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 عواملی که می توانند باعث فرسایش مینای دندان شوند شامل عادت های ناصحیح مسواک زدن، رفلکس معده (رفکس اسیدی) و پرخوری عصبی (که بطور مداوم دندان ها را در معرض اسید معده قرار می دهد و می تواند باعث فقر مواد غذایی مورد نیاز برای دندان شود) هستند. اصطکاک، سایش، فرسایش، استرس، و خوردگی (یا هر ترکیب از این عوامل) می تواند باعث از بین رفتن سطح رویی دندان شود. اصطلاحات تخصصی تری که برای توضیح این مکانیزم ها استفاده می شود شامل موارد زیر هستند:

ساییدگی: این پدیده مربوط به سایش طبیعی دندان ها به یکدیگر است که در زمان ساییده شدن دندان ها هنگام دندان قروچه به خصوص در زمان خواب مشاهده می شود.
خراشیدگی: این موضوع مربوط به فرسایش سطح دندان به خاطر استفاده آنها است که در هنگام مسواک زدن شدید دندان ها، نخ دندان کشیدن نا مناسب، گاز گرفتن اجسام سخت (همچون ناخن، سر بطری، یا خودکار)، یا جویدن تنباکو هم ممکن است ایجاد شود.
شکستگی های ریز: این مشکل در نتیجه ترک های ریز در دندان همچون ترک های ناشی از جویدن غذا ایجاد می شود.
خوردگی: این مشکل ریشه شیمیایی دارد و هنگامی ایجاد می شود که مواد اسیدی موجود در مواد مصرفی مثل داروی آسپرین یا قرص های ویتامین، غذاهای به شدت اسیدی و نیز برگشت اسید معده، استفراغ مکرر ناشی از پر خوری یا مصرف الکل با سطح دندان تماس پیدا می کند.

ترميم آمالگام

 معمول ترين ماده ترميمي است كه بيش از صد سال است كه استفاده مي شود. ماده اي با دوام، با كاربرد آسان، بسيار مقاوم به سايش و نسبت به ساير مواد ارزانقيمت مي باشد. به دلايل مذكور، سالها است اين ماده ، بعنوان انتخاب اول در بسياري از موارد، چه از نظر دندانپزشك و چه از نظر بيمار باقيمانده است. آمالگام بر اساس نظر بسياري سازمانهاي معتبر جهاني كه در رابطه با سلامت افراد كار مي كنند، ماده اي بي خطر، قابل اطمينان و مؤثر در ترميم دندان مي باشد. به دليل تحمل بسيار بالاي آمالگام نسبت به نيروهاي قوي جويدن ،بويژه در ترميم دندانهاي آسيا در خلف دهان كه نيروهاي جويدن به شدت اعمال مي شوند، توصيه مي شود. موارد بسيار اندكي از حساسيت افراد نسبت به آمالگام تا كنون گزارش شده است. معايب آمالگام عبارتنداز: حساسيت كوتاه مدت دندان نسبت به سرما و گرما پس از ترميم دندان، رنگ نقره اي ترميم كه از نظر زيبايي مطلوب نيست(بويژه هنگامي كه دندان ترميم شده در ناحيه قدامي دهان باشد)، مشهود بودن ترميم هنگام خنديدن و صحبت كردن شخص و بالاخره تراش دندان، دندانپزشك ممكن است در ترميمهاي آمالگام نسبت به ساير مواد ترميمي ميزان بيشتري از ساختمان دندان را بردارد تا آمالگام با دندان تطابق يابد.

ترميم كامپوزيت

كامپوزيت تركيبي از يك رزين آكريليك و ذرات نرم شبيه شيشه مي باشد كه ترميمي همرنگ دندان را به ما مي دهد. دوام و مقاومت به شكستگي كامپوزيت در حفرات كوچك تا متوسط با نيروهاي جويدن متوسط خوب است. ميزان كمتري از ساختمان دندان، در طي تراش دندان براي ترميم با كامپوزيت برداشته مي شود و اين امر منجر به داشتن ترميمي كوچكتر نسبت به آمالگام مي شود. كامپوزيت ها با مواد چسبنده به ساختمان دندان متصل مي شوندو دندان پزشك مي تواندترميم محافظه كارانه تري انجام دهد. در دندانهاي تحت نيروهاي مضغي شديد، ترميمهاي كامپوزيت مقاومت متوسطي نسبت به سايش دارند كه ميزان آن كمتر از مقاومت آمالگام است. قيمت آن متوسط است و به سايز حفره ترميمي و تكنيكي كه دندانپزشك براي جايگزيني آن در حفره انتخاب مي كند، بستگي دارد. زمان لازم براي قرار دادن يك ترميم كامپوزيت معمولاً بيشتر از آمالگام است. در ترميم كامپوزيت بايد بتوان حفره را در طي انجام ترميم، خشك و تميز نگهداشت. اين نوع ترميم ممكن است به مرور زمان دچار تغيير رنگ شود.

