Pehea e hoʻoponopono ai i nā niho ʻīlio i kū ʻole ʻia

Nā ʻīlio mandibular i hoʻoneʻe ʻia ma ka ʻōlelo a me ka ʻeha palate paʻakikī

ʻIke pinepine ʻia kēia maʻi i ka nānā ʻana i ka ʻīlio mua a i ʻole ka lua a i ʻole ma waena o 6 a me 8 mau makahiki i ka wā e hū ai nā niho paʻa (pakeke). Hoʻopili ʻia nā ʻīlio haʻahaʻa a i ʻole mau i loko o nā ʻiʻo palupalu o ka hale a i ʻole ka waha e hōʻeha nui ai a, malia paha, nā fistula o ka ihu. E ʻike i kā mākou pepa FAQ no ka ʻike hou aku e pili ana i kēia maʻi i nā ʻōpio ʻōpio. Pane ka pepa ʻoiaʻiʻo i nā nīnau he nui āu e pili ana i ke kumu o kēia pilikia a me nā lāʻau lapaʻau like ʻole. He mea nui ʻaʻole e hoʻopaneʻe i ka mālama ʻana i nā ʻīlio haʻahaʻa deciduous no ka mea he mau pule wale nō ka puka makani o ka manawa a hiki i ka hū ʻana o nā ʻīlio mau loa i ka 22 a 26 mau pule. Hiki i kekahi pilikia hou ke puka mai me nā niho nui a’e e ho’onui i ka poino. Manaʻo mākou iā ʻoe e leka uila iā mākou i nā kiʻi o nā niho (paʻa ka waha, nā lehelehe i luna a ʻaoʻao ma ka hema a me ka ʻākau) i kekahi mau lā ma mua o kou huakaʻi. Hoʻololi koke nā mea i ka ulu ʻana i nā ʻīlio a mālama paha iā ʻoe i kahi huakaʻi makehewa. He kūlana hoʻoilina kēia – he mutation autosomal recessive. Hiki i nā mākua ʻelua ke nānā maʻamau akā lawe i nā genes recessive no ke ʻano. Ke hāʻawi ʻia kēia ʻike moʻo ma luna o ka ʻōpala, ma kahi o hoʻokahi ʻīlio i loko o ʻehā e hoʻopilikia ʻia, ʻike ʻia he mea ʻino a hiki ke hāʻawi i ka ʻike genetic inā hānai ʻia. Eia kekahi, ʻelua mau pups i loko o ʻehā e lawe i kahi ʻano maʻamau mai kekahi makua a me kahi gene maʻamau mai kekahi. E nānā maʻamau kēia pups akā hiki ke hoʻopau i ka pilikia inā hānai ʻia. ʻO ka hope loa, ʻaʻole e lawe ʻia nā ʻano genes ʻē aʻe i hoʻokahi pup i loko o ʻehā. Inā ʻike ʻia kēia maʻi i loko o ka ʻōpala, ʻo ka hana ʻoi loa ke kuleana ʻaʻole e hānau hou mai nā mākua – ma ke ʻano he pālua a i ʻole hoʻokahi me nā mea ʻē aʻe. No ka mea, ʻaʻohe hoʻāʻo i kēia manawa e ʻike i kēia ʻano, ʻo ke koho ʻana i kahi hoa ʻē aʻe paha ke ʻano he mea lawe hoʻi lākou. Loaʻa paha i nā pups kaikunāne maʻamau a pau i nā genes recessive. He mea naʻauao ʻaʻole lākou e kōkua i ka hoʻihoʻi ʻana i ka pilikia i loko o ka waihona gene o ka pua. I nā ʻano ʻano he nui i hoʻopilikia ʻia, he liʻiliʻi loa ka waihona gene o nā mea hoʻohua e koho ai. Inā male mau nā mea lawe recessive a laila ʻaʻole i liʻuliʻu ma mua o ka piʻi ʻana o ka nui o nā pups me kēia ʻano. Ma luna o ʻehā mau makahiki ua nānā mākou i nā ʻano ʻano i mālama ʻia ma ʻaneʻi a he mea hoʻohaʻahaʻa i ka ʻike ʻana i ka nui o nā ʻano i hoʻopilikia ʻole ʻia ma mua ke ʻike mau ʻia nei. Ke mālama ʻia kahi ʻīlio no kēia maʻi, hāʻawi mau mākou i ka Kennel Club me kahi palapala Change of Conformation i hiki iā lākou ke hahai i ke kumu o ka makua. Noi mākou i ʻae ʻia e hoʻouna i kahi swab DNA i ka Animal Health Trust . Ua loiloi ʻia kēia ma ke ʻano he ʻāpana o kahi papahana noiʻi e ʻike i ke kumu maoli o ke ʻano me ka manaʻo e loaʻa kahi hoʻokolohua maʻalahi e ʻike i nā mea lawe recessive. I ka manawa e hiki ai i nā mea nona nā mea lawe recessive i ʻike ʻia ke koho i kahi hoa pili ʻole i ke ʻano.

Nā ʻīlio

ʻO ka poʻe nona nā ʻīlio ʻōpio i ʻike ʻia me kēia pilikia ma ka hōʻike mua ʻana e ʻōlelo ʻia e wehe koke i nā ʻīlio haʻahaʻa. ʻEkolu kumu no kēia:

ʻO ka mea mua, a ʻo ka mea nui, ʻoi kēia mau niho a paʻi i nā ʻiʻo palupalu o ka pala. ʻAʻole hiki i kēia mau pups ke pani i ko lākou waha me ka ʻeha ʻole a paʻa pinepine i ka waha e hāmama iki i mea e pale aku ai. ʻAʻole ʻoluʻolu kēia. E nānā i luna no kahi laʻana o ka pōʻino i hana ʻia i ka palaka paʻa e kēia pilikia.
ʻO ka lua, ʻo ka ulu ʻana o ka maʻi he rostral mai ka hui ʻana o ka ramus kū a me ka pae. Inā hoʻokomo ʻia nā ʻīlio haʻahaʻa i loko o nā lua i loko o ka palaka paʻa, ʻaʻole hiki ke ulu maʻamau o ka maʻa ma muli o ke kuʻi ʻana o nā niho ma muli o ke komo ʻana o nā ʻīlio haʻahaʻa i loko o nā lua palate paʻa. Hiki i kēia ke ho’ololi i ka iwi po’o ma ke kua a i ‘ole ke kūlou ventral o nā iwi lima (mau āwae lalo).
ʻO ke kolu, aia ka ʻīlio haʻahaʻa mau loa ma ka ʻōlelo a ka ʻīlio deciduous. ʻO ia hoʻi, inā ʻilihune nā ʻīlio haʻahaʻa deciduous, he ʻoiaʻiʻo e ʻoi aku ka ʻino o nā niho paʻa. E ʻike i ka radiograph ma lalo nei. Aia ma waho o nā ʻāwae nā ʻīlio lau a ʻike ʻia nā ʻīlio paʻa e ulu aʻe ana ma ka ʻāwae ma ke ʻano he «papale». He mea maopopo loa, he kuapo pololei ke ala pele o na i’a mau, aole e like me ka mea mau.

