PsycheDroidმეტნაკლებად. კრიზისი არაა.
shansmanპაციენტის მხრიდან სტერილიზაციის შემოწმების რაიმე მეთოდი არ არსებობს.
ერთ ნათარგმნ სტატიას დავაკოპირებ და იმედია გამოგადგება.
kariesis mkurnaloba
mkurnalobis procesi stomatologiur kabinetSi daTvalierebiT da eqim-stomatologTan konsultaciiT iwyeba. eqimi pacientis Civilebze dayrdnobiT, obieqturi daTvalierebiT da rentgenologiuri gamokvlevis daxmarebiT svams diagnozs, sTavazobs pacients mkurnalobis gegmas da acnobs mis Rirebulebas.
ukeTesia, Tuki pacieni aqtiur monawileobas miiReb Tavisi problemis ganxilvaSi. es eqimisTvisac kargia, radgan Tavidna aicilebs Semdgom problemebs mkurnalobis Sedegebis Sefasebisas rogorc klinikuri, ise finansuri TvalsazrisiT.
raSi gamoixateba pacientis aqtiuroba konsultaciisas? pirvel rigSi, mas SeuZlia dasvas nebismieri kiTxva dagegmil mkurnalobasTan dakavSirebiT, gamoTqvas Tavisi survili rogori Sedegis miReba unda da ra fasad.
daTvalierebisas pacients SeuZlia mosTxovos eqims aCvenos romel kbilze aqvs Rru. amis gakeTeba mosaxerxebelia intaoraluri videokameris saSualebiT. Tumca Cveulebrivi sarkiTac SeiZleba. yvelaze metad informatiuli rentgenis suraTia. masze eqimis pacients SeuZlia eqimis daxmarebiT dainaxos, Tu sadaa lokalizebuli Rru, kbilis gvirgvinis ra nawils ikavebs da ramdenad axlosaa pulpasTan. am informaciaze dayrdnobiT pacients SeuZlia Seafasos ramdenad safuZvliania eqimis mier SemoTavazebuli mkurnalobis gegma da SesaZlo garTulebebis riski.
aRWurviloba
ra SeiZleba “aRmoaCinoT” Tqveni janmrTelobisTvis saintereso stomatologiuri kabinetis daTvalierebisas?
miaqcieT yuradReba rogorc kabinetis, ise pesonalis sisufTaves, rezinis xelTaTmanebis arsebobas rogorc eqimis, ise asistentis xelebze. aseve instrumentebis sterilurobas samuSao magidaze.
stomatologiuri danadgari unda iyos ucxouri. magaliTad ruseTis warmoebis danadgarebi muSaoben zeTis kompresoriT. Sedegad bunikSi miwodebul haerSi ereva zeTis umciresi wveTebi, romelic xvdeba damuSavebuli Rrus zedapirze da SeuZlebels xdis Tanamedrove sabJeni masalebis gamoyenebas.
sxva danadgarebs rac Seexeba, aucilebelia iyos “terminatori” bunikebis dasamuSaveblad, ultaiisferi karada an specialuri magida steriluri iaraRebis Sesanaxad da baqtericiduli lampa kabinetis dezinfeqciisTvis.
sabJeni masalis arCeva.
pacientma unda airCios sabJeni masala: amalgama, qimiurad gamyarebadi kompoziti (SedarebiT iaffasiani) an sxiviT gamyarebadi (SedarebiT Zviri). riTi gansxvavdebian isini fasis garda?
amalgama _ saimedo metalis bJenia, Tumca araesTetiuri. garda amisa amalgamis bJenebi mavnebelia maTSi vercxliswylis Semcvelobis gamo. ZiriTadad maT akeTebn saReW kbilebze gvirgvinis qveS.
