دندانپزشکی زیبایی ,Cosmetic Dentistry

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اولین دندانپزشکی سیار (اداره بهداری ژاندارمری)
مجله دانشکده دندانپزشکی
سال دوم-شماره ششم خرداد ماه 1343

جراحی زیبایی به منظور افزایش طول تاج دندانهای قدامی در بیمار gummy smile که به هنگام لبخند مقدار زیادی از بافت لثه ای نمایان بوده است

RESTORING ENDODONTICALLY-TREATED TEETH
Dear friends and colleagues,
We know that endodontically-treated teeth must
be restored properly, and in a timely way, for the
following reasons:
1. To protect the remaining tooth from fracture.
2. To prevent reinfection of the root canal system.
3. To replace the missing tooth structure in order
to return the tooth to good function.
An excellent paper published in the Journal of
Endodontics by Salehrabi and Rotstein, wherein
they gathered data on > 1.4 MILLION teeth and
examined the outcome eight years later, revealed
that 97% of these teeth were still functional......but
3% failed. The co-authors examined the subset of
3% to find out why they failed.
Most of the failures of the 3% subset failed
because the tooth was not restored. In other
words, the endodontic treatment was good but the
follow-up restoration was absent, resulting in
failure!
Other studies have shown that leakage around
temporary fillings can contaminate the root canal
system causing ultimate failure. Furthermore, other
studies have shown that 100% of temporary fillings
will leak within 30 days. 100%!
So what can we learn from these investigations?
--The vast majority of endodontically-treated teeth
will succeed in the future.
--Every endodontically-treated tooth MUST be
restored within 30 days.
--Ideally, place a final permanent restoration in an
endodontically-treated tooth at the same visit
when the canals are obturated, whenever possible.
Because posterior teeth masticate, they all require
occlusal coverage' i.e., onlay or a crown.
Because anterior teeth do not masticate (they only
incise), a bonded composite in the access opening
may suffice.
Patients must understand at the outset that having
root canal treatment is like buying 1 shoe----the
other shoe is the final restoration.
Stephen Cohen

مزایا و محدودیت های لامینیت ونیر/ قسمت سوم

ﻣﺰﺍﯾﺎﯼ ﻟﻤﯿﻨﯿﺖ ﻭﻧﯿﺮﻫﺎ
–1 ﻓﺮﺍﻫﻢ ﺁﻭﺭﺩﻥ ﻇﺎﻫﺮﯼ ﻃﺒﯿﻌﯽ ﻭ ﺯﯾﺒﺎ ﺑﺮﺍﯼ ﺩﻧﺪﺍﻥ
–2 ﺟﻬﺖ ﺍﺳﺘﻔﺎﺩﻩ ﺍﺯ ﻭﻧﯿﺮﻫﺎ ﻧﯿﺎﺯ ﺑﻪ ﺗﺮﺍﺵ ﺑﺴﯿﺎﺭ ﻛﻢ ﻭ
ﻣﺤﺎﻓﻈﻪ ﻛﺎﺭﺍﻧﻪ ﺍﺯ ﺳﻄﺢ ﺩﻧﺪﺍﻥ ﺩﺍﺭﯾﻢ ( ﺑﺮﺧﻼﻑ ﺭﻭﻛﺶﻫﺎﯼ
ﻛﺎﻣﻞ) ﺩﺭ ﻧﺘﯿﺠﻪ ﺑﺨﺶ ﺯﯾﺎﺩﯼ ﺍﺯ ﺳﺎﺧﺘﻤﺎﻥ ﺩﻧﺪﺍﻧﯽ ﺳﺎﻟﻢ
ﺣﻔﻆ ﺧﻮﺍﻫﺪ ﺷﺪ ﻭ ﺩﺭ ﻋﯿﻦ ﺣﺎﻝ ﺳﺎﺧﺘﺎﺭﯼ ﻣﺤﻜﻢ ﻭ ﺯﯾﺒﺎ
ﺧﻮﺍﻫﯿﻢ ﺩﺍﺷﺖ
–3 ﺛﺒﺎﺕ ﺭﻧﮓ ( ﻭﻧﯿﺮﻫﺎﯼ ﺳﺮﺍﻣﯿﻜﯽ ﺩﺭ ﻣﻘﺎﯾﺴﻪ ﺑﺎ ﺍﻧﻮﺍﻉ
ﻛﺎﻣﭙﻮﺯﯾﺘﯽ ﻧﺴﺒﺖ ﺑﻪ ﺗﻐﯿﯿﺮ ﺭﻧﮓ ﻣﻘﺎﻭﻡﺗﺮﻧﺪ)
–4 ﻭﻧﯿﺮﻫﺎﯼ ﺳﺮﺍﻣﯿﻜﯽ ﻧﺴﺒﺖ ﺑﻪ ﻭﻧﯿﺮﻫﺎﯼ ﻛﺎﻣﭙﻮﺯﯾﺘﯽ
ﻣﺤﻜﻢﺗﺮ ﻭ ﺑﺎﺩﻭﺍﻡﺗﺮ ﻭ ﺯﯾﺒﺎﺗﺮ ﻫﺴﺘﻨﺪ.