No kēia mau kumu ʻekolu, ʻoi aku ka maikaʻi o ka wehe ʻana i nā niho ʻīlio haʻahaʻa me ka hikiwawe e hiki ai ke hāʻawi i ka manawa lōʻihi ma waena o ke ʻoki ʻana a me ka manawa e hū ai nā niho paʻa ma waena o 22 a 24 mau pule. E ʻike i kā mākou waihona no ke kiʻi ʻana o ka wehe ʻana i nā ʻīlio deciduous. ʻO ko mākou manaʻo he mea pono e wehe i kēia mau niho ma o nā lau ākea ākea. ʻO nā kumu: ʻEkolu a ʻehā paha ka lōʻihi o ke aʻa niho deciduous ma mua o ka lei aliʻi i ʻike ʻia a me ka curved – pinepine 2.5cm ka lōʻihi a me ka curved. Aia ka piko aʻa ma lalo o ke kolu o ka premolar lalo. E ʻike i nā kiʻi waena a me ka ʻākau ma lalo me nā niho deciduous i unuhi ʻia i waiho ʻia ma luna o ke kahua unuhi. He palupalu loa nā aʻa a e haki maʻalahi ke hoʻoikaika nui ʻia i ka wā e wehe ʻia ai. Pono e ʻike a wehe ʻia kahi aʻa haʻihaʻi i ʻole ia e hoʻomau i ka hana ʻana i mea pale i ke ala pele o ka ʻīlio mau a hiki ke hoʻoulu i ka maʻi kūloko. Aia ka niho hope mau ma ka lingual i ka niho deciduous a i loko o ka iwi ā i kēia wā. ʻO ka hoʻohana ʻana i nā luxators a i ʻole nā mea hoʻokiʻekiʻe ma ka hapa lingual o ka niho deciduous e hōʻino mau i ka ulu ʻana o ka enamel o ka niho mau. E nānā i nā kiʻi ma lalo e hōʻike ana i nā ʻīlio (a me ke kolu o ka incisor) me ka pōʻino nui i ka enamel. Hōʻike pū ka radiograph i ka nui o ka pōʻino e hiki mai ana i nā niho – e ʻike i ka ʻīlio luna a me ka incisor pili. Pono e unuhi ʻia kekahi mau niho i ʻeha nui a hiki ke hoʻoponopono ʻia me ka mea i hoʻopaʻa ʻia. Hiki ke pale ʻia kēia pōʻino me ka ʻenehana akahele me ka hoʻohana ʻana i kahi ala ʻoki ākea. ʻAʻole hiki i ka ʻoki ʻana e wehe i nā ʻīlio deciduous ke pale aku i ka pono o ke ʻoki ʻana i nā ʻīlio paʻa, akā, me ka ʻole o ia, e hoʻoholo ʻia nā hihia liʻiliʻi inā waiho ʻia i ke ʻano. ʻAʻole makemake ka nui o nā mea nona ka ʻoki ʻana i nā ʻōpio ʻōpio. ʻO ko mākou manaʻo, ʻo ka wehe ʻana i nā ʻīlio deciduous haʻahaʻa, ʻaʻole ia e hōʻoiaʻiʻo ʻaʻole e hiki hou mai ka pilikia i ka wā e hū ai nā niho paʻa akā me ka ʻole o ke ʻoki ʻia ʻana he ʻuʻuku loa ka manawa. Ka hoʻonui lei aliʻi i nā pups I kekahi mau hihia i koho ʻia – ʻo ka maʻamau wale nō ka neʻe ʻana o ka ʻōlelo haʻahaʻa loa – hiki iā mākou ke noʻonoʻo e kau i nā hoʻonui lei aliʻi ma nā ʻīlio haʻahaʻa e kōkua i ke alakaʻi ʻana iā lākou i kahi kūlana kūlohelohe. Lawe ia i kekahi mau mea maopopo ʻole a ʻaʻole kūpono a hana paha i nā hihia āpau. Hōʻike nā kiʻi ma lalo i nā hoʻonui lei aliʻi ma kahi ʻōpio Springer Spaniel. E ʻoluʻolu e hoʻomaopopo ʻaʻole kūpono ka hoʻohana ʻana i ka pōleʻa lāʻau e kōkua ai i ka huki ʻana i nā ʻīlio haʻahaʻa haʻahaʻa ma ka ʻōpū i kēia makahiki a ʻaʻole pono – e ʻike i lalo.

Nā ʻīlio makua

Inā hoʻoneʻe ʻia nā niho paʻa i ka ʻōlelo, ʻoi aku ka nui o ka ʻīlio ma mua o 24 pule. ʻO ka ʻeha i hana ʻia e nā niho ma nā ʻiʻo palupalu hiki ke nui me ka ʻeha ma muli o ka hopena. Hoʻomaʻi kinipōpō Nui nā manaʻo kuhi hewa e pili ana i ka lāʻau kinipōpō. E ʻoluʻolu e heluhelu pono i kēia mau mea. Mai ho’āʻo i ka lāʻau lapaʻau me nā niho deciduous (puppy) . ʻElua kumu nui o kēia. He palupalu nā niho ʻīlio a hiki ke haki. ʻO ka mea nui loa, ke ulu nei ka ʻōpuʻu niho ʻīlio makua ma ka ʻāwae waena a hiki i ka niho ʻīlio deciduous (e nānā i ka radiograph ma luna o ka ʻāpana ʻīlio). Inā hele ka lei i waho, e wili ke aʻa i loko. ʻO kēia ka mea e hoʻoneʻe ai i ka ʻōpuʻu niho paʻa ma mua o ka mua. E hoʻohana wale ʻia ka lāʻau lapaʻau me nā niho makua a ma kekahi mau hihia wale nō i loaʻa i nā ʻīlio haʻahaʻa ke ala maʻemaʻe e hoʻohuli ʻia i ka ʻaoʻao – ma hope – ma waena o ke kolu o ka incisor luna a me ka ʻīlio. Hiki ke pōkole loa ka puka makani, ma kahi o 6 mau pule, a hoʻomaka i ka wā e pili ana nā niho ʻīlio haʻahaʻa me ka palale paʻakikī. Inā ʻoe e noʻonoʻo ana i ka lāʻau lapaʻau e nīnau i kāu kauka lapaʻau i ko lākou manaʻo a e kiʻi iā lākou e hoʻouna mai iā mākou i nā kiʻi o kēlā me kēia ʻaoʻao o ka waha paʻa mai ka ʻaoʻao me ka pani ʻana a me nā lehelehe i luna. He mea koʻikoʻi ka nui a me ke ʻano o ka pōleʻa a i ʻole Kong. Pono ke anawaena o ka poepoe ka mamao ma waena o ka piko o na niho niho lalo a me 50%. No laila, inā he 30mm kēia mamao, he 45mm ke anawaena o ka poepoe. Inā liʻiliʻi ka pōleʻa, e noho ʻo ia ma waena o nā ʻīlio haʻahaʻa a ʻaʻole e hoʻoulu i ka ikaika i ka wā e nahu ai ka ʻīlio. Hiki i ka pōpō nui ke komo i nā ʻīlio haʻahaʻa i loko o ko lākou mau kumu. Pono ka poepoe e “haawi” ke nahu ka pup. ʻOi aku ka maikaʻi o ka ʻōpala semi-hollow. He abrasive nā pōpō Tennis a hiki ke hōʻino i ka ʻili niho akā no ka manawa pōkole hiki ke hana i ka hana a mākou e makemake ai. Pono ka mea nāna e hoʻoikaika i ka pāʻani me ka pōleʻa i nā manawa he nui i ka lā (6 – 8) a i ʻole i nā manawa a lākou e ʻae ai me ka manawa pōkole. Pono ka poepoe ma ke alo o ka waha no ka maikai. Inā ʻaʻohe hopena maikaʻi i loko o ʻeono pule e aʻo hou ʻia kahi loiloi lāʻau holoholona. Loaʻa ka kikokikona mana loa ma ke kumuhana. Verhaert L 1999 Journal of Veterinary Dentistry 16: 2, 69-75.

