Ngā Momo Reera mō te Maimoatanga Niho
Kei te tere tonu te whanaketanga o ngā hangarau i roto i te mahi niho, ko tētahi tauira ko te whakamahinga o ngā rēseri. Ahakoa i mua he maha ngā tikanga niho i honoa ki te mamae, ki ngā haruru keri e whakararuraru ana i ngā io, me te toto i muri i te tikanga, i ēnei rā he maha ngā momo rēseri e tuku ana i tētahi wheako maimoatanga whakamarie ake, tika ake, ā, he maha ngā wā ka tere ake te whakaora. Heoi, kāore i te rite te mahi a ngā rēseri katoa. He rerekē ngā āhuatanga, ngā roangaru, me ngā tohu haumanu o ia momo. Nō reira, mā te mārama ki ngā momo kōwhiringa rēseri mō te maimoatanga niho ka āwhina i ngā tūroro ki te mārama ki te tikanga, ā, ka āwhina i ngā wāhi rongoā ki te whiriwhiri i te taputapu tika.
He aha te mahi a te laser i roto i te mahi niho?
He hihi mārama kaha-teitei te taiaho e arotahi ana ki tētahi roangaru motuhake. Ina tukuna ki te niho, ki ngā kiko ngohengohe rānei (ngā kapia), ka taea e te kaha taiaho te tapahi, te mimiti, te whakaiti i ngā huakita, te whakaoho rānei i te whakaora, i runga i te momo taiaho me te tautuhinga mana. Ka taea e ngā taiaho te whakakapi, te tāpiri rānei i ngā taputapu tuku iho pērā i ngā maripi, ngā wiri, me ngā kurete mō te horoi.
I te nuinga o te wā, ka taea te wehewehe i ngā reera niho ki ngā rōpū matua e rua: ngā reera kiko ngohengohe me ngā reera kiko mārō. Kei reira anō hoki ngā reera e whakamahia nuitia ana mō te rongoā (pēnei i te rongoā reera taumata-iti) i te mea mō ngā tikanga tapahi.
1. Taiaho Diode
Ko ngā taiaho diode tētahi o ngā taiaho tino kitea i roto i ngā whare niho nā te mea he iti te rahi me te whānui o te whakamahinga ki ngā kiko ngohengohe. Ko te tikanga ka mahi ēnei taiaho i ngā roangaru o te 810–980 nm.
Ngā whakamahinga matua:
– Te tapahi me te hanga i ngā kapia (gingivectomy/gingivoplasty)
– Te rongoā i ētahi mumura o ngā kapia me ngā pute niho hei rongoā tāpiri
– Te tango i te frenulum i te ngutu, i te arero rānei (frenectomy)
– Whakaora i ētahi mate pukupuku, i ngā whara kiko ngohengohe, i te āwhina rānei i te hemostasis (te whakaiti i te toto)
– Āwhina i ngā tikanga whakapaipai pēnei i te whakatikatika i te menemene kapia i ētahi wā
Te taikaha:
– He pai te hemostasis (he iti te toto)
– He maha ngā tukanga ka taea te mahi tere ake
– I ētahi wā, he māmā ake te mamae i muri i te pokanga
Te Whakatakotoranga:
– Kāore i te pai mō te tapahi i ngā kiko mārō pērā i te enamel niho, te wheua rānei
– Me whai mana hangarau kia kore ai e kino te kiko e karapoti ana i te wera.
2. Nd: YAG (Neodymium-Doped Yttrium Aluminium Garnet) Taiaho
Ko te roanga ngaru o te mahi a te taiaho Nd:YAG he 1064 nm te roa, ā, he hohonu ake te urunga ki roto i ngā kiko ngohengohe i ētahi atu taiaho. I roto i te mahi niho, he maha ngā wā ka whakamahia te Nd:YAG mō ngā tikanga niho me ētahi tikanga kiko ngohengohe.
Ngā whakamahinga matua:
– He rongoā tāpiri mō te periodontitis (te whakaiti i te nui o ngā huakita i roto i ngā pute o te kapia)
– Te tapahi i ētahi kiko ngohengohe
– Te toto totoka hei whakahaere i te toto
Te taikaha:
– He whai hua mō te whakahaere i te toto
– Ka āwhina i te patu huakita i ētahi wāhi hei wāhanga o te rongoā niho.