نيومرها

گلاس آينومرها موادي همرنگ دندان هستند كه از مخلوط اسيد آكريليك و پودر شيشه نرم تهيه مي شوند و براي ترميم حفرات بويژه در سطح ريشه دندانها استفاده مي شوند. گلاس آينومرها مقادير اندكي فلورايد آزاد مي سازندكه براي بيماران در معرض خطر بالاي پوسيدگي ممكن است مفيد باشد. ميزان تراش دندان و در نتيجه وسعت ترميم نهايي در ترميم با گلاس آينومر كوچكتر از آمالگام است. گلاس آينومر در ترميم هاي كوچك كه تحت فشارهاي مضغي قوي نيست، استفاده مي شود، چون مقاومت اندكي نسبت به شكستگي دارند، اغلب در حفرات كوچكي كه تحت فشار نيستند(بين دندانها) يا روي ريشه دندانها استفاده مي شوند. رزين آينومرها هم از فيلر شيشه و اسيدهاي آكريليك و رزين آكريليك تشكيل شده اند. آنها نيز مقاومت كم تا متوسطي نسبت به شكستگي داشته و در ترميم هايي كه تحت فشار نيست( بين دندانها) بكار مي روند. آينومرها در سطوح اكلوزال دچار سايش زيادي مي شوند. هم گلاس و هم رزين آينومرها رنگ طبيعي دندان را تقليد مي كنند ولي شفافيت مينا را ندارند. هردو بخوبي توسط بيماران تحمل مي شوند و به ندرت واكنش آلرژيك ديده شده است.

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مراقبتهاي بعد از ترميم

1 – پر کردن دندان با آما لگام مدت زماني نياز دارند که کاملاً سفت و سخت شوند بنابراين تا 2 ساعت بعد از تر ميم چيزي خورده نشود و تا 24 ساعت از سمت ديگر غذا خورده شود .
2 – درد و حساس شدن پس از تر ميم بعلت تراش و ناحيه تزريق طبيعي بوده ودر صورت ادامه بيش .از دو روز به دندانپزشک مراجعه شود
3- بهتر است پس از مصرف غذاهاي رنگي نظير چاي , قهوه , شکلاتهاي کاکائو دار و کشيدن سيگار بعلت آنکه ترميمهاي همرنگ يا کامپوزيت رنگها را بخود جذب مي کنند و تغيير رنگ مي .دهند, دهان آب کشيده شده و مسواک زده شود
4 – حساس بودن دندانها به مايعات و غذاهاي سرد و گرم تا يک ماه اول طبيعي بوده و چنانچه در . اين مدت از شدت آن کاسته نشد حتماً به دندانپزشک مراجعه شود
5 – دندانهاي ترميم شده مقاومت و استحکام کمتري نسبت به دندانهاي طبيعي دارند بنابراين خوردن غذاهاي سفت و شکننده با آن خصوصاً در تر ميمهاي بزرگ نظير پسته , فندق , يخ , ته ديگ , استخوان , شکلاتهاي سفت , آب نبات و… مجاز نميباشد زيرا باعث شکستن ترميم يا . .ديواره هاي باقيمانده دندان ميگردد
6 – دندانهاي ترميم شده مي توانند مجداً پوسيده شوند بنا براين ر عايت بهداشت دهان و دندان .نظير مسواک زدن و کشيدن نخ دندان الزاميست

از سری مطالب پزشکی عمومی و غیر تخصصی سایت (اطلاعات  عمومی و غیر تخصصی پزشکی برای افزایش دانش سلامت  و اطلاعات عمومی پزشکی بازدیدکنندگان)