–5 ﺑﻪ ﻋﻨﻮﺍﻥ ﺟﺎﯾﮕﺰﯾﻨﯽ ﺑﺮﺍﯼ ﺭﻭﻛﺶﻫﺎﯼ ﻛﺎﻣﻞ ﺩﺭ ﺩﺭﻣﺎﻥ
ﺩﻧﺪﺍﻥﻫﺎﯾﯽ ﻛﻪ ﺩﭼﺎﺭ ﺷﻜﺴﺘﮕﯽ ﺍﻧﺴﯿﺰﺍﻝ ﻭ ﯾﺎ ﺗﻐﯿﯿﺮ ﺭﻧﮓ
ﺷﺪﻩﺍﻧﺪ
–6 ﺑﺎﻓﺖ ﻟﺜﻪ ﻭﻧﯿﺮﻫﺎﯼ ﺳﺮﺍﻣﯿﻜﯽ ﺭﺍ ﺑﻪ ﺧﻮﺑﯽ ﺗﺤﻤﻞ ﻛﺮﺩﻩ
ﻭ ﺩﭼﺎﺭ ﺍﻟﺘﻬﺎﺏ ﻭ ﺗﺤﻠﯿﻞ ﻧﺨﻮﺍﻫﺪ ﺷﺪ .
ﻣحدودیت های ﻟﻤﯿﻨﯿﺖ ﻭﻧﯿﺮﻫﺎ
–1 ﺍﯾﻦ ﺩﺭﻣﺎﻥ ﻧﯿﺎﺯﻣﻨﺪ ﭘﺮﻭﺳﻪ ﻻﺑﺮﺍﺗﻮﺍﺭﯼ ﺍﺳﺖ
–2 ﭘﺮﻭﺳﻪ ﺍﻧﺠﺎﻡ ﮔﺮﻓﺘﻪ ﺑﺮﮔﺸﺖﻧﺎﭘﺬﯾﺮ ﺍﺳﺖ
–3 ﻫﺰﯾﻨﻪ ﺳﺎﺧﺖ ﺍﯾﻦ ﻧﻮﻉ ﺭﺳﺘﻮﺭﯾﺸﻦﻫﺎ ﺑﺎﻻﺳﺖ.
–4 ﻣﺎﺭﺟﯿﻦﻫﺎﯼ ﺷﻜﻨﻨﺪﻩ
–5 ﻣﻌﻤﻮﻻً ﺩﺭ ﺻﻮﺭﺕ ﺗﺮﻙ ﺑﺮﺩﺍﺷﺘﻦ ﻭ ﯾﺎ ﺷﻜﺴﺘﻦ ﻭﻧﯿﺮﻫﺎ
ﻗﺎﺑﻞ ﺗﺮﻣﯿﻢ ﻧﯿﺴﺘﻨﺪ ﻭ ﯾﺎ ﺑﻪ ﺳﺨﺘﯽ ﺗﺮﻣﯿﻢ ﻣﯽﺷﻮﻧﺪ
–6 ﺭﻧﮓ ﺍﯾﻦ ﻧﻮﻉ ﺭﺳﺘﻮﺭﯾﺸﻦﻫﺎ ﭘﺲ ﺍﺯ ﻗﺮﺍﺭﺩﺍﺩﻥ ﺩﺭ
ﺩﻫﺎﻥ، ﻗﺎﺑﻞ ﺗﻐﯿﯿﺮ ﻧﺨﻮﺍﻫﺪ ﺑﻮﺩ
–7 ﭘﺮﻭﺳﻪ ﺟﺎﯼ ﮔﺬﺍﺭﯼ ﻭﻧﯿﺮﻫﺎ ﺑﺴﯿﺎﺭ ﻣﺸﻜﻞ ﻭ ﻭﻗﺖﮔﯿﺮ
ﺍﺳﺖ
–8 ﺑﻪ ﻋﻠﺖ ﺗﺮﺍﺵ ﺟﺰﯾﯽ ﺳﻄﺢ ﺩﻧﺪﺍﻥ ﻭ ﺑﺮﺩﺍﺷﺖ ﻣﯿﻨﺎ،
ﻣﻤﻜﻦ ﺍﺳﺖ ﺩﻧﺪﺍﻥ ﻧﺴﺒﺖ ﺑﻪ ﻏﺬﺍﻫﺎﯼ ﺳﺮﺩ ﻭ ﮔﺮﻡ ﺣﺴﺎﺱ
ﺷﻮﺩ .
–9 ﺑﺎﺩﺭﺻﺪ ﺍﺣﺘﻤﺎﻝ ﺑﺴﯿﺎﺭ ﻛﻢ، ﻟﻤﯿﻨﯿﺖ ﻭﻧﯿﺮﻫﺎ ﻣﻤﻜﻦ ﺍﺳﺖ
ﺍﺯ ﺳﻄﺢ ﺩﻧﺪﺍﻥ ﻣﻮﺭﺩ ﻧﻈﺮ ﺟﺪﺍ ﺷﻮﻧﺪ. ﺟﻬﺖ ﺟﻠﻮﮔﯿﺮﯼ ﺍﺯ
ﻭﻗﻮﻉ ﺍﯾﻦ ﺣﺎﺩﺛﻪ، ﺑﺎﯾﺪ ﺍﺯ ﻭﺍﺭﺩ ﺁﻭﺭﺩﻥ ﻓﺸﺎﺭ ﺑﯿﺶ ﺍﺯ ﺣﺪ ﺑﻪ
ﺩﻧﺪﺍﻧﻬﺎﯼ ﺩﺍﺭﺍﯼ ﻭﻧﯿﺮ ﺟﻠﻮﮔﯿﺮﯼ ﻧﻤﻮﺩ.