Nā ʻīlio makua i hoʻoneʻe ʻia ma ka ʻōlelo – Nā koho ʻoki

Hiki ke mālama ʻia kēia mau niho paʻa e nā koho ʻekolu. ʻAʻole loaʻa nā koho āpau i nā hihia āpau. Hōʻike ʻia kēia mau koho ma lalo nei a ʻo ka wehe ʻana paha i nā niho ʻīlio haʻahaʻa (a ʻo ka incisors pū kekahi), ka ʻoki lei aliʻi a me ka pulpectomy ʻāpana a i ʻole ka orthodontics ma o ka mokulele inclined bite i hoʻopaʻa ʻia i nā ʻīlio luna a me nā incisors. ʻAʻole loaʻa ka koho hope i nā ʻīlio a pau inā he liʻiliʻi ka diastema ma waena o ke kolu o luna a me ka ʻīlio no ka neʻe ʻana o nā ʻīlio haʻahaʻa a i ʻole inā aia nā ʻīlio haʻahaʻa ma hope (palatal) a i nā ʻīlio luna. Ka ʻoki ʻana o ke Aliʻi a me ka ʻāpana ʻo Coronal Pulpectomy ʻO kēia kā mākou koho i makemake nui ʻia a pili i ka hoʻemi ʻana i ke kiʻekiʻe o nā canine haʻahaʻa i kēlā o nā incisors pili. He hana maʻemaʻe kēia e hoʻemi i ke kiʻekiʻe o ka lei aliʻi haʻahaʻa e hōʻike ana i ka pulp. Pono ia e wehe i kekahi pulp (partial coronal pulpectomy) a me ka hoʻokomo ʻana i ka pulp capping pololei. He kaʻina hana maʻalahi kēia a lawe i ka helu kūleʻa kiʻekiʻe loa (ma ko mākou mau lima) mai ka loaʻa ʻana o Mineral Trioxide Aggregate (MTA). Ua hoʻohana mākou iā ia ma ke ʻano he mea i koho ʻia mai ka makahiki 2005. ʻO ka mea hana mua (calcium hydroxide) ʻoi aku ka nui o ka caustic a makemake ʻia e «puhi» i ka pulp. ʻO ka helu kūleʻa o nā hihia i mālama ʻia ma MTA i ʻōlelo ʻia he 92% i kahi haʻawina seminal he ʻumi makahiki i hoʻokumu ʻia ma nā keʻena niho niho ma Finland. Hoʻohālikelike kēia me 67% i ka wā o ka caclium hydroxide ma mua ka mea hana. Luotonen N et al, JAVMA, Vol 244, No. 4, February 15, 2014 Vital pulp therapy in dogs: 190 hihia (2001-2011). ʻO ka manaʻo o ke kaʻina hana, ʻo ia ka mālama ʻana i ke ola o ka pulp a ʻae i nā canine haʻahaʻa pōkole e ulu maʻamau a kōkua i ka ikaika o nā ʻāwae haʻahaʻa.

Ua haʻalele ka radiograph i ka ʻīlio haʻahaʻa ma mua o (hema) a ma hope koke o ke ʻoki ʻana (ʻākau). E hoʻomaopopo i ka morphology ʻole o nā niho canine – nā paia lahilahi a me nā aʻa aʻa hāmama.

I mea e nānā ai i kēia kaʻina hana o ka makua, pono mākou e radiograph i kēia mau niho i ʻelua mau manawa ma 4-6 mau mahina ma hope o ka hana ʻana a ma 12 -16 mau pule ma hope o ka hana. He māka pono kēia. ʻO ka 92% o ka kūleʻa i ʻōlelo ʻia e hōʻike ana he 8% hemahema. ʻO ka hapalua o ka poʻe i hāʻule i ke aʻo ʻana ʻo Luotonen i hala ma mua o hoʻokahi makahiki post-op. No ka hōʻoia ʻana i kekahi hemahema o ke oʻo ʻana, ʻaʻole mākou e hana i kēia hana ke ʻole ka mea nona ka ʻae ʻana i kēia .

He 18 pule ma hope o ka ʻīlio haʻahaʻa. Loaʻa ka hoʻopiha piha ʻana.

Hōʻike ka radiograph hema i ka ʻīlio hema hema ma hope koke o ka ʻoki ʻana i ka lei aliʻi a me ka pulpectomy hapa. He niho like ka radiograph akau he 18 pule ma hope o ka hana. E nānā i ka mānoanoa o nā paia niho, ke kūkulu ʻana i kahi alahaka niho kūloko ma waena o ka pulp a me ka pāpale pulp pololei a me ke aʻa i pani ʻia a oʻo. Hōʻike kēia mau pae ʻekolu i kahi kaʻina hana kūleʻa i kēia pae. ʻO ka maikaʻi o kēia kaʻina hana, ʻo ia ke aʻa holoʻokoʻa a me ka hapa nui o ka lei aliʻi. ʻAʻole hoʻonāwaliwali ʻia ka ikaika a me ka pono o ka iwi ā lalo e ke kaʻina hana a maikaʻi loa nā hopena lōʻihi ma muli o ka hoʻohana ʻana i ka Mineral Trioxide Aggregate ma ke ʻano he lole pulp pololei. Kaʻi ʻana ʻO ka ʻoki ʻoki ʻana o ka ʻīlio haʻahaʻa e ʻoluʻolu paha i nā mea kūʻai aku no ka mea e hoʻoponopono koke ʻia ka pilikia me ka ʻole o ka maopopo ʻole o ka orthodontics a me ka nānā post-op he ʻāpana o kēlā me kēia kaʻina hana ʻoki kalaunu. Eia naʻe, nui ka poʻe nona ka hopohopo (pono) no ka nalowale ʻana o ka niho a me ka nawaliwali o ka iwi ā lalo. ʻAʻole ia kā mākou koho makemake. ʻAʻole kēia he ʻokiʻoki maʻalahi a ʻo ka hopena o ka nalo ʻana o ke aʻa ke kumu o ka nāwaliwali o nā ʻāwae lalo. Hoʻohui ʻia kēia inā wehe ʻia nā ʻīlio haʻahaʻa ʻelua. No ka mea he kaʻina hana koho kēia (eg sterile) hiki ke hoʻohana i kahi allograft iwi e hoʻopiha i ka hakahaka i hana ʻia e ka nalowale ʻana o ka niho ʻīlio nui. E hoʻoikaika ka hoʻopili ʻana i ka ulu iwi hou i loko o kekahi mau pule. Hiki ke kūʻai nui ʻia nā grafts no ka mea he nui ka hakahaka e hoʻopiha ʻia. Hiki i kēia ke hoʻonui nui i ke kumukūʻai o ke kaʻina hana.

Ua hoʻoneʻe ʻia ka ʻīlio hema hema a me ka radiograph aʻa ma mua o ke ʻoki ʻana.

Haʻalele ke kiʻi i ka ʻāpana ʻīlio ma hope o ka wehe ʻana i ke kaʻe. Hōʻike ka radiograph i ka hemahema o ka maʻi maʻi ke hele ʻole ka niho.

Radiograph o ke kumu i ka manawa i kau ʻia ai ka osteoallograft.