Te Whakatakotoranga:
– Nā te hohonu o te urunga, me whakangungu ngā kaiwhakahaere kia kore ai e wera rawa.
– Ehara i te mea koinei te kōwhiringa tuatahi mō ngā tikanga mō ngā kiko mārō
3. Rēhia Er:YAG (Erbium:YAG)
Ko te reihi Er:YAG te mea e pai ake ana mō ngā tikanga kiko mārō. Ko tōna roangaru, tata ki te 2940 nm, ka mimitihia e te wai me te hydroxyapatite (he wāhanga kohuke o ngā niho). Nō reira, he whai hua tēnei reihi mō te tapahi i te enamel me te dentin me te tino tika.
Ngā whakamahinga matua:
– Te whakarite poka (tango i ngā pirau niho) mō ngā whakakī
– Ka tango i ētahi anga niho, ā, ka āwhina i te maimoatanga niho i ētahi wāhi
– Ngā mahi ki ngā kiko mārō me ngā kiko ngohengohe i raro i ngā tohu motuhake
Te taikaha:
– Ka taea te whakamahi ki ngā niho (enamel/dentin)
– Mō ētahi tūroro, ka whakaitihia te hiahia mō te rongoā whakamoe nā te iti ake o te wiri i te wiri.
– He tika te mahi, ā, ka whakaitihia te kino ki ngā kiko e karapoti ana
Te Whakatakotoranga:
– He nui ake te utu o ngā taputapu
– Ehara i te mea he pai ngā take pirau katoa; i ētahi wā me wiri tonu kia tino oti ai.
4. Laser Er,Cr:YSGG (Erbium, Chromium:YSGG)
Ko te roanga ngaru o te taiaho Er,Cr:YSGG kei te 2780 nm pea, ā, he whai hua anō hoki ki ngā kiko mārō nā te mea he nui te mimiti wai. E mōhiotia ana tēnei taiaho mō tana hangarau rehu wai hei āwhina i te whakahaere i te wera i te wā e tapahi ana i te kiko.
Ngā whakamahinga matua:
– Te whakarite i ngā whakakī me te tango i ngā pirau niho
– Te tapahi i ētahi kiko ngohengohe
– Te maimoatanga niho i roto i ētahi tohu
– Te āwhina i ngā pokanga iti ki ngā kiko o te waha
Te taikaha:
– Ka taea te whakahaere i ngā kiko mārō me ngā kiko ngohengohe
– He pai ake te whakahaere wera nā te whakakotahitanga o te wai me te pūngao taiaho
– He mea ngāwari ki ētahi tūroro
Te Whakatakotoranga:
– Me whakangungu te pihi ako me te whakatakoto tawhā
– He nui te utu haumi mō ngā taputapu
5. Rēhia CO₂ (Waro Hauhā)
E mahi ana te taiaho CO₂ i te roanga ngaru o te 10.600 nm, ā, he tino mimiti te wai, he tino whai hua ki ngā kiko ngohengohe. Nā tēnei i rongonui ai i roto i te pokanga waha me te whakahaere whara.
Ngā whakamahinga matua:
– Te tango i ngā whara o te kiko ngohengohe (hei tauira, ētahi fibromas, kiko hyperplastic)
– Te tango i te kapia me te hanga i ngā āhua motuhake o te kapia
– Āwhina i te whakahoromata me te whakapūmau i te mata
Te taikaha:
– He tino whai hua te tapahi i ngā kiko ngohengohe
– He iti rawa te toto, ā, he maroke ake te wāhi mahi
– He māmā ake te pupuhi pea i muri i te tikanga i ētahi wā.
Te Whakatakotoranga:
– Kāore e whakamahia mō ngā mahi niho (kiko mārō)
– Me whai haumarutanga tāpiri nā te āhua o te mārama
6. Ākoni Taiaho (kāore i te tino whakamahia)
Kāore i te tino whakamahia ngā taiaho argon i ēnei rā i ērā atu whakatupuranga taiaho. Heoi, i ngā wā o mua, kua whakamahia ngā taiaho argon mō ētahi tikanga kiko ngohengohe me te ataahua nā runga i ā rātou taunekeneke ahurei ki ētahi tae me ngā rauemi.