–10 ﻫﻤﺎﻧﻄﻮﺭ ﻛﻪ ﻗﺒﻼً ﻧﯿﺰ ﺑﯿﺎﻥ ﺷﺪ ﺍﻓﺮﺍﺩ ﺩﺍﺭﺍﯼ ﻋﺎﺩﺍﺕ
ﭘﺎﺭﺍﻓﺎﻧﻜﺸﻨﺎﻝ ﻧﻈﯿﺮ ﺩﻧﺪﺍﻥ ﻗﺮﻭﭼﻪ ﻛﺎﻧﺪﯾﺪ ﺧﻮﺑﯽ ﺟﻬﺖ
ﺍﺳﺘﻔﺎﺩﻩ ﺍﺯ ﻭﻧﯿﺮﻫﺎﯼ ﺳﺮﺍﻣﯿﻜﯽ ﻧﯿﺴﺘﻨﺪ ﭼﺮﺍ ﻛﻪ ﺍﯾﻨﮕﻮﻧﻪ
ﻋﺎﺩﺍﺕ ﻣﯽﺗﻮﺍﻧﻨﺪ ﻣﻨﺠﺮ ﺑﻪ ﺷﻜﺴﺘﮕﯽ ﻭ ﯾﺎ ﺗﺮﻙ ﺑﺮﺩﺍﺷﺘﻦ
ﻭﻧﯿﺮ ﺷﻮﻧﺪ.
ﻣﻌﻤﻮﻻً ﻟﻤﯿﻨﯿﺖ ﻭﻧﯿﺮﻫﺎ ﻧﯿﺎﺯ ﺑﻪ ﻣﺮﺍﻗﺒﺖ ﺩﻧﺪﺍﻧﭙﺰﺷﻜﯽ ﺧﺎﺻﯽ
ﻧﺪﺍﺭﻧﺪ ﻭ ﺗﻨﻬﺎ ﺑﺎﯾﺪ ﺑﻪ ﺭﻋﺎﯾﺖ ﺑﻬﺪﺍﺷﺖ ﺧﻮﺏ ﺩﻫﺎﻥ ﻭ
ﺩﻧﺪﺍﻥ ﺍﺯ ﺟﻤﻠﻪ ﻣﺴﻮﺍﻙ ﺯﺩﻥ ﺭﻭﺯﺍﻧﻪ ﻭ ﺍﺳﺘﻔﺎﺩﻩ ﺍﺯ ﻧﺦ ﺩﻧﺪﺍﻥ
ﺍﺩﺍﻣﻪ ﺩﺍﺩ ﻭ ﻫﻤﭽﻨﯿﻦ ﺍﺯ ﻭﺍﺭﺩ ﺁﻭﺭﺩﻥ ﻓﺸﺎﺭ ﺑﯿﺶ ﺍﺯ ﺣﺪ ﺑﻪ
ﺩﻧﺪﺍﻥﻫﺎﯼ ﻣﻮﺭﺩ ﻧﻈﺮ ﺍﺟﺘﻨﺎﺏ ﻛﺮﺩ

لاﻣﯿﻨﯿﺖ ﻭﻧﯿﺮ/ ﺑﺨﺶ ﺩﻭﻡ. ﻣﻮﺍﺭﺩ ﮐﺎﺭﺑﺮﺩ ﻭ ﻋﺪﻡ ﮐﺎﺭﺑﺮﺩ
ﺑﻪ ﻃﻮﺭ ﻛﻠﯽ ﺍﺯ ﻟﻤﯿﻨﯿﺖ ﻭﻧﯿﺮﻫﺎ ﺟﻬﺖ ﺑﺎﺯﺳﺎﺯﯼ ﺩﻧﺪﺍﻥﻫﺎﯼ
ﺷﻜﺴﺘﻪ ﻭ ﯾﺎ ﺗﻐﯿﯿﺮ ﺭﻧﮓ ﺩﺍﺩﻩ ﻭ ﻫﻤﭽﻨﯿﻦ ﺩﻧﺪﺍﻧﻬﺎﯼ ﻛﻮﭼﻚ ﻭ
ﺑﺪ ﺷﻜﻞ ﺍﺳﺘﻔﺎﺩﻩ ﻣﯽﺷﻮﺩ . ﺑﺮﺍﯼ ﺑﻠﻨﺪ ﻛﺮﺩﻥ ﻃﻮﻝ
ﺩﻧﺪﺍﻥﻫﺎﯾﯽ ﻛﻪ ﺑﺮﺍﺛﺮ ﺳﺎﯾﺶﻫﺎﯼ ﺩﻧﺪﺍﻧﯽ ﻛﻮﺗﺎﻩ ﺷﺪﻩﺍﻧﺪ ﻭ
ﻫﻤﭽﻨﯿﻦ ﺑﺮﺍﯼ ﻣﺜﻠﺚﻫﺎﯼ ﺳﯿﺎﻩ ﺭﻧﮕﯽ ﻛﻪ ﺑﻪ ﺩﻧﺒﺎﻝ ﺗﺤﻠﯿﻞ
ﻟﺜﻪ ﺑﯿﻦ ﺩﻧﺪﺍﻧﻬﺎ ﺍﯾﺠﺎﺩ ﻣﯽﺷﻮﻧﺪ ﻧﯿﺰ ﻣﯽﺗﻮﺍﻥ ﺍﺯ ﺍﯾﻦ ﺭﻭﺵ
ﺍﺳﺘﻔﺎﺩﻩ ﻛﺮﺩ .