Hoʻonui lei aliʻi ma nā niho ʻīlio haʻahaʻa makua I kekahi mau hihia maʻalahi o ka hoʻoneʻe ʻana i ka ʻōlelo, hiki iā mākou ke hoʻohana i ka hoʻonui lei aliʻi no kekahi mau pule. No kēia lapaʻau, hoʻopaʻa mākou i nā hoʻonui resin composite ma nā canine haʻahaʻa e hoʻonui i ka lōʻihi o ka lei aliʻi ma kahi o 30%. ʻO kēia ka mea e hiki ai i nā ʻīlio haʻahaʻa ke noho i ke kūlana kūpono a hāʻawi pū i ka leverage hou aʻe e ʻoki i nā ʻōlelo aʻoaʻo kalaunu. Hoʻomau ka hoʻonui lei aliʻi ma kahi o 2 mau mahina a laila wehe ʻia a hoʻomaʻemaʻe ʻia ka ʻili o ka niho. ʻO ka pōʻino nui, inā e hōʻino a haki paha ka ʻīlio, pono ʻoe e hoʻi i ʻaneʻi no ka hoʻoponopono ʻana. Hiki i nā lāʻau a me nā mea paʻakikī ʻē aʻe ke hōʻino maʻalahi a pono e hoʻihoʻi ʻia kekahi mau mea pāʻani no ka wā lapaʻau. ʻO ka hoʻopaʻa ʻana i ka Orthodontic ʻO ka ʻoki ʻana i ka Orthodontic ma ke ʻano he lapaʻau ka hopena liʻiliʻi loa o nā koho ʻekolu. Me he mea lā ʻoi aku ka liʻiliʻi o ka invasive ma mua o ke kaʻe ʻana akā pono ke koho pono a me ka mālama ʻana. ʻO ka maʻamau, hoʻopaʻa ʻia kahi mokulele nahu resin composite ma nā niho o luna (e ʻike i lalo) me ka ʻoki ʻana i nā ʻaoʻao. Hoʻopili ka ʻīlio haʻahaʻa me ka incline i ka wā e pani ai ka waha, a i ka wā lōʻihi, ʻoi aku ka ikaika i ka niho. He ʻehā a ʻewalu pule kēia. E neʻe pinepine ka ʻīlio haʻahaʻa i kahi kūlana lingually ke hoʻoneʻe ʻia ka mokulele nahu. Hiki i kēia ke hana inā pōkole loa ke kiʻekiʻe o ka niho o ka ʻīlio haʻahaʻa (stunted). Inā ʻaʻole paʻa ka ʻīlio haʻahaʻa e ka iwi ā luna i ka wā e pani ʻia ai ka waha, pono paha e ʻoki hou ʻia. E hūnā pū ka lāʻau Orthodontic i kahi kīnā a ʻaʻole e hana ʻia ke ʻole ka mea maʻi i neutered. Eia kekahi, he kuleana ko mākou e haʻi aku i ka Kennel Club i kahi hoʻololi o ka conformation. Hōʻike nā kiʻi ma lalo nei i kahi ʻīlio hema hema ma mua o ka mālama ʻana a ma hope o ka hoʻohana ʻana i kahi mokulele nahu. Noho ka mokulele nahu i loko o ka waha e like me ka lōʻihi o ka mana o ka nahu e ʻoki i ka ʻīlio haʻahaʻa i kahi kūlana maʻamau ma ka hoʻokuʻu ʻana iā ia i luna. ʻAʻole kūpono nā ʻīlio a me nā mea nona kēia. Hiki ke hoʻokuʻu ʻia nā mokulele nahu inā nahu ka ʻīlio i kahi lāʻau a i ʻole kekahi mea paʻakikī. Pono e hoʻomaʻemaʻe a hoʻoponopono ʻia nā mokulele bite i kēlā me kēia manawa ma lalo o ka hoʻomaha a i ʻole ka anesthesia. ʻO kēia mau mea a pau, ʻoi aku ka nui o ka huakaʻi a me nā lilo no ʻoe a ʻoi aku ka maʻi anesthesia no kāu holoholona. ʻO ko mākou manaʻo inā loaʻa nā hopena i kūkulu ʻia i loko o kahi lapaʻau ʻaʻole pono e hoʻohana ʻia. Poakahi, 14 Okatoba 2019 Kākau ʻia e Davin R. Ringen, DVM kuhi hewa ʻana o nā niho i nā ʻīlio - ʻīlio lab brown Hoʻohauʻoli mau ka ʻīlio hou a lawe mai i ka ikehu i loko o kahi home aloha. Ke hoʻoholo ʻia, pono e nānā ʻia kāu ʻīlio hou e kāu kahu holoholona ʻohana maʻamau. He mea maʻamau ka loiloi ʻia ʻana o nā ʻīlio ʻōpio ma 8, 12 a me 16 mau pule a i ʻole i ka manawa o ka hāpai ʻana i nā ʻīlio kahiko. I loko o kēia mau hoʻokolohua, he mea koʻikoʻi ka loiloi i ka niho a me ka occlusion (nahu) i mea e nānā ai no ka hemahema o nā niho i nā ʻīlio (a i ʻole malocclusions).

Hoʻokaʻawale i nā niho i nā ʻīlio

I nā pule he 12, loaʻa i nā ʻīlio he 28 o ko lākou mau niho deciduous (pepe). No ka maxilla (auwae luna) a me ka iwi ma lalo (ka iwi ā lalo), he 3 ʻoki, 1 canine (fang) a me 3 niho premolar i kēlā me kēia ʻaoʻao. Puka mua ka ʻūhā, ma kahi o 3 pule o ka makahiki, a ma hope o nā niho ʻīlio. Puka ka deciduous premolars ma waena o 4-12 pule. ʻAʻohe niho mola. Ke hele mai nā niho deciduous, pono e hana ʻia kahi hoʻokolokolo waha. I loko o kēia manawa o ka hoʻomohala ʻana, hiki ke ʻike ʻia kahi malocclusion (nahu maʻamau). Ua hoʻokaʻawale ʻia nā malocclusions ma ka papa I, II, III a i ʻole IV. E nānā ʻia nā malocclusion papa I a me II ma kēia blog. Ua wehewehe ʻia ka malocclusion Papa I ma ke ʻano he niho hoʻokahi a i ʻole nā niho he nui i kahi kūlana ʻano ʻole me ka maʻa a me ka maxilla i kahi pilina maʻamau me kekahi. Ua wehewehe ʻia ka malocclusion Class II e kahi maʻi lima pōkole loa e pili ana i ka maxilla. Hiki i nā poʻe maʻi me kahi malocclusion Class II ke loaʻa nā niho i nā kūlana kūlohelohe.

