Te Tukanga Horoi Io Niho
Ko te maimoatanga pakiaka—e kiia ana ko te pakiaka i roto i te mahi niho—he tikanga hei rongoā i te mate, i te mumura rānei i roto i te kiko o roto rawa o te niho (pulp), te wāhi kei reira ngā io me ngā uaua toto. He tokomaha e whakaaro ana he hononga tēnei tikanga ki te mamae, ki te "io" rānei o te niho, ka pakarukaru. Heoi, ki te tika te mahi, ko te whāinga o te maimoatanga pakiaka he tiaki i te mahi tūturu o te niho, kia taea ai e ia te ngaungau me te pupuri i te hanganga o te kauae.
E matapakihia ana i roto i tēnei tuhinga te wā e hiahiatia ai tēnei tikanga, ngā mahi e whai wāhi ana, ngā wheako o te tūroro, me te tiaki i muri i te maimoatanga kia tino pai ai ngā hua.
He aha ngā io niho, ā, he aha ai e raru ai?
Kei roto i te niho te rūma penupenu, kei reira ngā io, ngā oko toto, me te kiko honohono. Ka whakaratohia e te penupenu te kare ā-roto (pērā i te mamae i te makariri, i te wera rānei) ā, ka āwhina i te hanga i te kiko niho i te wā e whanake ana. Heoi, i te pakeketanga o te niho, ka iti ake te hiranga o te mahi a te penupenu nā te mea ka taea e te niho te ora i waho o te kiko e karapoti ana i te pakiaka.
Ka puta ngā raruraru ina riri, ina mumura, ina pangia rānei te penupenu, nā te mea i te nuinga o te wā:
1. Ngā kare ā-whatu (ngā kōhao) e hōhonu ana tae noa ki te penupenu.
2. I turuturu te wāhi tawhito, ā, ka taea anō e ngā huakita te tomo mai.
3. Ngā niho pakaru, ngā niho whati rānei nā te pānga, nā te mahi rānei ki te kuru i ngā niho (bruxism).
4. Ngā tukanga whakakī anō e pēhi ana i te penupenu.
5. Ētahi mate kapia kino ka pā ki te kiko tautoko o ngā pakiaka.
Ki te kore te mate e rongoatia, ka horapa te huakita ki te pito o te pakiaka, ka puta he whewhe (he pute wai). Koia te take he mea nui te horoi i ngā io o ngā niho hei whakaora i te ora.
Ngā Tohu me ngā Tohu e Tohu Ana ki te Maimoatanga o te Awa Pūtake
Ehara i te mea me horoi te io i ngā mamae niho katoa , engari me tūpato ki ngā tohu e whai ake nei:
– Te mamae e pāorooro ana, e mau tonu ana, inā koa i te pō.
– He mamae koi, ā, ka roa te wā e memeha atu ai i muri i te pāngia e te wera/mātao.
– Te mamae i te ngau, te teitei rānei o ngā niho i te katinga o te waha.
- Ngā kapia pupuhi, ka puta he "whewhe" iti ki te kapia (fistula), ka puta mai rānei he waikura.
- Huringa tae niho (pōuri ake) nā te mate o te penupenu.
– I ētahi wā, kāore he mamae engari e whakaatuhia ana e te hihi-X te mate i te pito o te pakiaka.
Ko te tikanga ka whakaūhia e ngā tākuta niho te mate mā te whakamātautau haumanu, te whakamātautau urupare io (whakamātautau makariri/wera), te whakamātautau patopato, me te hihi-X periapical hei aromatawai i te āhua o te pūtake me te wheua e karapoti ana.
Te Kaupapa o te Horoi i ngā Io Niho
Ka whakahaerehia te maimoatanga o te awa pakiaka ki:
– Te tango i te kiko penupenu kua pangia, kua mate rānei.
– Ka horoi i ngā huakita me ngā para kiko mai i te awa pakiaka.
– Te hanga me te whakahoromata i te awa pakiaka kia rite ai mō te hiri.
- Ārai i te mate te mahi auau me te whakamamae i te mamae.
– Hei tiaki i ngā niho kia kore ai e hiahiatia te tango.
Ara, kāore tēnei tikanga e "whakangaro" i te niho, engari ka rongoā i te pūtake o te raruraru mai i roto i te niho.
Ngā Wāhanga o te Tukanga Horoi Io Niho
Ko te tikanga horoi i te io o te niho ka mahia i roto i te 1-3 haerenga, i runga i te nui o te mate, te maha o ngā awa pakiaka, me te āhua o te niho.
1. Te Whakangote me te Wehenga Niho
Ka hoatu e te tākuta he rongoā whakamoe ā-rohe hei whakangā i te tūroro. Kātahi ka wehea te niho, ka whakamahia he ārai rapa hei pupuri i te wāhi kia maroke, hei ārai hoki i te poke o ngā huakita i te huware.
2. Te whakatuwheratanga o te urunga ki te rūma penupenu
Ka uru paku te tākuta ki te mata o te niho (mai i runga ake i te niho kauae, mai i muri rānei i ngā niho o mua) kia tae atu ai ki te rūma penupenu me te tomokanga ki te awa pakiaka.
3. Te Tango i te Pulp me te Whakatau i te Roa Mahi
Ka tangohia te kiko penupenu kua pakaru mā te whakamahi i tētahi taputapu motuhake (kōnae endodontic). Ka whakatauhia e te tākuta te roa o te awa pakiaka mā te whakamahi i tētahi hihi-X, i tētahi taputapu hiko rānei (apex locator) kia tika ai te horoi, kia tae atu ai ki te pito o te pakiaka me te kore e kino ki te kiko e karapoti ana.