qimiuri gamyarebis kompozitebi _ rogorc dasaxelebidanac Cans myardeba qimiuri reaqciis xarjze, romelic mimdinareobs pasta-bazissa da pasta-katalizators Soris. es masala myaria, ar ixsneba nerwyvSi. nakls warmoadgens SezRuduli ferTa Skala, gamyarebis mcire dro (rac xels uSlis eqims bJenis modelirebaSi), sxiviT gamyarebad masalebTan SedarebiT cudi “Sewebebis” unari kbilis qsovilebTan.
sxiviT gamyarebadi kompozitebi anu heliobJenebi _ piris RruSi myardeba mxolod gansazRvruli sigrZis sinaTlis talRebis saSualebiT, romelsac specialuri lampa asxivebs. maTi es Tviseba eqims sasualebas aZlevs imuSaos auCqareblad, SemoqmedebiTad. garda amisa, sxiviTgamyarebadi kompozitebi gamodis gansxavebuli ferebisa da gamWvirvalobis: aris opakurebi, anu gauWvirvale, riTac ifareba kbilis muqi qsovilebi an metali. aris naxevradgamWvirvale da gamWvirvale, kbilis qsovilebis _ dentinisa da minanqris Sesacvlelad. is, rom masala sxiviT myardeba maTi naklicaa, radgan gamyarebisas bJenSi warmoiqmneba daWimuloba, ramac SeiZleba gamoiwvios bzarebi.
ukanasknel droSi SemuSavebul iqna didi zomis Rruebis dabJenis teqnologia, romlis drosac gamoiyeneba rogorc qimiuri, ise sxiviT gamyarebadi kompozitebi, rac saSualebas iZleva maqsimalurad gamoyenebul iqnas maTi pliusebi.
mkurnalobis teqnika
mkurnalobis Sedegi damokidebulia ara imdenad gamoyenebul masalebze, ramdenadac mkurnalobis teqnikaze.
miaqcieT yuradReba, rogor “burRavs” (apreparirebs) eqimi Tqvens kbils. aucilebeli rom am procesSi kbili ar gadaxurdes da periodulad grildebodes wylis WavliT. TviTon preparireba unda iyos wyvetili da zewolis gareSe.
preparirebis dros eqimi unda iyenebdes sxvadasxva daniSnulebis instrumentebs: maRali siCqaris “turbinuli” buniki, romelsac stvenis magvari xma aqvs (maTi brunvis siCqare daaxloebiT 250 000 bruni wuTSi), gaTvaliswinebuli minanqrisa da magari dentinis preparirebisTvis.
dabali siCqaris buniki, romelsac zuzunis magvari xma aqvs gaTvaliswinebuli karisiT dazianebuli darbilebuli dentinis mosacileblad.
zogierTi eqimi muSaobs asistentis gareSe da radganac ver aswreben wylis amoqaCvas piris Rrudan “mSralad” muSaoben. maSinac ki, roca wyliT muSaoben da pacients gadanerwyvebis saSualebas aZleven, preparirebul RruSi nerwyvis moxvedrsas masSi Semavali cilebi ileqeba Rrus kedlebze da SemdgomSi xels uSlis bJenis mimagrebas.
preparirebis Semdeg eqimi amowmebs, xom ar darCa kidev mkvdari qsovilebi amisaTvis xSirad gamoiyeneba “kariesis aRmomCeni” anu karies-markeri, romelic amorCeviT Rebavs kbilis mkvdar qsovilebs. misi gamoyeneba icavs eqimis preparirebis dros Secdomisagan, xolo pacients __ meoradi kariesis ganviTarebis riskisagan.
axla modiT gavarkvioT, saWiroa Tu ara sarCuli bJenis qveS? teqnologiur wvrilmanebs Tu ar CavuRrmavdebiT, mokle pasuxi iqneba __ ara. kariesis mkurnalobis Tanamedrove teqnologiebis gamoyenebiT saRculi bJenis qveS saWiro araa, maSinac ki, roca kbilis Rru anu “nervi” ixsneba. garda imisa, rom sarCuli asustebs bJens, igi aseve zrdis mkurnalobis Rirebulebas.