ﻣﻮﺍﺭﺩ ﻛﺎﺭﺑﺮﺩ ﻟﻤﯿﻨﯿﺖ ﻭﻧﯿﺮﻫﺎ
ﻭﻧﯿﺮﻫﺎ ﻣﯽﺗﻮﺍﻧﻨﺪ ﺟﻬﺖ ﺑﺎﺯﺳﺎﺯﯼ ﺯﯾﺒﺎﯾﯽ ﻭ ﻋﻤﻠﻜﺮﺩ ﺩﺭ
ﻣﻮﺍﺭﺩ ﺯﯾﺮ ﺑﻜﺎﺭ ﺭﻭﻧﺪ :
1 ﺩﻧﺪﺍﻥﻫﺎﯼ ﺗﯿﺮﻩ ﻭ ﯾﺎ ﺩﻧﺪﺍﻧﻬﺎﯾﯽ ﻛﻪ ﺩﭼﺎﺭ ﺗﻐﯿﯿﺮ ﺭﻧﮓ
ﺷﺪﻩﺍﻧﺪ
2 ﺩﻧﺪﺍﻥﻫﺎﯼ ﻫﯿﭙﻮﻛﻠﺴﯿﻔﯿﻪ
3 ﺩﯾﺎﺳﺘﻢﻫﺎﯼ ﻣﺘﻌﺪﺩ
4 ﻟﺘﺮﺍﻝﻫﺎﯼ
‌Peg shape
5 ﺩﻧﺪﺍﻥﻫﺎﯼ ﺷﻜﺴﺘﻪ ﻭ ﻟﺐ ﭘﺮ ﺷﺪﻩ
6 ﺩﻧﺪﺍﻥﻫﺎﯾﯽ ﻛﻪ ﻣﻮﻗﻌﯿﺘﯽ ﻟﯿﻨﮕﻮﺍﻟﯽ ﻧﺴﺒﺖ ﺑﻪ ﺳﺎﯾﺮ
ﺩﻧﺪﺍﻧﻬﺎﯼ ﻗﻮﺱ ﻓﻜﯽ ﺩﺍﺭﻧﺪ
7 ﺩﻧﺪﺍﻥﻫﺎﯾﯽ ﺑﺎ ﻣﻮﻗﻌﯿﺖ ﻧﺎﻣﻨﺎﺳﺐ ﺑﺪﻭﻥ ﻧﯿﺎﺯ ﺑﻪ
ﺍﺭﺗﻮﺩﻧﺴﯽ
ﻣﻮﺍﺭﺩ ﻋﺪﻡ ﻛﺎﺭﺑﺮﺩ ﻟﻤﯿﻨﯿﺖ ﻭﻧﯿﺮﻫﺎ
1 ﻋﺪﻡ ﻭﺟﻮﺩ ﺳﺎﺧﺘﺎﺭ ﻛﺎﻓﯽ ﺩﻧﺪﺍﻧﯽ (ﻣﯿﻨﺎ ﺟﻬﺖ ﺑﺎﻧﺪﯾﻨﮓ)
2 ﻗﺮﺍﺭﮔﯿﺮﯼ ﺩﻧﺪﺍﻥ ﺩﺭ ﻣﻮﻗﻌﯿﺘﯽ ﻟﺒﯿﺎﻟﯽ ﺗﺮﺍﺯ ﺣﺎﻟﺖ ﻋﺎﺩﯼ
3 ﻓﻀﺎﯼ ﺑﯿﻦ ﺩﻧﺪﺍﻧﯽ ﺑﺴﯿﺎﺭ ﺯﯾﺎﺩ ﻭ ﺍﻓﺰﺍﯾﺶ ﯾﺎﻓﺘﻩ
4 ﺑﻬﺪﺍﺷﺖ ﺩﻫﺎﻧﯽ ﺿﻌﯿﻒ ﻭ ﻧﺎﻣﻨﺎﺳﺐ ﻭ ﻭﺟﻮﺩ
ﭘﻮﺳﯿﺪﮔﯽﻫﺎﯼ ﻣﺘﻌﺪﺩ
5 ﻭﺟﻮﺩ ﻋﺎﺩﺍﺕ ﭘﺎﺭﺍﻓﺎﻧﻜﺸﻨﺎﻝ ﻧﻈﯿﺮ ﺑﺮﺍﻛﺴﯿﺴﻡ
6 ﻛﺮﺍﻭﺩﯾﻨﮓ ﻣﺘﻮﺳﻂ ﺗﺎ ﺷﺪﯾﺪ ﺩﻧﺪﺍﻧﯽ

لامینیت ونیر/ قسمت اول

لاﻤﯿﻨﯿﺖ ﻭﻧﯿﺮ ﺑﻪ ﻻﯾﻪﺍﯼ ﻧﺎﺯﻙ ﺍﺯ ﻣﻮﺍﺩ ﺳﺮﺍﻣﯿﻜﯽ
ﺩﻧﺪﺍﻧﭙﺰﺷﻜﯽ ﮔﻔﺘﻪ ﻣﯽﺷﻮﺩ ﻛﻪ ﻋﻤﺪﺗﺎً ﺟﻬﺖ ﺑﻬﺒﻮﺩ ﺯﯾﺒﺎﯾﯽ
ﺩﻧﺪﺍﻧﻬﺎ ﺑﻪ ﻭﯾﮋﻩ ﺩﻧﺪﺍﻧﻬﺎﯼ ﻗﺪﺍﻣﯽ، ﺑﺮﻭﯼ ﺳﻄﺢ ﺩﻧﺪﺍﻧﻬﺎ ﻗﺮﺍﺭ
ﺩﺍﺩﻩ ﻣﯽﺷﻮﺩ. ﺑﺪﯾﻦ ﺗﺮﺗﯿﺐ ﻟﻤﯿﻨﯿﺖ ﻭﻧﯿﺮ ﺭﺍﻫﯽ ﺟﻬﺖ
