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مقالات ارتودنسی

تاریخ انتشار: شنبه 10 مرداد 1394
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منظور از ارتودنسی ثابت این است که بیمار نمی تواند دستگاه ارتودنسی را از دهان خارج نماید. در دستگاه ارتودنسی ثابت اجزا به صورت نگین هایی برروی دندان چسبانده شده و ثابت می گردند. این نگین ها اصطلاحاً براکت نام دارند و یک سیم از بین این براکتها گذرانده می شود که با کش های ظریفی که به دور براکت ها انداخته می شود(و می توانند رنگی باشند) در جای خود ثابت می شوند. این کشها هر جلسه تعویض می شوند ولی سیم ها ممکن است هر جلسه عوض نشود و براکت ها هم که تا پایان درمان باقی می مانند. این روش درمانی برخلاف درمان های متحرک، تا حدی وابسته به همکاری بیمار می باشد.

طول درمان ارتودنسی ثابت بین 8 تا 18 ماه می باشد ولی براساس نوع ناهنجاری بیمار و شدت مشکل ممکن است بیشتر هم بشود. بیمار در طول دوره ی درمانی ثابت نباید غذاهایی با قوام سفت مثل ته دیگ، بلال، میوه های هسته دار، زیتون و غیره را استفاده نماید. در غیر این صورت براکت از دندان جدا می شود که می بایست براکت جدیدی برای بیمار چسبانده شود که این امر می تواند باعث طولانی شدن زمان درمان و آسیب به دندان گردد. در این دوره بیمار از نظر بهداشت، به مراقبت های خاصی نیاز دارد تا از ایجاد تغییر رنگ و پوسیدگی در دندان ها جلوگیری به عمل آید.

گاهی به دلیل عدم همخوانی اندازه ی فک ودندان ها و یا وجود مشکل های فکی متوسط که امکان جفت شدن قابل قبول دندان ها را میسر نمی کند (وقتی بیمار بعد از بلوغ مراجعه کرده و امکان اصلاح روابط فکی نیست و تمایل به جراحی نیز وجود ندارد)،باید از دندانهای دائمی بیمار کشیده شود.

« بهترین زمان ارتودنسی »

زمانی که ساختمانهای صورت در حال رشد و نمو هستند اصلاح روابط آنها معمولاً با هدایت صحیح روند رشد آنها انجام می شود . بنابراین اعمال ارتودنسی در این زمان راحت تر و ساده تر است و به زمان کمتری نیاز دارد . از طرفی میزان موفقیت های درمانهای ارتودنسی در این دوره زیادتر است .

بعد از کامل شدن رشد و شکل گرفتن روابط ساختمانهای صورت با یکدیگر ، در صورتی که این روابط نادرست باشد تصحیح این روابط ، زمان ، کار وانرژی بیشتری نیاز دارد و میزان موفقیت درمان کمتر است . بهترین سن مراجعه جهت معاینه ارتودنسی هنگام رویش دندانهای دائمی جلو است .

اکثر درمانهای ارتودنسی که در آنها نیاز به تصحیح روابط اسکلتی فک باشد بهتر است در دختر بچه ها قبل از ۱۳ سالگی و در پسر بچه ها قبل از ۱۵ سالگی انجام شود . بهر حال والدین باید توجه داشته باشند که هرگاه ناهنجاریهای قابل توجهی در فک و دندانهای کودک مشاهده کردند یا کودک آنها دچار عادات غلط نظیر مکیدن انگشت است باید هر چه زودتر به متخصص ارتودنسی مراجعه کنند .

* چگونه از ابتلا به ناهنجاریهای فک و صورت پیشگیری کنیم ؟

اگر چه ارث نقش مهمی درایجاد ناهنجاریهای فک و صورت دارد ولی با رعایت موارد زیر میتوان تا حد زیادی از این ناهنجاریها جلوگیری کرد :

۱ - اهمیت دادن به دندانهای شیری و مراقبت از آنها ؛ بی توجهی به دندانهای شیری باعث از دست رفتن زودهنگام این دندانها و رویش نادرست دندانهای دائمی می شود . بعد از رویش دندانهای شیری باید کودک را جهت مسواک کردن دندانهایش کمک کنیم . بهتر است والدین برای مدتی دندانهای کودک را مقابل آینه مسواک کنند تا کودک طریقه مسواک کردن صحیح را یادبگیرد . اگرکودک اصرار دارد که خودش دندانهایش را مسواک کند والدین باید همزمان با کودک دندانهایشان را مسواک کنند تا کودک روش مسواک کردن را یاد بگیرد .

بهترین سن مراجعه جهت معاینه ارتودنسی هنگام رویش دندانهای دائمی جلو است .

۲ - مراجعه به موقع و منظم به دندانپزشک ؛ مشاوره با دندانپزشک ، بخصوص بعد از رویش اولین دندانهای دائمی می تواند از ابتلا به بسیاری از ناهنجاریهای فک و صورت جلوگیری کند .

۳ - جلوگیری از ایجاد عادتهای غلط در کودک ؛ بعضی از عادتهای غلط کودکان عبارتست از : مکیدن انگشت ، فشردن زبان به طرف جلوی دهان ، مکیدن یا جویدن لب و جویدن ناخن .

در مورد چگونگی ایجاد ناهنجاریهای در اثر این عادت ها مختصیری توضیح می دهیم .

* مکیدن انگشت :

مکیدن انگشت شست یا انگشتان دیگر یکی از عادتهایی است که در زمان نوزادی ممکن است در کودک وجود داشته باشد . گر چه این عمل در نوزاد ممکن است نشانگر گرسنگی و اخطاری به والدین جهت توجه به تغذیه او باشد ، ولی باقی ماندن این عادت بعد از دو یا سه سالگی می تواند عامل پیدایش تغییرات دائمی در استخوان و دندانهای فک بالای کودک باشد .

بعضی از کودکان در زمان رویش دندانهایشان دوست دارند انگشتان یا دست خود را داخل دهان ببرند ، چون فشار روی لثه در زمان رویش دندانها باعث آرامش کودک می شود . می توان از وسایل بهداشتی که به عنوان دندانگیر وجود دارد ، استفاده کرد تا مکیدن انگشت برای کودک عادت نشود .

در اثر فشار مداوم انگشت روی دندانها و استخوان جلو سقف دهان ، این ناحیه به طرف بالا متمایل و به تدریج فاصله آن از فک پائین بیشتر می شود . همچنین دندانهای پیشین فک بالا به طرف خارج و دندانهای پیشین فک پائین به سمت داخل منحرف می شوند و بین دندانهای فک بالا و پائین فاصله ایجاد می شود . به طوری که فک بالا و پائین دندانها در ناحیه جلوی دهان به هم نمی رسند .

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