Ka mālama ʻana i nā Malocclusions i nā ʻīlio

Hoʻomaʻamaʻa pinepine ʻia nā malocclusions o nā niho deciduous ma Animal Dental Care a me Oral Surgery. ʻO ka malocclusion maʻamau o nā niho deciduous e pili ana i nā canine deciduous mandibular, e hū ana ma kahi kūlana pololei (papa I malocclusion). Ke alakaʻi nei kēia kūlana ʻano ʻino i ka palatal trauma i ka wā e pili ai nā niho niho deciduous haʻahaʻa me ka palate. Hiki i nā maʻi me ka malocclusion papa II ke loaʻa nā niho i ka pili ʻana i ka palate ma muli o ka pōkole pōkole o ka maʻi. ʻO nā kūlana ʻelua ke kumu o ka trauma nui i ka palate a he kumu nui o ka ʻeha. He mea nui ka hoʻomaʻamaʻa mua ʻana a me ka hana ʻana e hōʻemi i ka ʻeha a me ka ʻeha. ʻO ka ʻeha a me ka hōʻoluʻolu mai kēia occlusion traumatic hiki ke hōʻeha i nā ʻano ʻino. He ʻoi nā niho deciduous a hoʻopilikia nui i ka wā ʻaʻole i hoʻonohonoho pono ʻia ma ka waha. ʻAʻole pono e hoʻopaneʻe ʻia ka lāʻau lapaʻau ʻana e kāu kauka lapaʻau ʻohana a i ʻole kahi niho niho holoholona. Hoʻohana pinepine ʻia nā ʻano hoʻolālā ʻelua no ka mālama ʻana i nā occlusion traumatic i hoʻokumu ʻia e nā niho canine deciduous mandibular. ʻO nā hoʻolālā lapaʻau e pili ana i ka neʻe ʻana o nā niho i kahi kūlana hana a i ʻole ka unuhi ʻana o nā niho canine deciduous mandibular. Hoʻoholo ʻia ke koho lapaʻau e ke ʻano a me ka paʻakikī o ka malocclusion, ke ʻano o ka ʻīlio a me ka ʻohana. I mea e hoʻoneʻe ai i nā niho niho niho deciduous mai kahi occlusion traumatic, ua kūkulu ʻia nā hoʻonui composite ma luna o nā niho canine mandibular, e kuhikuhi ana iā lākou i kahi kūlana maʻamau (Kiʻi 3). Ma hope o ka huli ʻana o kēia mau niho i kahi occlusion maʻamau a exfoliated (hāʻule i waho) e ʻoi aku ka nui o nā niho paʻa e hahai i kēlā kūlana maʻamau. ʻO ka pōʻino o kēia kaʻina hana, ʻo ia ka hoʻonui ʻana o kēia mau ʻōlelo aʻoaʻo i ka niho, hiki ke hoʻopaʻa i nā mea ʻē aʻe a hiki ke hana ma ke ʻano he fulcrum e hiki ai i ka haki ʻana o ka niho. Pono nā mea nāna e hoʻopaʻa waha i ka ʻīlio i ka wā e paʻa ana kēia mau hoʻonui. Inā ʻaʻole kūpono kēia mau palena no ka mea nona ka hale, ʻike pinepine ʻia ka unuhi ʻana i nā niho deciduous. ʻO ka unuhi ʻana o kēia mau niho e hoʻomaha iki i ka ʻeha o kēia malocclusion. Pono mau nā loiloi ukali no kēia mau maʻi. ʻOiai ke kau ʻia nei nā mea hoʻonui ʻia, pono e nānā hou i kēlā me kēia pule. Inā ola nā ʻōlelo hoʻohuihui i ka mālama ʻana a laila e hāʻule pū lākou me nā ʻīlio deciduous. No nā hihia i hana ʻia ai ka unuhi ʻana o nā canines mandibular deciduous, ʻōlelo ʻia ka nānā hou ʻana i 2 mau pule, ma hope o ka unuhi ʻana. Hoʻoponopono hou ʻia ka mea maʻi ma 6 mahina o ka makahiki e loiloi i nā niho makua i ka wā e hū ana. He mea maʻamau ka pono o ka lapaʻau hou ʻana ke loaʻa ka niho makua. ʻO ka hope loa, me ka nānā ʻole i ke ala lapaʻau i lawe ʻia, ʻo kā mākou pahuhopu mua ka loaʻa ʻana o kāu ʻīlio i ka ʻeha a me ka hana no kona ola holoʻokoʻa. Kii 1 . ʻO ka ʻeha ʻeha ma muli o ka pili ʻana o ka niho niho deciduous mandibular i ka palale. Pono e kuhikuhi ʻia ka niho deciduous canine haʻahaʻa i ka diastema ma waena o ka niho deciduous canine o luna a me 3 o luna. I kēia hihia, ua hoʻopili ʻia ka niho ʻīlio deciduous haʻahaʻa i loko a pili i ka ʻiʻo palatal. Kiʻi 2. He kiʻi o ka palaka paʻa o ka ʻīlio me kahi malocclusion papa II (he pōkole ka maʻi maʻi). Aia nā niho ʻīlio deciduous i ka traumatic occlusion me ka palatal tissue. E nānā i ke kaumaha a me ka ʻeha o ka ʻiʻo palatal aia ma ka ʻaoʻao o loko o nā niho niho deciduous luna. Kiʻi 3. ʻO ka mea maʻi me ka hoʻonui ʻia ʻana o ka piko ma luna o nā niho canine deciduous mandibular i ka hoʻāʻo ʻana e hoʻokaʻawale i nā niho i kahi kūpono. $C:\Users\Owner\Desktop\Residency\Image library\Base narrow mandibular canines\Hazel\DSCN4879.JPG$ Kiʻi na Free-Photos mai Pixabay (10/14/2019)

