█ _ 0 حصريا كتاب ❞ Endodontics Principles and Practice ❝ 2024 Practice: Endodontics Principles Practice Mahmoud Torabinejad, DMD, MSD, PhD Professor Program Director, Department of Endodontics, School Dentistry, Loma Linda University, Linda, California Richard E Walton, MS Professor, The University Iowa, College Iowa City, Iowa Copyright 2009 by Saunders, an imprint Elsevier Inc SAUNDERS Vascular Changes During Inflammation When the dental pulp is injured, it responds in same way as other connective tissues with a two phase immune response The initial nonspecific but rapid, occurring minutes or hours second specific and includes production antibodies Before detailed nature was known, phenomena associated to tissue injury, including redness, pain, heat, swelling, known inflammation Although much more now about injury at cellular level, these “cardinal signs” remain important Except for they are all vascular origin Heat redness results increased blood flow, swelling from increased formation interstitial fluid because permeability capillaries In tissues, such skin (in which first described), Because pulp is within rigid, noncompliant chamber, cannot swell, increase in tissue pressure At one time, thought that this rise would spread rapidly strangle vessels entering root canal apical foramen Closer study has revealed incorrect Elevations fluid pressure localized injured area A short distance from maintained normal limits As rises, intraluminal (inside) local increases balance this, so that vessels patent gradients nutrients wastes leave enter the capillaries change allow greater exchange time changes occur capillaries, lymphatic vessels become heavily employed, removing excess debris addition, anastomoses microvascular bed allow be shunted around so oxygenation nutrition nearby uninjured not compromised If cause removed, processes will gradually return vasculature normal, repair or regeneration can take place persists size, necrose This necrosis remain localized pulpal abscess, although often spreads throughout seen largely mediated nerves sympathetic fibers through the precapillary sphincters alter pressure, distribution Sensory nerve release number of neuropeptides most prominently calcitonin gene–related peptide (CGRP) substance P (These names historic origin unrelated function molecules setting ) neuropeptides comes about through axon reflexes, whereby branch sensory stimulated causes peptides by another mechanism, excitation elements flow increased capillary permeability, neurogenic كتب طب الأسنان مجاناً PDF اونلاين هو فرع من فروع الطب يختص بدراسة وتشخيص ومعالجة أمراض الفم والوجه والفكين والأسنان والأنسجة المحيطة بها والوقاية منها ويتفرع إلى العديد الاختصاصات يعتبر فنا وعلما أطباء أو جراحو هم المختصون تشخيص ووقاية وعلاج تجويف يساعد طبيب فريق داعم يوفر خدمات مثل استخدام التصوير الشعاعي وغيرها التقنيات لضمان صحيح وتخطيط للعلاج قد يشمل العلاج ملء تجاويف وإزالة أعصاب أثناء علاج الجذور اللثة قلع إذا استلزم الأمر واستبدال المفقودة بأطقم كثيرا ما يستخدم التخدير قبل الذي يسبب الألم يمكن بالذهب الفضة الخزف مزيج تدخل الأنسجة الرخوة للفم ضمن مجال أكثرها شيوعا