ﺩﺳﺘﯿﺎﺑﯽ ﺑﻪ ﯾﻚ ﻟﺒﺨﻨﺪ ﺯﯾﺒﺎ ﺑﺎ ﺣﺪﺍﻗﻞ ﺗﺮﺍﺵ ﻭ ﺁﺳﯿﺐ ﺑﻪ
ﺩﻧﺪﺍﻥ ﺍﺳﺖ. ﻭﻧﯿﺮﻫﺎ ﻧﻪ ﺗﻨﻬﺎ ﺭﻧﮓ ﻭ ﺳﺎﯾﻪ ﺩﻧﺪﺍﻥ ﺭﺍ ﺗﻐﯿﯿﺮ
ﻣﯽﺩﻫﻨﺪ ﺑﻠﻜﻪ ﺍﯾﻦ ﺗﺼﻮﺭ ﺭﺍ ﺍﯾﺠﺎﺩ ﻣﯽﻛﻨﻨﺪ ﻛﻪ ﺩﻧﺪﺍﻥ ﻣﻮﺭﺩ
ﻧﻈﺮ ﺩﺭ ﻣﻮﻗﻌﯿﺘﯽ ﺑﻬﺘﺮ ﻭ ﻫﻤﺎﻫﻨﮓﺗﺮ ﺩﺭ ﻗﻮﺱ ﺩﻧﺪﺍﻧﯽ ﺟﺎﯼ
ﮔﺮﻓﺘﻪ ﺍﺳﺖ .
ﺗﻔﺎﻭﺕ ﺍﺻﻠﯽ ﻟﻤﯿﻨﯿﺖ ﻭﻧﯿﺮ ﻭ ﻛﺮﺍﻭﻥ ﺩﺭ ﺍﯾﻦ ﺍﺳﺖ ﻛﻪ
ﻛﺮﺍﻭﻥ ﺗﻤﺎﻡ ﺳﻄﻮﺡ ﺩﻧﺪﺍﻥ ﺭﺍ ﭘﻮﺷﺶ ﻣﯽﺩﻫﺪ ﻭ ﺑﻪ ﻫﻤﯿﻦ
ﻋﻠﺖ ﻧﯿﺎﺯ ﺑﻪ ﺗﺮﺍﺵ ﺑﯿﺸﺘﺮﯼ ﺍﺯ ﺑﺎﻓﺖ ﺩﻧﺪﺍﻧﯽ ﺩﺍﺭﺩ ﺩﺭ ﺣﺎﻟﯽ
ﻛﻪ ﻟﻤﯿﻨﯿﺖﻫﺎ ﺗﻨﻬﺎ ﺳﻄﺢ ﺑﺎﻛﺎﻝ ﺩﻧﺪﺍﻧﻬﺎ ﺭﺍ ﻣﯽﭘﻮﺷﺎﻧﻨﺪ ﻭ ﺩﺭ
ﻧﺘﯿﺠﻪ ﺩﺭﻣﺎﻧﯽ ﻣﺤﺎﻓﻈﻪﻛﺎﺭﺍﻧﻪﺗﺮ ﻧﺴﺒﺖ ﺑﻪ ﻛﺮﺍﻭﻥﻫﺎ ﻣﺤﺴﻮﺏ
ﻣﯽﺷﻮﻧﺪ ﭼﺮﺍ ﻛﻪ ﻣﻨﺠﺮ ﺑﻪ ﺣﻔﻆ ﺑﺨﺶ ﺯﯾﺎﺩﯼ ﺍﺯ ﺳﺎﺧﺘﺎﺭ
ﺩﻧﺪﺍﻧﯽ ﺳﺎﻟﻢ ﺧﻮﺍﻫﺪ ﺑﻮﺩ.
ﺩﻭ ﻣﺎﺩﻩ ﺍﺻﻠﯽ ﺟﻬﺖ ﺳﺎﺧﺖ ﻟﻤﯿﻨﯿﺖ ﻭﻧﯿﺮﻫﺎ ﻭﺟﻮﺩ ﺩﺍﺭﻧﺪ
ﻛﻪ ﻋﺒﺎﺭﺗﻨﺪ ﺍﺯ:
–1 ﻛﺎﻣﭙﻮﺯﯾﺖ ﺭﺯﯾﻦﻫﺎ
–2 ﭘﺮﺳﻠﻦ ﺩﻧﺪﺍﻧﯽ
ﻭﻧﯿﺮﻫﺎﯼ ﻛﺎﻣﭙﻮﺯﯾﺘﯽ ﻣﻤﻜﻦ ﺍﺳﺖ ﻣﺴﺘﻘﯿﻤﺎً ﺗﻮﺳﻂ ﺧﻮﺩ
ﺩﻧﺪﺍﻧﭙﺰﺷﻚ ﺩﺭ ﻣﻄﺐ ﺩﺭ ﺩﻫﺎﻥ ﺑﯿﻤﺎﺭ ﺟﺎﯾﮕﺰﯾﻦ ﺷﻮﻧﺪ ﻭ ﯾﺎ
ﺍﯾﻨﻜﻪ ﺑﻪ ﺭﻭﺵ ﻏﯿﺮ ﻣﺴﺘﻘﯿﻢ ﻭ ﺩﺭ ﻻﺑﺮﺍﺗﻮﺍﺭ ﺳﺎﺧﺘﻪ ﺷﺪﻩ ﻭ
ﺳﭙﺲ ﺑﺮ ﺭﻭﯼ ﺩﻧﺪﺍﻥ ﺑﺎﻧﺪ ﺷﻮﻧﺪ. ﺍﻟﺒﺘﻪ ﻣﻌﻤﻮﻻً ﺍﺯ ﻛﺎﻣﭙﻮﺯﯾﺖ
ﺭﺯﯾﻦﻫﺎ ﺟﻬﺖ ﻟﻤﯿﻨﯿﺖ ﻭﻧﯿﺮﻫﺎﯼ ﻣﺴﺘﻘﯿﻢ ﺍﺳﺘﻔﺎﺩﻩ ﻣﯽﮔﺮﺩﺩ.