Hoʻolauna

Ua wehewehe ʻia ka hoʻololi ʻana o ka niho ‘o ka hoʻololi kūlana o nā niho ʻelua e pili ana i nā aʻa a i ʻole ka hoʻomohala ʻana a i ʻole ka hū ʻana o kahi niho i kahi kūlana maʻamau e kahi niho pili ʻole. ʻO ka hoʻololi ʻana o nā niho he anomaly o ka pele i hōʻike ʻia e ke kūlana hoʻololi o ʻelua mau niho pili [1,2]. Hiki i ka hoʻololi ke hoʻopili like i nā kāne ʻelua a, ʻoiai hiki ke loaʻa i ka maxilla a i ka mandible, ʻo ke alapine o ke komo ʻana o ka canine mau maxillary ka mea nui loa [3]. I loko o ka maxilla ua ho’ololi pinepine ‘ia ka canine me ka premolar mua (Figure 1a,b), emi pinepine me ka incisor lateral i ukali pinepine ‘ia e ka incisor waena a i ‘ole ka lua premolar I ka ho’ololi ‘ana i ka mandible ua hō’ike ‘ia e pili ana i ka canine a me ka incisor lateral wale no [3]. ].
ʻOkoʻa ka prevalence e like me nā mea kākau like ʻole. No laila, ua loaʻa iā 0.38% ma Turkey, 0.13% ma Saudi Arabia, 0.43% ma India. ʻOi aku ka kiʻekiʻe o ka prevalence i nā maʻi syndromic. ʻIke ʻia ka hoʻololi ʻana o nā niho ma kahi pākēneka o 14.29% i nā poʻe maʻi me Down’s Syndrome a ma kahi pākēneka o 4.1% i nā maʻi cleft palate. Wahi a ka hapa nui o nā mea noiʻi, ʻoi aku ka nui o ka transposition i nā wahine, ma ka maxilla, ma ke ʻano he unilateral a ma ka ʻaoʻao hema hema [4]. Ua hōʻike pinepine ʻia ka hoʻololi ʻana o nā niho unilateral ma mua o ka bilateral a lilo ka ʻaoʻao hema i ka mea i ʻoi aku ka nui ma mua o ka ʻaoʻao ʻākau. o ka canine mandibular a me ka incisor lateral ma ka ʻaoʻao hema [4,5]. ʻO nā canine ka niho maʻamau i ka ʻike ʻana i ka transposition. ʻO ka niho o ka ʻīlio luna he niho ka mea ʻokoʻa loa ke kūlana i ka haku ʻana o nā niho kanaka a he mea nui no ka orthodontist e ʻike pinepine i ko lākou wahi a neʻe iā ia [3]. ʻO kēia mau niho i waho pinepine i waho o ka niho a hiki i ka maka a me ka palatal. Mai ka canine transposition o ka mua luna premolar i kekahi manawa e hōʻike i ka transposition o canine eruption ma kaʻaoʻao o ka maka ma waena o ka mua a me ka lua premolars, o ka oi aku ina he mau deciduous canine, no laila, e pili ana i deficiency o ka loa arch. Hoʻololi pinepine ka canine i ka mesial, ʻoiai ʻo ka premolar mua e huli i ka distal a i kekahi manawa huli i ka mesiopalatal [3,6]. ʻAʻole ʻike maopopo ʻia nā kumu. Ua hōʻike ʻo Nodine ʻo ka neʻe ʻana o ka lamina niho i ke ola embryonic ke kumu o ka neʻe ʻana a me ka ʻole o ka hū ʻana o nā canines [7]. Ua manaʻo ʻo Bruszt, ua piʻi aʻe ka ʻōpuʻu o ka ʻīlio i mua o nā incisors a ua hoʻoneʻe ʻia kona lei aliʻi i ka ʻaoʻao contralateral i ka wā o ka ulu a me ka pele [8]. Ua manaʻo ʻo Sutton, ʻo ka ikaika ʻino o ka pele i kuhikuhi ʻia i ka lei aliʻi e hoʻokele i ka ʻīlio ma ka laina waena, ʻo ia ka iwi mānoanoa [9]. Ua manaʻo ʻo Broadway ʻo ka neʻe ʻana o ka crypt o ka niho i hoʻopilikia ʻia ke kumu [10]. Ua ʻōlelo ʻo Bennet, ʻo kahi keʻakeʻa liʻiliʻi e like me kahi ʻāpana kumu liʻiliʻi e lawa ia e hoʻohuli i kahi niho mai kona ala maʻamau o ka pele [11]. Ua ʻōlelo ʻo Vichi1 et al., ʻo ka hoʻolaha ʻana o nā incisors haʻahaʻa, hoʻonui axial inclination o ka canine unrupted a me kahi ʻāpana crossectional symphyseal nui o ka auwae nā kumu kumu [12]. Ua hōʻike ʻo Javid ʻo ke ʻano conical o ka lei a me ke aʻa o ka canine mandibular i maʻalahi i kona neʻe ʻana [13]. ʻO ka hoʻololi holoʻokoʻa kahi e hoʻololi ai ka lei a me ke kumu holoʻokoʻa o nā niho i hoʻopili ʻia i nā wahi i loko o ka pio a pili pono. I ka ho’ololi ‘ole ‘ana (i kapa ‘ia ‘o “pseudo” a i ‘ole “par-tial-transposition”) hiki ke ho’ololi ‘ia nā lei ali’i i ka wā e noho mau ai nā a’a a’a ma ke kūlana ma’amau. ua hoʻololi ʻia, no laila ua pili nā niho ʻelua a ʻo kā lākou mau koʻi lōʻihi e kū kekahi i kekahi [14,15]. Hoʻopili pinepine ʻia ka hoʻololi ʻana o nā niho me kekahi mau pilikia niho congenital e like me ka peg-like lateral incisors, hypodontia, ankylosed waiu niho, nā niho i hoʻololi nui ʻia, a me nā niho dilacerated. Ua hōʻike ʻo Shapira et al i ka 18.5% o ka poʻe me ka transposition e loaʻa i hoʻokahi a ʻoi aku ka nalowale o nā niho, koe naʻe nā mola ʻekolu. ʻO ka ʻoki ʻaoʻao ka niho i nalowale pinepine ʻia (14%). Ua ukali ʻia kēia e ka maxillary (6%) a me ka mandibular (3%) lua premolar. Ua ʻike ʻia nā ʻāpana liʻiliʻi liʻiliʻi i ka 9% o nā hihia me nā transpositions. 32% kanaka i mālama i nā niho waiū, 45% i hoʻololi nui i nā ʻīlio maxillary a ʻo 14% i hoʻopilikia i nā mola ʻekolu [16]. He mea kakaikahi ka hoʻololi ʻana o ka mandibular a ʻike pinepine ʻia me ka canine mandibular a me ka incisor lateral. I ka maikaʻi o ko mākou ʻike, hōʻike mākou i ka hōʻike hihia mua o ka transposition unilateral piha o ka canine akau mandibular me ka incisor lateral o kahi maʻi malihini Suria ma ka palapala. Ua hana ʻia ke aʻo ʻana e like me nā loina etika o ka Hōʻike o Helsinki.

Hoike hihia

He kanaka maʻi kāne 14 makahiki no Suria, i hōʻike aku i ka maʻi maʻi i koʻu keʻena niho pilikino, ʻo Athens, Helene. Ua hoʻopiʻi ʻo ia i ka ʻeha o ka niho pohō ma ka ʻaoʻao mua ʻākau lalo. Ua hoʻopiʻi ʻo ia i ka hopena o ka meaʻai ma waena o nā niho a me ka paʻakikī o ka mastication. ʻO kāna moʻolelo olakino a me kāna moʻolelo pilikino he mea kōkua ʻole. Ua hōʻike ʻia ka mōʻaukala niho i hala ua loaʻa ʻo ia i ka unuhi ʻole ʻia. Ma ka nānā ʻana i loko o ka waha, aia ka ʻaoʻao ʻaoʻao ʻākau ma kahi o ka ʻīlio akau mandibular a me ka ʻīlio ma kahi o ka incisor lateral. He mea maʻamau ka overjet a me ka overbite. ʻAʻohe mea ʻino ʻē aʻe i loaʻa i loko o ka waha waha. ʻO ka radiograph periapical intra-oral a me ka orthopantamograph (OPG) i hōʻoia hou i kēia hui me ka ʻole o nā mea ʻino ʻē aʻe i pili i ka maxillary a i ʻole ka maʻi āpau (Figure 2).
Ua hōʻike ʻia ka hoʻokolohua lapaʻau i ka mola mua deciduous mobile a me ka ʻaoʻao ʻaoʻao deciduous i hoʻopaʻa ʻia ma ka ʻaoʻao ʻākau a me ka ʻaoʻao ʻaoʻao mau loa ma ka ʻaoʻao contra lateral. Hiki ke hōʻike ʻia nā ʻike lapaʻau ʻaʻole nalo, hopena, a pale ʻia paha ka incisor lateral mau loa mai ke ala o ka pele. Inā ʻaʻole i hoʻokō ʻia nā ana interceptive mua o ka hoʻoponopono ʻana i ka incisor ʻaoʻao i kona kūlana kūpono ma ka ʻaoʻao o ka incisor waena i ka manawa kūpono ma mua o ka hū ʻana o ka canine mau loa, e hū ia ma ke kūlana transposed me ka incisor ʻaoʻao i hū mua ʻia ectopically. ʻO ka ʻike mua ʻana a me ka pale ʻana i kēlā ʻano maʻi i ka manawa kūpono e pale i ka ulu ʻana o kēia transposition. Ma ka ʻike mua ʻana o ka hoʻomohala ʻana i ka transposition interceptive lapaʻau i hoʻomaka ʻia, ʻo ia ka wehe koke ʻana o ka mandibular left deciduous first molar. Ua hana ʻia ka unuhi ʻana o ka molar mua deciduous mandibular ma lalo o LA. Ua ʻike ʻia ka ʻaoʻao ʻaoʻao me nā mammelons kaulana i ke kumu unuhi. Wehe ʻia hoʻi ka ʻāʻī ʻaoʻao deciduous a me ka ʻīlio. Ua hana ʻia ka manaʻo o ka ʻaoʻao haʻahaʻa a hoʻolei ʻia i mea e mahalo ai i ka hoʻololi ʻana o ka ʻūhā lateral mau loa. Ua hoʻokumu ʻia ka mālama orthodontic piha me ka ʻenehana uea pololei me ke kaulahao elastic. Ua hoʻokū pololei ʻia ka ʻoki ʻoki ʻaoʻao ʻākau mau i kona kūlana maʻamau i loko o ka pio i loko o 8 mau mahina. Ua lawe ʻia kekahi radiograph panoramic. Ma hope o ka hoʻoponopono ʻana i ka orthodontic, ua nānā ʻia ke ola o ka niho i hoʻololi ʻia a ʻike ʻia ka niho (Figure 3).
Ma hope o ka neʻe ʻana, pono e hoʻopaʻa ʻia ka ʻāʻī ʻaoʻao ma kona kūlana hou a hiki i ka hū ʻana o ka ʻīlio mau loa ma kahi mamao loa. Ua hoʻohana ʻia ka lingual retainer o ka uea i hoʻopaʻa ʻia. Ma hope o 1 ½ makahiki o ka hoʻomaka ʻana o ka lāʻau lapaʻau orthodontic ua ʻike ʻia ka hū ʻana o ka premolar mua. ʻAʻole i ʻā ʻia ka ʻīlio maʻi ʻākau mau loa. Ua ʻike ʻia ka hemahema o ka lewa no ka ʻīlio maʻi paʻa ma ka ʻaoʻao hema o ka pā. Ke nānā ʻia nei ka hahai ʻana a me ka mālama ʻana no ia mea (Figure 4a-h).

