Isihloko
I-methylene blue ekwelapheni amazinyo: ukudaya nocwaningo lokwelapha ngokukhanya
I-methylene blue inezindima eziningana ezihlukene ekwelapheni amazinyo nasocwaningweni. Ingagqamisa umehluko lapho udokotela wamazinyo ehlola umfantu osolwayo ezinyweni. Ekwelapheni ngokukhanya okulwa namagciwane, isebenza njengento ezwela ukukhanya esetshenziswa nokukhanyiswa okulawulwayo. Abacwaningi baselabhorethri baphinde bahlole imiphumela yayo kumaseli amazinyo. Lokhu kusetshenziswa kuphendula imibuzo ehlukene futhi akukwazi ukuqinisekisa ukusebenza kokunye.
Lo mehluko ubalulekile lapho ukusesha “ukusetshenziswa kwe-methylene blue emazinyweni” kuholela kusukela esithombeni esithathwe ngesibonakhulu kuya esincomweni somuthi wokuxubha. Umugqa oluhlaza okwesibhakabhaka obonakalayo uyinto ebonwe ekuhloleni. Ukuncipha kwamagciwane kumasampula athathiwe kuwumphumela wokwelapha. Akukho kulokhu okufakazela ukuthi ukuxubha ngodayi kuvimbela ukubola kwamazinyo noma kusindisa izinyo elilimele.
Qondanisa ukusetshenziswa nendawo okwenzeka kuyo
Leli thebula lokusetshenziswa lihlukanisa into esetshenzisiwe, umbuzo obuzwayo, nesiphetho ubufakazi obungasisekela. Izingxube ezisetshenziswe ezifundweni zichazwe ukuze zihlonzwe, hhayi njengeziyalezo zokuzilungisa.
| Ukusetshenziswa | Ingxube nendawo yokusetshenziswa | Lokho okungakufakazela | Lokho okungakufakazeli |
|---|---|---|---|
| Ukwenza umfantu osolwayo ubonakale | Isixazululo sokudaya esikhethwe uchwepheshe wezokwelapha; ukuhlolwa kwamazinyo kusetshenziswa ukukhulisa isithombe | Ukugqama okukhulu kwesici esifinyeleleka ekuhloleni | Ukujula okuphelele komfantu, isimo se-pulp, noma ukuthi kudingeka yini ukukhishwa kwezinyo |
| Ukwelashwa kwemisele yezimpande ngokukhanya | Into ezwela ukukhanya nendlela yokufaka ukukhanya eqondene nocwaningo, ngaphakathi komsele owelashwe uchwepheshe | Izinguquko kumagciwane athathwe kumasampula noma eminye imiphumela echazwe kusengaphambili | Ukuqedwa ngokuphelele kwamagciwane noma ukusinda kwezinyo isikhathi eside ngokusekelwe ezibalweni zamagciwane kuphela |
| Ukwelashwa kwezicubu ezizungeze amazinyo ngokukhanya | Isixazululo sikadayi esifakwa endaweni ethile kanye nokukhanyiswa okuchaziwe, ngokuvamile kufundwa kuhambisana nokwelashwa ngokususa ukungcola ngezinsimbi | Imiphumela eyengeziwe uma kuqhathaniswa neqembu lokuqhathanisa elifanele | Okuthatha indawo yokususwa koqweqwe lwamagciwane nodaka lwamazinyo oluqinile |
| Ucwaningo lwamaseli amazinyo | Uketshezi lokukhulisa amaseli oluchaziwe nokuchayeka ezintweni elabhorethri | Ukusabela kwamaseli ngaphansi kwalezo zimo zokuhlola | Inzuzo yokufaka udayi emazinyweni esiguli |
| Umuthi wokuxubha we-methylene blue owenziwe ekhaya | Ingxube engalinganiselwe ngokwezinga eliqinisekisiwe nokuchayeka okuphindaphindiwe emlonyeni | Akukho siphetho ngokusebenza esivela ekusetshenzisweni okungenhla | Ukuvimbela ukubola kwamazinyo okuqinisekisiwe, ukwelapha isifo sezinsini, noma uhlelo oluphephile lokusebenzisa ekhaya |
Ingabe i-methylene blue ingaveza izinyo elinomfantu?
Ingasiza uchwepheshe wezokwelapha abone umugqa osolwayo. I-American Association of Endodontists ichaza ukudaya nge-methylene blue kuhambisana nokukhulisa isithombe, ukudlulisa ukukhanya ezinyweni, ukuhlola ngokuluma, nokuhlola izicubu ezizungeze izinyo ngensimbi yokuphenya lapho kuhlolwa izinyo elinomfantu. Ukudaya kuyingxenye eyodwa yalokho kuhlola. Leso sihloko sochwepheshe siphinde sigcizelele ukubaluleka kokuhlola ukuthi umfantu unwebeka ibanga elingakanani futhi siphawule ukuthi akukho ukuhlolwa okujwayelekile okubikezela umphumela wesikhathi eside kukodwa.