ﺩﺭ ﺣﺎﻟﯽ ﻛﻪ ﻭﻧﯿﺮﻫﺎﯼ ﺳﺮﺍﻣﯿﻜﯽ ﺗﻨﻬﺎ ﺑﻪ ﺭﻭﺵ ﻏﯿﺮﻣﺴﺘﻘﯿﻢ ﻭ
ﺩﺭ ﻻﺑﺮﺍﺗﻮﺍﺭ ﺳﺎﺧﺘﻪ ﻣﯽﺷﻮﻧﺪ

لبخند لثه ای یا gummy smile / بخش دوم

ﻟﺒﺨﻨﺪ ﻟﺜﻪ ﺍﯼ ﭼﯿﺴﺖ؟
ﺗﺸﺨﯿﺺ ﺻﺤﯿﺢ، ﻋﺎﻣﻞ ﮐﻠﯿﺪﯼ ﺩﺭ ﺣﻞ ﻣﺸﮑﻼﺕ
ﭘﯿﭽﯿﺪﻩ ﻣﺮﺑﻮﻁ ﺑﻪ ﺯﯾﺒﺎﯾﯽ ﺍﺳﺖ. ﻇﺎﻫﺮ ﻟﺒﺨﻨﺪ ﺩﺍﺭﺍﯼ
ﺗﺎﺛﯿﺮ ﺧﺎﺹ ﺩﺭ ﻫﺮ ﺩﻭ ﺣﻮﺯﻩ ﺯﯾﺒﺎﯾﯽ ﻭ ﺍﺣﺴﺎﺱ
ﺍﺳﺖ . ﺯﻣﺎﻧﯽ ﮐﻪ ﺍﻓﺮﺍﺩ ﺑﻪ ﺩﻧﺒﺎﻝ ﺭﻭﺵﻫﺎﯼ ﺩﺭﻣﺎﻧﯽ
ﺯﯾﺒﺎﯾﯽ ﺩﻧﺪﺍﻥ ﺑﺨﺎﻃﺮ ﻭﺟﻮﺩ ﺍﺣﺴﺎﺱ ﻧﺎﺧﻮﺷﺎﯾﻨﺪ
ﺩﺭﺑﺎﺭﻩ ﻟﺒﺨﻨﺪ ﺧﻮﺩ ﻣﯽﺭﻭﻧﺪ، ﻫﻤﻮﺍﺭﻩ ﺍﯾﻦ ﺍﺣﺘﻤﺎﻝ
ﻭﺟﻮﺩ ﺩﺍﺭﺩ ﮐﻪ ﻓﺮﺩ ﺩﺍﺭﺍﯼ ﯾﮏ ﻣﺸﮑﻞ ﻭﺍﻗﻌﯽ ﺩﺭ
ﺍﯾﻦ ﺭﺍﺑﻄﻪ ﺑﺎﺷﺪ. ﺑﺮﺧﯽ ﺍﻓﺮﺍﺩ ﺍﺣﺴﺎﺱ ﻣﯽﮐﻨﻨﺪ
ﺑﺨﺶ ﺯﯾﺎﺩﯼ ﺍﺯ ﺑﺎﻓﺖ ﻟﺜﻪ ﺁﻧﻬﺎ ﺩﺭ ﺣﺎﻟﺖ ﻋﺎﺩﯼ
ﻧﻤﺎﯾﺎﻥ ﺍﺳﺖ ﯾﺎ ﻟﺜﻪﻫﺎﯼ ﺁﻧﻬﺎ ﺩﺭ ﺯﻣﺎﻥ ﻟﺒﺨﻨﺪ ﺯﺩﻥ
ﺑﯿﺶ ﺍﺯ ﺣﺪ ﺑﻪ ﭼﺸﻢ ﻣﯽﺁﯾﺪ. ﺻﺮﻑ ﻧﻈﺮ ﺍﺯ ﺍﯾﻨﮑﻪ
ﺩﺭ ﺍﯾﻦ ﺣﺎﻟﺖ ﺩﻧﺪﺍﻥ ﻓﺮﺩ ﮐﻮﭼﮏ ﺑﻪ ﻧﻈﺮ ﻣﯽﺭﺳﺪ
ﯾﺎ ﺑﺨﺶ ﺯﯾﺎﺩﯼ ﺍﺯ ﺑﺎﻓﺖ ﻟﺜﻪ ﻧﻤﺎﯾﺎﻥ ﻣﯽﺷﻮﺩ، ﺩﺭ
ﻫﺮ ﺩﻭ ﺣﺎﻟﺖ ﺩﻧﺪﺍﻥﻫﺎ ﺩﺍﺭﺍﯼ ﺗﻤﺎﺱ ﻣﻨﺎﺳﺐ ﺑﺎ
ﯾﮑﺪﯾﮕﺮ ﻧﯿﺴﺘﻨﺪ . ﻫﻤﭽﻨﯿﻦ ﻟﺒﺨﻨﺪ ﻟﺜﻪﺍﯼ ﻣﯽﺗﻮﺍﻧﺪ
ﺍﺣﺴﺎﺱ ﺧﺠﺎﻟﺖ ﻭ ﮐﻢ ﺭﻭﯾﯽ ﺭﺍ ﺑﺮﺍﯼ ﻓﺮﺩ ﺑﻪ ﻫﻤﺮﺍﻩ
ﺩﺍﺷﺘﻪ ﺑﺎﺷﺪ.
