Методические указания для обучающихся практические занятия тема: Эндодонтические заболевания
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| МЕТОДИЧЕСКИЕ УКАЗАНИЯ ДЛЯ ОБУЧАЮЩИХСЯ ПРАКТИЧЕСКИЕ ЗАНЯТИЯ Тема: Эндодонтические заболевания Цели занятия: А) Профессиональные
Б) Воспитательные
Учебная карта занятия Организационный момент (тема, цели, условия и требования) Задание 1: Прочитайте и переведите текст «Endodontic diseases» Endodontic and periodontal diseases can provide many diagnostic and management challenges to clinicians, particularly when they occur concurrently. As with all diseases, a thorough history combined with comprehensive clinical and radiographic examinations are all required so an accurate diagnosis can be made. This is essential since the diagnosis will determine the type and sequence of treatment required. Although there are many factors that contribute to the development and progression of endodontic and periodontal diseases, the primary cause of both diseases is the presence of bacterial infections with complex microbial flora. Many authors have reported the similarity of the bacterial flora associated with endodontic and periodontal infections and it is widely accepted that an untreated infection of one of these tissues can lead to signs or symptoms of disease within the other tissue. Cross-seeding of bacteria from one tissue to the other can also occur and this can occur in either direction (i.e., from the root canal to the periodontium, or vice versa) through communication pathways such as the apical foramen, lateral canals, accessory canals (i.e., small canals that run from the floor of the pulp chamber to the furcation region of multi-rooted teeth), dentinal tubules, developmental defects (e.g., radicular grooves, invaginations) and other disease-related or iatrogenic defects of the tooth root (e.g., caries, cracks, perforations). Some endodontic diseases may have manifestations that affect the periodontal tissues. In particular, a chronic apical abscess may appear to be associated with a periodontal pocket. A chronic apical abscess is defined as a localized collection of pus with a draining sinus – the abscess is located in the periapical region of a tooth and is typically a result of an infected root canal system. The draining sinus may exit the mucosa in any location, either close to or at some distance from the abscess. In some cases, the draining sinus may be located immediately adjacent to, or alongside, the gingival sulcus and this can have the appearance of a deep, narrow periodontal pocket. In other cases, the draining sinus may be tracking through the periodontal ligament itself, although this would seem unlikely to occur in a tooth with a healthy periodontal ligament. The furcation region of multi-rooted teeth may have a radiolucency if there are accessory canals draining into the furcation. The root canal infection may be in one or more canals and may occur in teeth that have pulpless and infected root canal systems or in teeth that have been previously endodontically treated. Irreversible pulpitis rarely, if ever, will cause periodontal or osseous defects, although it is possible that one canal may have irreversible pulpitis while one or more of the other canals or the pulp chamber is infected – this situation has been termed “pulp necrobiosis”. The history together with the clinical and radiographic examination will generally reveal a factor that has caused the pulp necrosis and subsequent infection (e.g., caries, a crack, marginal breakdown of a restoration, trauma, etc.). Задание 2: Прочитайте и переведите следующие слова и словосочетания: to provide many diagnostic and management challenges to clinicians, to occur concurrently, clinical and radiographic examinations, the type and sequence of treatment required, to contribute to the development and progression of endodontic and periodontal diseases, the primary cause of diseases, it is widely accepted, cross-seeding of bacteria, vice versa, the furcation region of multi-rooted teeth, disease-related or iatrogenic defects, to be associated with a periodontal pocket, a localized collection of pus, to be located immediately adjacent to, or alongside, the gingival sulcus, this would seem unlikely to occur, irreversible pulpitis, pulp necrobiosis, to reveal a factor. Задание 3: Определите истинное или ложное утверждение:
Вопросы для подготовки по теме занятия: Приготовьте ответы на вопросы по теме «Эндодонтические заболевания»:
Вопросы по теме для самостоятельного изучения: – Суффиксы существительных – Суффиксы глаголов – Суффиксы прилагательных – Суффиксы наречий Тема: Клинические и диагностические процедуры в эндодонтии Цели занятия: А) Профессиональные