ra aris restavracia?
sityva restavracia iTargmneba, rogorc “dakargulis aRdgena”. stomatologiaSi cneba “restavracia” gulisxmobs kbilis funqciuri (ReWva, kbeCa) da esTetiuri (silamaze, Sesabamisoba gverdiT kbilebTan da mTlianad adamianis ierTan) formis aRdgenas.
ar aqvs mniSvneloba, kbili mTlianadaa daSlili, nawilobriv, Tu ubralod ferSecvlilia __ preparirebis dros kbilis gvirgvinis didi nawili iqlibeba da Tavidan aRdgeba sxiviT gamagrebadi masaliT saWiro feriTa da formiT. aseTi samuSaos Sesruleba stomatologiaSi umaRles klasad iTvleba, TiTqmis xelovnebad. restavraciis dros qsovilebi aRdgena fena-fena sxvadasxva ferisa da simkvrivis masalebiT dentinisa da minanqris Sesabamisad, aRdgeba kbilis zedapiris mTeli reliefi __ yeli, saWreli kide Tu borcvebi.
sworad damuSavebuli da resatvrirebuli kbili arafriT ar unda gansxvavdebodes namdvilisgan ukve samuSaos damTavrebisTanave.
ra aris CanarTi?
rogorc saxelwodebidan Cans, es aris eqimis mier formirebul RruSi dafiqsirebuli xelovnuri konstruqcia.
gansxvaveba bJensa da CanarTs Soris imaSia, rom bJens eqimi akeTebs uSualod piris RruSi. CanarTi ki calke mzaddeba da Semdeg fiqsirdeba piris RruSi. bJenisagan gansxvavebiT CanarTi SeiZleba iyos sxvadasxva masalis --- liTonis, faifuris an igive sabJeni masalis. CanarTis gamoyeneba TiTqmis mTlianad gamoricxavs daZabulobas kbilis qsovilSi da maSasadame misi dazianebis risksac. CanarTis saSualebiT ukeTesad xdeba gverdiT kbilebTan kontaqtis aRdgena. faifuris CanarTebi wina kbilebze anu vinirebi gacilebiT xangrZlivi da saimedoa, vidre bJenisgan gakeTebuli vinirebi.
stomatologiuri momsaxurebis fasebi.
da bolos __ stomatologiuri momsaxurebis fasebis Sesaxeb. ratomaa igi ase gansxvavebuli da riTia es ganpirobebuli.
arsebobs stomarologiuri momsaxurebis ori modeli: erTi, orientirebuli samuSaos moculobaze da pacientebis raodenobaze, SedarebiTi dabali fasebiT. da meore, orientirebuli pacientis srul mkurnalobaze da maRali arisxis klinikur standartze.
pirveli tipis klinikaSi daxmareba xdeba ZiriTadad krizisul situaciaSi. anu roca pacienti modis garkveuli problemiT da iTxovs mkurnalobas. aRar rCeba dro pacientis mTliani mdgomareonis sesafaseblad, radgan samuSao “konveirulia” dilidan-saRamomde.
meore tipis klinika __ “butikis” tipisaa, sadac eqimi flobs stomatologiis xelovnebas, mraval klinikur “ileTs”, diagnostikas, unars amoicnos pacientis realuri saWiroeba, Sefasos misi mdgomareoba srulas, dasaxos mkurnalobis optimaluri gegma, da aqvs pacientTan iseTi urTierTobis unari, rom daexmaros mas, gaacnobieros Tavisi mdgomareoba da daiTanxmos mkurnalobis srul kursze.
Tu ra tipis klinikas airCevs, es pacientis saqmea, Tumca gaiTvaliswineT, rom miRebuli maRali xarisxi gasiamovnebT ufro didxans, vidre dazogili Tanxa.
http://www.medportal.ru/enc/stomatology/Plomby/6/პ.ს. ქართულად ვერ ვაკოპირებ
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კითხვა სტომატოლოგთან, ნაწილი II