ﺑﻨﺎﺑﺮﺍﯾﻦ ﺗﻌﺮﯾﻒ ﻟﺒﺨﻨﺪ ﻟﺜﻪﺍﯼ ﭼﯿﺴﺖ؟ ﺍﯾﻦ ﻣﻮﺿﻮﻉ
ﯾﮏ ﻣﺴﺌﻠﻪ ﺍﺣﺴﺎﺳﯽ ﺍﺳﺖ ﻭ ﺑﻨﺎﺑﺮﺍﯾﻦ ﺍﺯ ﻓﺮﺩﯼ ﺑﻪ
ﻓﺮﺩ ﺩﯾﮕﺮ ﻓﺮﻕ ﻣﯽﮐﻨﺪ. ﺍﻣﺎ ﯾﮏ ﻟﺒﺨﻨﺪ ﻣﻌﻤﻮﻻً
ﺯﻣﺎﻧﯽ ﮐﻪ 4 ﻣﯿﻠﯿﻤﺘﺮ ( ﺑﻄﻮﺭ ﺗﻘﺮﯾﺒﯽ ﯾﮏ ﻫﺸﺘﻢ
ﺍﯾﻨﭻ) ﺍﺯ ﺑﺎﻓﺖ ﻟﺜﻪ ﻧﻤﺎﯾﺎﻥ ﺷﻮﺩ ﺑﻪ ﻋﻨﻮﺍﻥ ﻟﺒﺨﻨﺪ ﻟﺜﻪ ­
ﺍﯼ ﺩﺭ ﻧﻈﺮ ﮔﺮﻓﺘﻪ ﻣﯽﺷﻮﺩ. ﺯﻣﺎﻧﯽ ﻟﺒﺨﻨﺪ « ﻟﺜﻪﺍﯼ »
ﻣﯽﺷﻮﺩ ﮐﻪ ﻭﺿﻌﯿﺖ ﺩﻧﺪﺍﻥ، ﺑﺎﻓﺖ ﻟﺜﻪ ﻭ ﻓﮏ ﺑﺎﻻ
ﺩﺭ ﻫﻤﺎﻫﻨﮕﯽ ﻭ ﺗﻨﺎﺳﺐ ﺑﺎ ﯾﮑﺪﯾﮕﺮ ﻧﺒﺎﺷﻨﺪ .
ﺑﺴﯿﺎﺭﯼ ﺍﻓﺮﺍﺩ ﺍﺯ ﺍﻧﺘﺨﺎﺏﻫﺎﯼ ﻗﺎﺑﻞ ﺍﺳﺘﻔﺎﺩﻩ ﺑﺮﺍﯼ
ﺗﺼﺤﯿﺢ ﯾﺎ ﺗﻐﯿﯿﺮ ﻇﺎﻫﺮ ﻟﺒﺨﻨﺪ ﻟﺜﻪﺍﯼ ﺧﻮﺩ ﻣﻄﻠﻊ
ﻧﯿﺴﺘﻨﺪ . ﺍﮔﺮ ﻭﺟﻮﺩ ﻟﺒﺨﻨﺪ ﻟﺜﻪﺍﯼ ﺑﺎﻋﺚ ﺷﻮﺩ ﺯﻧﺪﮔﯽ
ﻓﺮﺩ، ﺭﺍﺣﺘﯽ، ﻭ ﺍﻋﺘﻤﺎﺩ ﺑﻪ ﻧﻔﺲ ﻭﯼ ﺗﺤﺖ ﺗﺎﺛﯿﺮ
ﻗﺮﺍﺭ ﮔﯿﺮﺩ، ﺷﺎﯾﺪ ﺯﻣﺎﻥ ﺁﻥ ﺑﺎﺷﺪ ﮐﻪ ﮐﺎﺭﯼ ﺑﺮﺍﯼ
ﺁﻥ ﺍﻧﺠﺎﻡ ﺷﻮﺩ . ﺩﺭ ﺍﯾﻦ ﺭﺍﺑﻄﻪ ﺭﻭﺵﻫﺎﯼ ﻣﺨﺘﻠﻔﯽ
ﺑﺮﺍﯼ ﺣﻞ ﻣﺸﮑﻞ ﻭﺟﻮﺩ ﺩﺍﺭﺩ . ﺑﺮﺍﯼ ﺍﯾﻦ ﮐﺎﺭ ﺍﺑﺘﺪﺍ
ﺷﻤﺎ ﻧﯿﺎﺯ ﺑﻪ ﻣﻌﺎﯾﻨﻪ ﯾﮏ ﺩﻧﺪﺍﻥﭘﺰﺷﮏ ﺑﺮﺍﯼ ﺗﻌﯿﯿﻦ
ﻭﺟﻮﺩ ﻟﺒﺨﻨﺪ ﻟﺜﻪﺍﯼ ﺩﺭ ﺻﻮﺭﺕ ﺧﻮﺩ ﻫﺴﺘﯿﺪ. ﺩﺭ