Te whakamahinga (he iti, ā, e whakawhirinaki ana ki te taputapu):
– Ētahi tikanga kiko ngohengohe
– Ētahi whakamahinga i roto i te whakapūhuitanga o ngā rauemi whakaora i te wā o mua (me ngā herenga)
Ngā Kōrero:
I ēnei rā, he maha ngā wāhi rongoā e whiriwhiri ana i te diode, te erbium, te Nd:YAG, te CO₂ rānei nā te mea he ngāwari, he whānui ake hoki te tautoko i ngā taputapu hou.
7. Te Whakaora Taiaho Taumata-Iti (LLLT) / Te Whakarerekētanga Whakaahua
He rerekē ki ngā taiaho "pokanga" e tapahi ana i te kiko, ka whakamahia e te LLLT te pūngao iti-pūngao hei whakaora. Ehara i te mea ko te waru, ko te tapahi rānei te whāinga, engari ko te āwhina i te whakaiti i te mamae me te mumura me te whakaoho i te whakatikatika kiko.
Ngā whakamahinga matua:
– Te whakaiti i te mamae i muri i ētahi maimoatanga (hei tauira, i muri i te tango niho, i te maimoatanga periodontal rānei)
– Ka āwhina ki te whakaora i ngā mate pukupuku (ngā mate pukupuku aphthous) i ētahi wā
– Āwhina ki te whakaiti i te mumura o te TMJ/te mamae o ētahi uaua hei rongoā tāpiri
Te taikaha:
– Kāore e pokanoa, ā, he tino whakamarie
– He rongoā tautoko pai pea mō ētahi tūroro
Te Whakatakotoranga:
– He tino whakawhirinaki te whai huatanga ki te tātaritanga me te tikanga mahi
– Kāore e whakakapi i te rongoā tuatahi mēnā he pūtake mate, he pirau kiri rānei kei te kaha haere.
Me pēhea te whiriwhiri i te taiaho "tika"?
Ko te whiriwhiri i te momo laser ka whakatauhia e etahi mea:
1. Momo kiko e arotahihia ana: kiko ngohengohe me te kiko mārō.
2. Te kaupapa o te tikanga: te tapahi, te patu huakita, te whakaiti i te huakita, te hanga āhua ataahua, te whakaora rānei.
3. Āhua o te tūroro: hei tauira, te paepae mamae, te hiahia kia whakahaerea te toto, te hītori o ētahi mate, me te taumata o te manukanuka.
4. Te tohungatanga o te kaiwhakahaere me ngā tikanga haumanu: he mea nui ngā tawhā taiaho (mana, roa, aratau pā) mō te haumaru.
5. Te utu me te wātea o ngā taputapu: ko ētahi pūnaha taiaho e hiahia ana ki ngā haumitanga nui me te tiaki auau.
Te haumaru me ngā mea e tika ana kia mōhiotia e ngā tūroro
He haumaru te nuinga o ngā tikanga tātai niho ina mahia e te tākuta niho whakangungua, ā, e whai ana i ngā tikanga tika. Ko te tikanga, ka mau ngā tūroro me ngā kaimahi hauora i ngā karu tiaki e tika ana mō te momo tātai. Hei tāpiri, me pātai ngā tūroro:
– He aha ngā tohu mō te whakamahinga o te taiaho i tēnei take?
– Me whai tonu te rongoā whakamoe?
– Kei te pēhea te tiaki i muri i te pokanga?
– He aha ngā mōrearea ka pā mai (hei tauira, te werawera, te mamae ngawari, te pupuhi rānei)?
Te Katinga
Kua noho ngā reera hei wāhanga nui o te mahi niho hou, e tuku ana i te huinga o te tika, te whakamarie, me te whai huatanga. He painga motuhake tō ngā reera pēnei i te diode, Nd:YAG, Er:YAG, Er,Cr:YSGG, me te CO₂ i runga i te kiko e hiahiatia ana me ngā hiahia o te tikanga. I taua wā, ka mahi te LLLT hei rongoā tautoko mō te whakaora me te whakaiti i te mamae. Hei whakamutunga, ko te kōwhiringa pai ehara i te mea ko tēhea reera te mea tino matatau, engari ko tēhea e pai ana ki tō tātaritanga, ki ngā whāinga maimoatanga, me te haumaru o te tūroro. Whakawhitiwhiti kōrero ki tō tākuta niho kia tino whiwhi koe i te mahere maimoatanga tika me ngā hua tino pai.