Isibonakhulu sikhulisa ingxenye efinyeleleka ekubukweni; asenzi zonke izingxenye ezifihlekile zibonakale. Ngakho umugqa odayiwe udinga ukuhunyushwa ngokuhambisana nokwakheka kwezinyo nezinye izinto ezitholakele. Awukwazi ukuveza ngokuzimela ukuthi i-pulp iphilile yini, ukuhlonza wonke umthombo wobuhlungu, noma ukufakazela ukuthi izinyo alisakwazi ukulungiseka.
Umehluko phakathi kwezinhlobo zemifantu nawo ubalulekile. Umhlahlandlela we-AAE weziguli ngamazinyo anemifantu uhlukanisa imifantu engajulile yoqweqwe lwangaphandle lwezinyo neziqongo zamazinyo eziphukile, amazinyo anemifantu, amazinyo ahlukene phakathi, kanye nokuphuka kwezimpande okuqonde phezulu naphansi. Ukwelashwa kuncike ohlotsheni, endaweni, nasebungakweni. Ukuthola umugqa akufani nokuthola izinyo elihlukene phakathi.
Uma udokotela wamazinyo ephakamisa ukukhishwa kwezinyo ngemva kokudaya, imibuzo ewusizo ithi: “Yiluphi uhlobo lomfantu olukhona?”, “Yikuphi okutholakele okubonisa ubungako bawo?”, nokuthi “Lokho okutholakele kuthinta kanjani ukuthi izinyo lingalungiswa yini?” Le mibuzo ifuna izizathu ezisekela isincomo. Umugqa omnyama kakhulu uwodwa awuzona lezo zizathu.
Kungani ezinye izivivinyo zamazinyo zisabalulekile
Isiguli singazibuza kufanele ukuthi kungani kudingeka ukuhlolwa okwengeziwe ngemva kokuthwetshulwa ngesikena noma ukuhlolwa ngesibonakhulu. Izivivinyo ezihlukene zihlola izingxenye ezihlukene zenkinga. Uhlaka lwe-AAE lokuxilonga amazinyo anemifantu naphukile luhlanganisa ukuhlolwa kwe-pulp, okutholakala ezicutshini ezizungeze izinyo, ukubuka, nokuthwetshulwa kwezithombe ukuze uchwepheshe akwazi ukwakha ukuxilongwa kwe-pulp nezicubu ezizungeze isihloko sempande.
Ngokwesibonelo, ukuhlolwa kwe-pulp ngokubanda noma ngogesi kuphenya ukusabela kwe-pulp. Ukuhlola ngensimbi yokuphenya kuhlola izicubu ezizungeze izinyo. Ukudlulisa ukukhanya ezinyweni kuhlola ukuthi ukukhanya kudlula kanjani. Udayi ugqamisa umehluko endaweni engaphezulu. Lokhu okubonwayo kungase kusekele incazelo efanayo, noma kushiye ukungaqiniseki okudinga ukuhlolwa okwengeziwe. Ukuphinda isivivinyo esisodwa esibukeka sihlaba umxhwele akuthathi ngokuzenzakalelayo indawo yezinye.
Ukwelapha ngokukhanya kusebenzisa udayi ngendlela ehlukile
Ekwelapheni ngokukhanya okulwa namagciwane, okuvame ukufushaniswa ngokuthi aPDT, i-methylene blue imunca ukukhanya okufanele futhi ihlanganyele ekuphendukeni kwamakhemikhali okubangelwa ukukhanya okungalimaza amagciwane. Lokhu kudinga ingxube echaziwe yento ezwela ukukhanya nokuchayeka ekukhanyeni okulawulwayo. Ubudlelwano phakathi kwe-methylene blue nokukhanya okubomvu buchaza ukuthi kungani ubude begagasi lokukhanya, indlela yokuliletha, nokuchayeka kukho kuyingxenye yokwelashwa uqobo.
Ngakho ukwelashwa okuphenywayo kuyinhlanganisela, hhayi nje “i-methylene blue.” Isivivinyo sezicubu ezizungeze amazinyo esabelwe ngokungahleliwe, esinabahlanganyeli abangu-36, saqhathanisa i-methylene blue emanzini nengxube equkethe into enciphisa ukungezwani kobuso boketshezi, sisebenzisa ukukhanyiswa kwe-660-nm ngemva kokususwa kodaka lwamazinyo nokusheleliswa kwezimpande. Ucwaningo lwabika ukuthi wawungekho umehluko ophawulekayo phakathi kwamaqembu ekuncipheni kwamagciwane noma esilinganisweni sesimo sokwelashwa esahlolwa. Ukushintsha uketshezi oluthwala udayi akuzange kuveze ngokuzenzakalelayo inzuzo ewusizo ekwelapheni.
Zibonisani izivivinyo zokwelashwa kwamazinyo?