ﺍﯾﻦ ﺣﺎﻟﺖ ﺗﺸﺨﯿﺺ ﺩﻗﯿﻖ ﻋﻠﺖ ﻫﻤﻮﺍﺭﻩ ﻣﯽﺗﻮﺍﻧﺪ ﻣﺎ
ﺭﺍ ﺑﻪ ﺳﻤﺖ ﺑﻬﺘﺮﯾﻦ ﺭﺍﻫﮑﺎﺭ ﻫﺪﺍﯾﺖ ﮐﻨﺪ

● ﻟﺒﺨﻨﺪ ﻟﺜﻪ ﺍﯼ یا Gummy Smile / بخش اول

ﮔﺎﻫﯽ ﺍﻭﻗﺎﺕ ﺑﻪ ﺍﻓﺮﺍﺩﯼ ﺑﺮﻣﯽ ﺧﻮﺭﯾﻢ ﮐﻪ ﺑﻪ ﻫﻨﮕﺎﻡ ﻟﺒﺨﻨﺪ ﻣﻘﺪﺍﺭ ﺯﯾﺎﺩﯼ ﺍﺯ ﻧﺴﺞ ﻟﺜﻪ ﺁﻧﻬﺎ ﻣﺸﺨﺺ ﻣﯽ ﺷﻮﺩ. ﻋﻠﺖ ﺍﯾﻦ ﻋﺎﺭﺿﻪ ﻣﯽ ﺗﻮﺍﻧﺪ ﺑﻠﻨﺪ ﺑﻮﺩﻥ ﺍﺭﺗﻔﺎﻉ ﻓﮏ ﺑﺎﻻ ، ﮐﻮﺗﺎﻩ ﺑﻮﺩﻥ ﻟﺐ ﺑﺎﻻ ﯾﺎ ﮐﻮﺗﺎﻩ ﺑﻮﺩﻥ ﺩﻧﺪﺍﻥ ﻫﺎ ﺑﺎﺷﺪ. ﺩﺭﻣﺎﻥ ﺍﯾﻦ ﻧﺎﻫﻨﺠﺎﺭﯼ ﺩﺭ ﻣﻮﺍﺭﺩ ﭘﯿﺸﺮﻓﺘﻪ ﺟﺮﺍﺣﯽ ﻓﮏ ﻭ ﺻﻮﺭﺕ ﻭ ﺩﺭ ﻣﻮﺍﺭﺩ ﺧﻔﯿﻒ ﺗﺮ ، ﺟﺮﺍﺣﯽ ﻟﺜﻪ ﺍﺳﺖ . ﺩﺭ ﺻﻮﺭﺗﯽ ﮐﻪ ﻃﻮﻝ ﺩﻧﺪﺍﻥ ﻧﯿﺰ ﮐﻮﺗﺎﻩ ﺑﺎﺷﺪ ، ﺑﻬﺘﺮ ﺍﺳﺖ ﺍﺑﺘﺪﺍ ﻟﺜﻪ ﺑﯿﻤﺎﺭ ﺗﻮﺳﻂ ﺟﺮﺍﺣﯽ ﺑﺎﻻﺗﺮ ﺑﺮﺩﻩ ﺷﻮﺩ ﻭ ﺳﭙﺲ ﺑﺎ ﺍﺳﺘﻔﺎﺩﻩ ﺍﺯ ﻻﻣﯿﻨﯿﺖ ﭼﯿﻨﯽ ﯾﺎ ﮐﺎﻣﭙﺎﺯﯾﺖ ، ﺍﺭﺗﻔﺎﻉ ﺩﻧﺪﺍﻥ ﻫﺎ ﺗﺼﺤﯿﺢ ﺷﻮﺩ.

ﺩﺭ ﻣﻮﺍﺭﺩﯼ ﮐﻪ ﻟﺜﻪ ﻫﺎ ﺩﺭ ﯾﮏ ﯾﺎ ﭼﻨﺪ ﺩﻧﺪﺍﻥ ﺑﺎﻻﺗﺮ ﯾﺎ ﭘﺎﯾﯿﻦ ﺗﺮ ﺍﺯ
ﺳﺎﯾﺮ ﺩﻧﺪﺍﻥ ﻫﺎ ﺑﺎﺷﻨﺪ، ﭘﯿﺶ ﺍﺯ ﺩﺭﻣﺎﻥ ﺗﺮﻣﯿﻤﯽ ﻭ ﺯﯾﺒﺎﯾﯽ ﺑﻬﺘﺮ
ﺍﺳﺖ ﺟﺮﺍﺣﯽ ﻟﺜﻪ ﺩﺭ ﺣﺪ ﻃﺒﯿﻌﯽ ﺧﻮﺩ ﻗﺮﺍﺭ ﺩﺍﺩﻩ ﺷﺪﻩ ﺗﺎ ﺑﺎ ﺳﺎﯾﺮ ﻗﺴﻤﺖ ﻫﻤﺎﻫﻨﮓ ﺑﻪ ﻧﻈﺮ ﺑﺮﺳﻨﺪ