\n\n
\n\n在口腔临床检查中,叩诊要以旁边正常的牙为对照牙,先叩对照牙,再叩击患牙。叩诊力量先轻叩,再逐渐加力,一般以叩诊正常牙不引起疼痛为适宜的力量。
\n\n叩诊的反应:按其与正常牙反应的比较,定为:
\n\n是指用冷热温度对牙齿进行测试,从而了解牙齿最中心,含有神经、血管的牙髓活力情况,这测试也需选择对照牙。
\n\n一般情况下,正常牙髓对 20~50℃的水不感到疼痛,10~20℃冷水及 50~60℃热水可能引起不适。低于 10℃为冷刺激,高于 60℃为热刺激。
\n\n温度测试结果的表示及临床意义:
\n\n医生会用器械夹住前牙切端或抵住后牙咬合面的窝沟,做唇(颊)舌(腭)向,近远中和上下摇动,并观察记录晃动的幅度。
\n\n按不同的动度记录,松动的程度分为三度:
\n\n观察牙龈以及口腔粘膜的色形质的情况,包括牙龈的色泽,有无充血,肿胀,溃疡等。
\n\n观察牙龈以及口腔粘膜有无增生或者萎缩。
\n\n\n\n一次性口腔器械盘,里面包括口镜,探针,镊子。
\n\n\n\n气枪又名三用腔,用来冲洗窝洞,吹干牙面或窝洞。
\n\n用于检查咬合关系。
\n\n用于检查牙齿邻接关系,清除嵌塞食物。
\n\n\n\n通过口内检查可以了解牙齿的基本情况,再结合其他检查,如 X 线片等。来进行牙齿、牙周情况的综合诊断。
\n\n临床中需要综合运用检查方法,比如临床常见的龋齿,通过探针探查可以了解窝沟有无龋齿,龋齿的深度,再结合冷热敏感测试,可以了解患牙的牙髓活力情况,从而为临床制定治疗计划提供必要依据。
\n\n牙周探诊以及松动度检查,可以及早发现牙齿是否有牙周炎的一些表现。对于口腔粘膜的一些病损,比如扁平苔癣和白斑(如下图),通过口内检查可以做到早发现,早治疗。
\n\n\n\n\n\n\n\n\n\n很多人会有这样的经历,在口内检查中会有一些疼痛感,因为本身口内存在多颗坏牙,在就诊的过程中,为了准确找到牙疼的定位,牙齿接受叩诊,冷热温度测试时,就会有一些不适感。
\n\n医生也可以根据叩疼程度,冷热测试的反应来进行综合判断。这些情况下检查的疼痛感是否是因为患牙本身的炎症引起的。
\n\n\n\n综上,口内检查是临床上非常重要的一部分,世界卫生组织(WHO)1981 年制定的牙齿健康标准包括:牙齿清洁,无龋洞,无疼痛感,牙龈颜色正常,无出血现象。
\n\n一般建议常规每年检查一次,对于易感人群,建议半年一次。方可对口腔疾病做到早发现,早治疗。
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