Imiphumela incike esimweni, enqubweni elandelwayo, kulokho okuqhathaniswa nakho, nakumphumela olinganiswayo. Izifundo ezimbili zemisele yezimpande zibonisa ukuthi kungani isimangalo esithi “kubulala amagciwane amazinyo” sibanzi kakhulu ukuba siqondise ukwelashwa.
Esivivinyweni sango-2020 esabelwe ngokungahleliwe samazinyo obisi angaphambili angu-30 ane-pulp efile, ukuncipha komthamo wamagciwane kwaba ngu-93% ngokwelashwa okujwayelekile kanye no-99% ngokwelashwa okujwayelekile okuhambisana ne-aPDT. Umehluko wawungaphawuleki ngokwezibalo. Iphesenti elikhulu alizange libonise ukuthi inqubo eyengeziwe yayingcono kuleso sivivinyo.
Isivivinyo sokwelapha sango-2023 esasihlanganisa imisele yezimpande engu-24 sathola ukuncipha okukhulu okuphawulekayo kwamagciwane aphilayo nezingxenye ezimbili zamagciwane lapho i-aPDT ilandela ukulungiswa okujwayelekile. Lokho kusekela okutholakele ngokunciphiswa kwamagciwane okuqondene naleyo nqubo. Akufakazeli kukodwa ukuthi kuba nokukhishwa kwamazinyo okumbalwa noma ukugcinwa kwamazinyo okungcono isikhathi eside.
Imihlahlandlela iphinde icabangele ubufakazi obubanzi. Isiqondiso sesinyathelo sesibili se-European Federation of Periodontology se-periodontitis yesigaba I–III, esisekelwe kumhlahlandlela wayo we-S3 wango-2020, siphakamisa ukuthi ukwelapha ngokukhanya ngamabanga obude begagasi achaziwe e-660–670-nm noma e-800–900-nm kungangezwa ekuhlanzweni ngezinsimbi ngaphansi kwezinsini. Lesi sincomo siphathelene nokwelashwa kwezicubu ezizungeze amazinyo; akufanele sisetshenziswe ngokuzenzakalelayo kuzo zonke izimo zokwelashwa kwamazinyo.
Okutholakele ngamaseli amazinyo akubona ubufakazi bomuthi wokuxubha
Iphepha locwaningo elivame ukubaluleka lapha liphathelene nendlela yokusebenza ehluke ngokuphelele. Ocwaningweni lwaselabhorethri lukaMikulás nozakwabo lwango-2020, abacwaningi bachaya amaseli ayisiqalo e-pulp yamazinyo abantu kanye nama-mitochondria ahlukanisiwe obuchopho ku-monomer ye-resin i-TEGDMA. I-methylene blue yabuyisela ngokwengxenye izilinganiso ezithile zokusebenza kwama-mitochondria ezaziphazamisekile ngaphansi kwalezo zimo zokuhlola.
Lo msebenzi waphenya indlela amaseli akhiqiza futhi asebenzise ngayo amandla. Awuzange uhlole abantu abaxubha amazinyo, ukuvimbela ukubola kwamazinyo, ukwelapha umfantu wezinyo, noma umuthi wokuxubha osulungile. Amaseli abantu elabhorethri ahlala ewubufakazi baselabhorethri. Umehluko ochazwa umtapo wocwaningo phakathi kwezivivinyo kubantu nezifundo zokuhlola usiza ukuhumusha lolu hlobo lomphumela.
Lokhu kusho ukuthini ngezinsolo zomuthi wokuxubha nokunakekelwa komlomo
Ubufakazi obungenhla abuqinisekisi uhlelo lokusebenzisa i-methylene blue emazinyweni ekhaya. Ukwengeza udayi emuthini wokuxubha kushintsha ingxube yomkhiqizo osulungile ngaphandle kokubonisa ukuthi ingxube entsha isebenza ngendlela ewusizo, ukuthi ukuchayeka kuyo ngokuphindaphindiwe kuyamukeleka, noma ukuthi iyahambisana yini nezinto ezisetshenziswe ekulungiseni amazinyo. Futhi ukukhanya okuthengiselwa abathengi akuphindi inqubo yokwelapha ngokukhanya eyenziwa uchwepheshe.
Ngenqubo yokwelapha amazinyo ephakanyiswayo, buza ukuthi ibhekana nakuphi ukuxilongwa, ingeza yiphi inzuzo ekunakekelweni okujwayelekile, nokuthi yiluphi ucwaningo olwahlola leyo nzuzo. Ngesimangalo somuthi wokuxubha, cela ubufakazi ngomkhiqizo wangempela osulungile nangomphumela okuthiwa uyawunikeza. Iphepha locwaningo lokunciphisa amagciwane emisele yezimpande alikwazi ukuvala leso sikhala. Ngokufanayo, izivivinyo zokwelapha ngokukhanya ze-lichen planus yomlomo kanye nobufakazi ngezilonda zomlomo nomphimbo obuhlungu ziphathelene nezimo ezihlukene ezidinga ukuhlolwa kwazo.