4. Te Horoi me te Hanga i ngā Awa Pūtake
Koinei te wāhanga matua. Ka horoia te awa pakiaka, ka hangaia mā te whakamahi i ngā kōnae ā-ringa, i te mīhini hurihuri rānei. I roto i te tukanga, ka whakamakuku te taote niho ki te wai patu huakita hei patu i ngā huakita me te whakarewa i ngā kiko e toe ana. Ko te whāinga he hanga i tētahi awa ma, maeneene, ā, kua rite ki te whakakī.
5. Rongoā ā-uaua (Mēnā e hiahiatia ana)
Mena he kino te mate, he whēwhe rānei, ka whakanohoia pea e te tākuta he rongoā rangitahi (pēnei i te konupūmā hauwai) ki roto i te awaawa. Kātahi ka hipokina te niho ki tētahi whakakī rangitahi, ā, ka tonoa te tūroro kia hoki mai anō mō tētahi tirotiro whai muri i roto i ētahi rā, i ētahi wiki rānei.
6. Te Whakakī i te Awa Pūtake (Te Whakakī)
Kia ma, kia maroke hoki te awaawa, ka whakakīia te awaawa pakiaka e te tākuta niho ki te rauemi whakakī (ko te tikanga he gutta-percha) me te sima endodontic. Me piri te whakakī kia kore ai e hoki mai ngā huakita.
7. Ngā Whakakī Tuturu me/ranei ngā Karauna
I muri i te whakakī i te awa pakiaka, me whakahoki te niho ki tōna kaha. He maha ngā niho kua rongoatia ki ngā io ka pakarukaru nā te ngaronga o te hanganga nā te pirau, nā te urunga atu rānei ki te maimoatanga. Nō reira, he maha ngā tākuta e kī ana:
– Whakakī tuturu mō ngā kōhao iti, rānei
– Ngā karauna niho (karauna), inā koa mō ngā niho molar e nui ana te ngaungau.
He mea tino nui tēnei wāhanga whakaora. Tērā pea ka kore e angitu te maimoatanga pai mō te awa pakiaka mēnā ka turuturu te whakakī, ā, ka tomo anō ngā huakita.
He mamae tēnei tikanga?
I te wā e whakamahia ana te rongoā whakamoe ā-rohe, kāore te nuinga o ngā tūroro e pāngia e te mamae i te wā e mahia ana, engari he pēhanga iti, he wiri rānei mai i te taputapu. I muri i te tikanga, he mea noa te mamae, te ngawari rānei mō te 1–3 rā, inā koa ka ngau, i te mea ka urutau te kiko huri noa i te pakiaka. Ko te tikanga, ka tohua e ngā tākuta ngā rongoā whakamamae mamae, ā, i ētahi wā, ngā rongoā paturopi (mēnā he whānui te mate me te pupuhi).
Ki te kino haere te mamae, ki te pupuhi, ki te puta rānei te kirika, me hoki tonu te tūroro ki te tirotiro hauora.
Te Wā Tukanga me ngā Take Whakaawe
Ka rerekē te roa o te maimoatanga, hei tauira:
– Ngā niho o mua (1 hongere): he tere ake te āhua.
– Ngā niho mua-molar (1–2 awaawa): he āhua noa iho.
– Ngā niho kōwhao (3–4 ngā awaawa, i ētahi wā he nui ake): he uaua ake.
Ko ētahi atu āhuatanga ko te piko o te pakiaka, te whaiti o ngā awaawa, te nui o te mate, te hoki whakamuri rānei nā te korenga o te maimoatanga o mua.
Te Tiaki i muri i te Horoi i ngā Io Niho
Kia tika ai te whakaora, kia roa ai hoki te ora o ngā niho, me mahi e ngā tūroro ēnei mahi:
1. Kaua e ngaungau i te taha o te niho kua rongoatia kia oti rā anō te whakakī tuturu, te karauna rānei.
2. Tangohia te rongoā e ai ki ngā tohutohu a te tākuta.
3. Kia mau tonu te akuaku o te waha: paraihia ō niho kia rua i te rā, ka mirohia ō niho.
4. Tirohia kia rite ki te wātaka, inā koa mō te aromatawai i te hihi-X mēnā e tika ana.
5. Whakaarohia te tāuta i tētahi karauna mēnā ka tūtohutia e tō tākuta niho—ina koa mō ngā niho molar.
Ngā Tūponotanga me te Tūponotanga o te Rahunga
He nui te angitu o te maimoatanga o te awa pakiaka, engari kei reira tonu ngā tūponotanga pēnei i:
– Ētahi atu awa pakiaka e uaua ana ki te kimi.
– He tino piko, he ārai rānei te paipa.
– Ka turuturu te wāhi/karauna, ka pā anō te mate.
– Ngā pakaru niho kāore i kitea.
Mena ka rahua te niho, ka whakaarohia pea e te tākuta te tango i te niho pakiaka, te pokanga endodontic iti (apicoectomy), te tango rānei mēnā kāore e taea te whakaora.
Te Katinga
He taahiraa nui te tango io hei whakatika i te mate i roto i te niho, me te pupuri tonu i te mahi a te niho tūturu. Ko te kī ki te angitu kei roto i te tautuhi tika, te horoi pai i te awaawa, te whakakī kikī, me te whakaora whakamutunga kaha, ātete turuturu. Mena ka pāngia koe e te mamae niho tonu, te roa o te matekiri, te pupuhi rānei o ngā kapia, me toro atu koe ki te taote niho tonu kia taea ai te tīmata maimoatanga i mua i te kino haere o te mate, me te iti haere o ngā kōwhiringa maimoatanga.