Kūkākūkā

Hōʻike ka palapala e hiki i kekahi niho ke hōʻike i ka transposition. I kekahi manawa, aia ka ʻoki waena ma waena o ka ʻaoʻao ʻaoʻao a me ka ʻīlio o ka ʻaoʻao hoʻokahi, hiki ke kau ʻia ka ʻoki waena ʻākau ma kahi o ka hema a me ka hema ma kahi o ka incisor akau. Aia paha kahi ʻāpana ʻaoʻao ma waena o ka canine a me ka premolar mua a i kekahi manawa e hū ka canine ma waena o ka premolar mua a me ka lua [4,5]. Ma ka helu helu, ʻo ka maxillary permanent canine ka niho i komo pinepine ʻia i ka transposition (0.135-0.51%) a hōʻike i ka mea kiʻekiʻe loa o ka transposition me ka premolar mua [6]. ʻOiai he mea liʻiliʻi pinepine, akā ua kākau ʻia ka transposition canine me ka incisor ʻaoʻao, ka incisor waena a me ka kakaikahi me ka premolar lua a i ʻole ka molar mua [3,7,8].

Nā koho lapaʻau

1) ʻO ka wehe ʻana: ʻo ka wehe ʻana i nā ʻīlio transmigrated kekahi ʻano o ka mālama ʻana i ia mau hihia. 2) Ka hoʻololi ʻana: ke lawa ka wahi e hoʻokipa ai i ka ʻīlio 3) Hōʻike a me ka alignment Orthodontic. 4) Ka nānā ʻana e hāʻawi i ka manawa e ʻike ai inā loaʻa kahi neʻe hou ma hope o ka pau ʻana o ka ulu ʻana o nā niho. Hoʻokaʻawale ʻia ʻo Mupparapu (Ke ʻano 1-5) ma muli o ko lākou ʻano neʻe a me ke kūlana hope i loko o ka ʻāwae ke ʻike ʻia. ➢ ʻAno 1: Hoʻonoho ʻia ka ʻīlio ma ka mesio-angularly ma waena o ka laina waena i loko o ka iwi āwae, labial a lingual paha i ka niho mua a me ka ʻāpana lei o ka niho e ʻaʻa i ka laina waena. ➢ ʻAno 2: Hoʻopili ʻia ka ʻīlio ma ka ʻaoʻao ma kahi kokoke i ka palena haʻahaʻa o ka maʻi ma lalo o nā kihi o nā ʻoki. ➢ ʻAno 3: ʻO ka ʻīlio e hū ana i ka mesial a i ʻole ka mamao i ka ʻīlio ʻē aʻe. ➢ ʻAno 4: Hoʻopili ʻia ka ʻīlio ma kahi ākea kokoke i ka palena haʻahaʻa o ka maʻi ma lalo o nā ape o nā mola mua a i ʻole nā mola ma kēlā ʻaoʻao. ➢ ʻAno 5: Hoʻonohonoho ʻia ka ʻīlio ma ka laina waena. (The long axis of the tooth crossing the midline) me ka nānā ‘ole i ke kūlana pele [18]. ʻO ka hihia i hōʻike ʻia i kēia manawa, ua hōʻike ʻia ka piko o ka ʻīlio maʻi maʻi ʻākau e hele ana i ka laina waena a hiki i kahi liʻiliʻi ma waho a ma lalo paha o nā aʻa o nā incisors (Ke ʻano 2). Ua helu ʻo Peck S. lāua ʻo Peck L i ka transposition niho maxillary ma kahi ʻatikala maʻamau i paʻi ʻia ma Mei 1995 ma ka puke pai ʻAmelika o nā orthodontics and dentofacial orthopedics. Ma ke kumu o nā kumu anatomic, ʻelima ʻano o ka transpositions niho maxillary i ʻike paʻa ʻia ma waena o 201 poʻe i kā lākou noiʻi. Hōʻike ʻia ka papa inoa ma lalo e like me nā niho i pili. 1. Canine-Mua mua [Mx. C. P1] 2. Canine-Lateral incisor [Mx. C. 12] 3. Canine i ke kahua mola mua [Mx. C to M1] 4. Lateral incisor-Central incisor [Mx. 12. I1] 5. Canine a hiki i ke kahua kikowaena waena [Mx. C to I1] [1,2,5]. Kakaʻikahi loa ka hoʻololi ʻana o nā niho i loko o ka piko o mandibular (0.003%). ʻO nā niho maʻamau e pili ana i nā ʻīlio a me nā ʻāpana ʻaoʻao [4]. Ua hōʻike pū ʻia kekahi mau hihia o ka mandibular second premolar a me ka molar mua ma ka palapala. Ke ʻano o ka hoʻololi ʻana: Paʻa a piha ʻole paha ka hoʻololi [17]. He unilateral a bilateral paha [18]. I ka hoʻololi piha ʻana, hoʻololi ka lei a me ke aʻa holoʻokoʻa o nā niho i ko lākou mau wahi i ka ʻano piha ʻole, hoʻololi wale ʻia nā lei aliʻi a noho nā aʻa aʻa i ko lākou kūlana maʻamau [19]. ʻOi aku ka nui o ka hoʻololi ʻana unilateral ma mua o ka bilateral (12:1 ratio) a ʻo ka ʻaoʻao hema i hōʻike ʻia e pili pinepine ʻia ma mua o ka ʻaoʻao ʻākau (2:1 ratio) [20]. ʻIke ʻia ka hoʻololi ʻana o nā niho ma ke ʻano he transposition piha i ka wā e hoʻololi ai nā lei a me nā aʻa o nā niho i hoʻopili ʻia i nā wahi i loko o ka piko niho a me ka transposition piha ʻole ke hoʻololi ʻia nā lei aliʻi, akā mau nā aʻa i ko lākou kūlana maʻamau. ʻO ka canine kekahi o nā niho i komo maʻamau i ka hanana transposition [19,20]. ʻAʻole ʻike ʻia ke kumu o ka transposition. ʻO nā kumu i manaʻo ʻia ʻo ia ka hoʻoneʻe ʻana o ka ʻōpuʻu niho a i ʻole ka haʻalele ʻana i ka wā o ka ulu ʻana o ka niho, ka hoʻololi ʻana o ka genetic ma waena o nā ʻōpuʻu niho, nā pilikia mechanical i ka hū ʻana, ka nalowale mua a i ʻole ka paʻa ʻana o nā niho deciduous [21]. I ka heluna nui, ʻo ka prevalence o ka transposition niho ma kahi o 0.4%. Hoʻopili pinepine ia i ka niho niho/lateral incisor a ma ka ʻaoʻao hema. Me kēia, hāʻawi mākou i ka hōʻike mua o ka mandibular canine transposition a me ka premolar mua i kahi maʻi Libyan kāne no ka manawa mua ma ka palapala [22]. He mea koʻikoʻi loa ka ʻike mua ʻana o kahi transposition e ulu ana a he hopena nui i ka wānana. Hiki ke hana ʻia kēia e ka hoʻokolohua radiographic inā aia ka mea maʻi ma waena o 6 a 8 mau makahiki. Ke ʻike mua ʻia ka hoʻololi ʻana, hiki ke hana ʻia nā kaʻina hana interceptive e like me ka unuhi ʻana i nā niho deciduous a me ka hoʻokomo ʻana i nā alakaʻi o ka hū ʻana no nā niho paʻa, no laila e pale ai i ka ulu ʻana o ka anomaly. Ma ka ʻaoʻao ʻē aʻe, i ka wā e ʻike ʻia ai ka hoʻololi ʻana i ka wā ma hope, pono e hoʻoponopono ʻia ka hoʻolālā ʻana o ka lāʻau orthodontic [1,3]. ʻO ka transposition premolar canine kiʻekiʻe i nā poʻe maʻi makua hiki ke noʻonoʻo i nā koho lapaʻau, me ka ʻole a i ʻole ka unuhi ʻana o ka premolar [3], (Papa 1).