Б) Воспитательные
Учебная карта занятия Организационный момент (тема, цели и ход занятия) Задание 1: Проверка домашнего задания – Ответьте на вопросы преподавателя по теме «Эндодонтические заболевания». Задание 2: Прочитайте и переведите текст «Examination and Diagnostic Procedures» Endodontic diagnosis is similar to a jigsaw puzzle — diagnosis cannot be made from a single isolated piece of information. The clinician must systematically gather all of the necessary information to make a “probable” diagnosis. When taking the medical and dental history, the clinician should already be formulating in his or her mind a preliminary but logical diagnosis, especially if there is a chief complaint. The clinical and radiographic examinations in combination with a thorough periodontal evaluation and clinical testing (pulp and periapical tests) are then used to confirm the preliminary diagnosis. In some cases, the clinical and radiographic examinations are inconclusive or give conflicting results and as a result, definitive pulp and periapical diagnoses cannot be made. It is also important to recognize that treatment should not be rendered without a diagnosis and in these situations, the patient may have to wait and be reassessed at a later date or be referred to an endodontist. A key purpose of establishing a proper pulpal and periapical diagnosis is to determine appropriate clinical treatment. A simple, practical and universal classification system for endodontic diagnosis that uses terms related to clinical findings is essential. This system will help clinicians understand the progressive nature of pulpal and periapical disease, and guide them to the most appropriate treatment. The American Association of Endodontists and American Board of Endodontics have accepted the terms and recommend their use across all dental disciplines. In order to render proper treatment, a complete endodontic diagnosis must include both a pulpal and periapical diagnosis for each tooth evaluated. If in doubt, general practitioners should always refer patients to an endodontist for further evaluation. Apical Diagnoses Normal Apical Tissues are not sensitive to percussion or palpation testing and radiographically, the lamina dura surrounding the root is intact and the periodontal ligament space is uniform. As with pulp testing, comparative testing for percussion and palpation should always begin with normal teeth as a baseline for the patient. Symptomatic Apical Periodontitis represents inflammation, usually of the apical periodontium, producing clinical symptoms involving a painful response to biting and/or percussion or palpation. This may or may not be accompanied by radiographic changes (i.e. depending upon the stage of the disease, there may be normal width of the periodontal ligament or there may be a periapical radiolucency). Severe pain to percussion and/or palpation is highly indicative of a degenerating pulp and root canal treatment is needed. Asymptomatic Apical Periodontitis is inflammation and destruction of the apical periodontium that is of pulpal origin. It appears as an apical radiolucency and does not present clinical symptoms (no pain on percussion or palpation). Chronic Apical Abscess is an inflammatory reaction to pulpal infection and necrosis characterized by gradual onset, little or no discomfort and an intermittent discharge of pus through an associated sinus tract. Radiographically, there are typically signs of osseous destruction such as a radiolucency. To identify the source of a draining sinus tract when present, a gutta-percha cone is carefully placed through the stoma or opening until it stops and a radiograph is taken. Acute Apical Abscess is an inflammatory reaction to pulpal infection and necrosis characterized by rapid onset, spontaneous pain, extreme tenderness of the tooth to pressure, pus formation and swelling of associated tissues. There may be no radiographic signs of destruction and the patient often experiences malaise, fever and lymphadenopathy Задание 3: Прочитайте и переведите следующие слова и словосочетания: to be similar to a jigsaw puzzle, taking the medical and dental history, to gather all of the necessary information systematically, to make a “probable” diagnosis, to formulate in smb’s mind a preliminary but logical diagnosis, a chief complaint, a thorough periodontal evaluation, to confirm the preliminary diagnosis, conflicting results, to recognize, to be reassessed, to be referred to an endodontist, a key purpose, the American Association of Endodontists and American Board of Endodontics, in order to, if in doubt, percussion or palpation testing, involving a painful response to biting, severe pain to percussion, gradual onset, an intermittent discharge of pus, to identify the source of a draining sinus tract, a gutta-percha cone, extreme tenderness of the tooth to pressure, swelling of associated tissues. to experience malaise. Задание 4: Определите истинное или ложное утверждение:
Задание 5: Ответьте на вопросы по теме «Клинические и диагностические процедуры в эндодонтии»:
Вопросы для подготовки по теме занятия: Подберите текст по пройденной теме (объемом 500 печатных знаков) и подготовьте письменный перевод. Тема: Лечение корневого канала Цели занятия: А) Профессиональные
Б) Воспитательные
Учебная карта занятия Организационный момент (тема, цели и ход занятия) Задание 1: Проверка домашнего задания: – Предоставьте перевод текста по пройденной теме (объемом 500 печатных знаков) . Задание 2: Прочитайте и переведите текст «Root canal treatment». Each tooth has a space within it that contains blood vessels and nerve tissues that supply the tooth. A root canal treatment is needed if this tissue becomes infected or has severe swelling. The procedure involves cleaning out and filling that space to prevent bacteria from re-infecting the tooth. Root canal treatment allows the tooth to remain in place instead of being removed. Root canals must be carefully shaped, cleaned and filled to ensure the tooth remains free from re-infection. This is achieved by using: • Small files to widen and shape the root canals • A disinfecting solution to clean the root canals • A material called Gutta Percha to fill the root canals • An antibacterial sealer to prevent bacteria from re-infecting the root canal Root canal treatment helps to eliminate pain and infection from your tooth and allow the area to remain healthy. When the inside of a tooth has become infected from bacteria or severely swollen from trauma, a root canal treatment is the only way to save the tooth. As with any dental treatment, some inherent risks exist in having a root canal treatment. Up to 10% of root canal treated teeth may experience continued pain and infection from the following: • Nerve tissue remaining in the canal space • Gutta Percha and sealer failing to completely fill the canal space • An existing root fracture that was undetectable when the root canal treatment was done; in this case, the tooth will not become comfortable and must be extracted. A root canal treated tooth is at a significantly higher risk of fracturing than the same tooth without a root canal treatment. A crown or onlay that covers the cusps of the tooth will decrease the likelihood that the tooth will break and is highly recommended after the root canal treatment is done. What happens during root canal treatment? You will be given a local anaesthetic injection, and then an opening is made in the top of the tooth down to the pulp. The dentist will then use narrow files to remove the nerve and clean the tooth. A few x-rays may be taken to determine the length of your tooth root/s. He/she will use various different disinfectants to assure all bacteria are removed. The dentist will then replace the pulp, with a material we call Gutta Percha. This is necessary to prevent bacteria re-infecting the empty space where your nerve has been removed. Then the tooth will be filled with an ordinary filling material. A final x-ray will be taken of the completed root canal filling. Depending on the severity of your infection, the stages above may be done in more than one appointment. In most cases, after the tooth has been disinfected, the dentist may prescribe you some anti-biotics and suggest you come back in 2 weeks for completion of the root canal treatment. Задание 3: Прочитайте и переведите следующие слова и словосочетания: to contain blood vessels and nerve tissues, to supply the tooth, severe swelling, the procedure, to prevent bacteria from re-infecting the tooth, instead of, to ensure, to achieve by, small files, a disinfecting solution, a antibacterial sealer, to eliminate pain, the only way to save the tooth, up to 10% of root canal treated teeth, failing to completely fill the canal space, undetectable, onlay, the likelihood, a local anaesthetic injection, depending on the severity of an infection, one appointment, prescribe antibiotics. Задание 4: Определите истинное или ложное утверждение:
Задание 5: Ответьте на вопросы по теме «Лечение корневого канала»:
Вопросы для подготовки по теме занятия: Подберите текст по пройденной теме (объемом 500 печатных знаков) и подготовьте письменный перевод. Вопросы по теме для самостоятельного изучения:
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