m'kamwa m'kamwa zimakhala zokhazikika komanso zangwiro mwa odya zamasamba. Mukamagwiritsa ntchito mapuloteni a nyama, njirayi imasokonezeka (tikutanthauza njira za enzymatic zochitidwa ndi amylase). Ngati mufananiza pafupifupi, ndiye kuti izi ndizofanana ndi kugwiritsa ntchito shuga mwadongosolo, posachedwa mudzalemera kwambiri. Zoonadi, kuyerekezerako kumakhala kovuta, komabe, ngati dongosolo limodzi la enzymatic linapangidwa mwachilengedwe kuti liwononge chakudya chosavuta mumphika wa chakudya, ndiye kuti kuwonjezera kwa mapuloteni posachedwa kusokoneza ndondomeko yonse ya biochemical. Zoonadi, chirichonse chiri pachibale. Odwala ena adzadziwika kwambiri, ena ochepa. Koma zoona zake n’zakuti odya zamasamba ali ndi minyewa yolimba (enamel ndi dentini) m’malo abwino kwambiri (izi zinaphunziridwa ndi Lewis osati mongowerengera chabe, komanso mbiri yakale, zithunzi zapakompyuta zimavutitsabe madokotala a mano odya nyama mpaka lero). Mwa njira, Lewis mwiniwake anali wosadya zamasamba, koma atafufuza adakhala wamasamba. Anakhala ndi zaka 99 ndipo anamwalira pamphepo yamkuntho ku California akusefa.
Ngati zonse zimveka bwino ndi nkhani za caries ndi ma enzymatic reaction, ndiye chifukwa chiyani osadya masamba amachita bwino kwambiri ndi zida zam'mano ndi minofu yolumikizana? Funso limeneli linavutitsa Lewis ndi madokotala ena a mano moyo wake wonse. Chilichonse chokhala ndi njira zodziyeretsa komanso ubwino wamadzimadzi am'kamwa zimamvekanso bwino. Kuti ndidziwe, ndinayenera "kulowa" muzochiritsira zonse ndi histology ndikufanizira mafupa ndi minofu yolumikizana osati ya dera la maxillofacial, komanso ziwalo zonse ndi machitidwe.
Zotsatira zake zinali zomveka komanso zachibadwa. Minofu yolumikizana ndi mafupa a anthu osadya masamba nthawi zambiri amawonongeka komanso kusintha kusiyana ndi omwe amadya masamba. Ndi anthu ochepa amene angadabwe ndi zimene anapezazi. Koma anthu owerengeka amakumbukira kuti kafukufuku m'derali anayamba ndendende chifukwa cha mbali yopapatiza mano monga periodontics.
Wolemba: Alina Ovchinnikova, PhD, dotolo wamano, dokotala wa opaleshoni, wa orthodontist.