Inā he bilateral ka anomaly, pili nā niho like ma nā ʻaoʻao ʻelua; ʻoiai kakaikahi ka transposition asymmetrical. ʻAʻole i hōʻike ʻia ka hoʻololi ʻana i nā niho deciduous. Nui nā manaʻo i manaʻo ʻia e wehewehe i ka etiology o ka transposition e pili ana, nā ala pele i hoʻololi ʻia, ka hoʻololi kūlana o nā ʻōpuʻu niho i ka noho ʻana o nā niho kumu i hoʻopaʻa ʻia a me ka trauma [1]. I kēia manawa, hoʻololi ʻia nā canine mandibular me nā incisors lateral mandibular, kahi hōʻike ʻokoʻa loa. Ua hōʻike ʻo Shapira e hiki ke hoʻomohala ʻia ka hoʻololi ʻana o nā ʻīlio ma ke alo o nā ʻīlio ma muli o ka hū ʻana o ka incisor lateral mau loa e alakaʻi ai i ka nalowale mua ʻana o nā ʻīlio mua. ʻEkolu mau koho lapaʻau i hāʻawi ʻia i ka mea maʻi, e waiho i ka niho e like me ia [19]. No ka hoʻolikelike ʻana i nā ʻīlio i hoʻololi ʻia i loko o nā ʻōpū ʻaoʻao a me nā ʻāpana ʻaoʻao i hoʻololi ʻia i loko o nā ʻīlio a hoʻohālike i ka niho kūpono e komo pū ana me nā mīkini maʻalahi a me ka lōʻihi o ka mālama ʻana. Loaʻa iā ia kekahi mau manaʻo maikaʻi a me ka hana, ʻoi aku ka nalowale o ka occlusion alakaʻi ʻia i ka canine a hoʻololi ʻia ka contour gingival ma ka ʻaoʻao mua e koi ai i kahi kaʻina hana hou periodontal recontouring [7] a e hoʻoponopono i ka canine i hoʻololi ʻia i kona kūlana kumu ma o ke ʻano o ka mālama orthodontic paʻa. . ʻO ia ka mea e pili ana i nā kumu like ʻole e like me ke ʻano o ka occlusion o ka mea maʻi, ka nui o nā niho, esthetics, ke kūlana o nā radicular apices, socio-economic kumu, a ʻo ka mea hope akā ʻo ka mea nui ka hoʻoikaika o ka mea maʻi [1,4,5]. ʻO ka hoʻololi unilateral a me ka ʻaoʻao hema ka mea maʻamau ma mua o ka transposition bilateral. Hoʻohana ʻia ka huaʻōlelo hoʻololi holoʻokoʻa i ka wā e ʻike ʻia ai ka lei aliʻi a me ke kumu aʻa holoʻokoʻa o nā niho i pili i ko lākou kūlana transposed a me kahi transposition piha ʻole, inā ʻo ka transposition no ka lei aliʻi, akā ʻaʻole ke aʻa apex [23,24]. ʻO ke kūlana maʻamau o ka hoʻomohala ʻana o ka ʻūhā ʻaoʻao mau loa o ka mandibular he lingual ia i kona mua, a ma ka hū ʻana e neʻe ʻo ia i ka labially e hoʻihoʻi i ke kumu o ka niho deciduous [25-28]. ʻO ka wehewehe ʻana no ka hoʻoneʻe ʻana o ka incisor ʻaoʻao e ulu ana, ʻo ia ka paʻa lōʻihi o ka mea ma mua. ʻO kahi ʻē aʻe, ʻo ke ala kūpono ʻole o ka hū ʻana o ka niho mau ke kumu no ka nele o ka resorption o ka niho deciduous i hoʻopaʻa ʻia. ʻO nā hihia a pau i hōʻike ʻia o ka ectopic mandibular permanent lateral incisors pili i nā niho deciduous paʻa. He nui ka poʻe i hōʻike i kahi exfoliation mua o ka molar mua deciduous [27-29]. ʻAʻole maopopo naʻe, inā paha ʻo nā niho deciduous i mālama ʻia ke kumu, a i ʻole ka hopena o ka neʻe ʻana a me ka hū ectopic o ko lākou mau hope. ʻAʻole like me ka maxilla, kahi o ka neʻe ʻana o ka canine ke kumu nui o ka transposition, ma ka mandible ka hoʻoneʻe ʻana o ka incisor lateral mau loa ke kumu nui o ka transposition [25.26]. ʻO nā hoʻololi kūlana o ka hoʻonui ʻana o nā niho i ka wā mua loa o ka odontogenesis a me ka mana genetic i loko o ka follicle niho, ua manaʻo ʻia he kumu kumu no ka transposition niho [3,21,30]. I kēia hihia, ʻike ʻia ka transposition ma ke ʻano he ʻano piha me ke kōkua o ka hoʻokolohua lapaʻau a me nā ʻike radiographic. No laila, pono e hoʻoneʻe ʻia ka incisor ʻaoʻao ma ka ʻōlelo e wehe i ke keʻakeʻa no ka canine, a pono e neʻe ʻia ka canine me nā mechanics orthodontic a ma hope o ka hoʻohuli ʻana i nā niho i hoʻololi ʻia, e hoʻokō nā hopena lapaʻau i nā hana āpau a me ka nani a mālama i kahi kūpaʻa. occlusion.

Nā hopena

ʻO ka ʻike mua ʻana o nā transpositions e kōkua i ka hoʻoponopono ʻana me ka liʻiliʻi o ka pōʻino i nā ʻiʻo a puni. Hiki i kēia me ka hoʻokolohua lapaʻau i kēlā me kēia manawa a me ka nānā ʻana i ka radiographic piha. ʻO ka hana a me ka hoʻihoʻi esthetics i nā maʻi me ka transposition niho e pili ana i ka hoʻolālā lapaʻau a me ka hui pū ʻana o ka mea maʻi.

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