📘 ملخصات وشرح كتاب Endodontics Principles and Practice

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█ حصريا تحميل كتاب Endodontics Principles and Practice مجاناً PDF اونلاين 2022 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 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

تسجيل دخول

📘 Endodontics Principles and Practice

Endodontics
Principles and Practice

Mahmoud Torabinejad, DMD, MSD, PhD
Professor and Program Director, Department of Endodontics, School of Dentistry, Loma Linda University, Loma Linda, California
Richard E. Walton, DMD, MS
Professor, Department of Endodontics, The University of Iowa, College of Dentistry, Iowa City, Iowa
Copyright 2009 by Saunders, an imprint of Elsevier Inc.
SAUNDERS

Vascular Changes During Inflammation
When the dental pulp is injured, it responds in the same way as other connective tissues with a two-phase immune response.
The initial immune response is nonspecific but rapid, occurring in minutes or hours. The second response is specific and
includes the production of specific antibodies. Before the detailed nature of the immune response was known, the phenomena
associated with the response to tissue injury, including redness, pain, heat, and swelling, was known as inflammation.
Although much more is now known about the response to injury at the cellular level, these “cardinal signs” remain important.
Except for pain, they are all vascular in origin. Heat and redness are results of increased blood flow, and swelling results from
increased formation of interstitial tissue fluid because of increased permeability of the capillaries. In other tissues, such as skin
(in which inflammation was first described), the increased production of tissue fluid results in swelling. Because the dental pulp
is within a rigid, noncompliant chamber, it cannot swell, and the increased interstitial fluid formation results in an increase in
tissue fluid pressure. At one time, it was thought that this rise in interstitial fluid pressure would spread rapidly and strangle
vessels entering the root canal at the apical foramen. Closer study has revealed that this is incorrect. Elevations in tissue fluid
pressure remain localized to the injured area. A short distance from the injury, tissue fluid pressure is maintained within normal
limits. As interstitial fluid pressure rises, the intraluminal (inside) pressure of the local capillaries increases to balance this, so
that the vessels remain patent. During the response to injury, the gradients by which nutrients and wastes leave and enter the
capillaries change to allow greater exchange. At the same time these changes occur in the capillaries, lymphatic vessels
become more heavily employed, removing excess tissue fluid and debris. In addition, anastomoses in the microvascular bed
allow blood to be shunted around an area of injury, so that the oxygenation and nutrition of nearby uninjured tissue are not
compromised. If the cause of the injury is removed, these processes will gradually return the vasculature to normal, and repair
or regeneration can take place. If the injury persists and increases in size, this tissue will necrose. This necrosis can remain
localized as a pulpal abscess, although it more often spreads throughout the pulp.
The vascular changes seen in inflammation are largely mediated by local nerves. The sympathetic fibers through the
precapillary sphincters can alter the pressure, flow, and distribution of blood. Sensory nerve fibers release a number of
neuropeptides but most prominently calcitonin gene–related peptide (CGRP) and substance P. (These names are of historic
origin and unrelated to the function of these molecules in this setting.) The release of these neuropeptides comes about
through axon reflexes, whereby one branch of a sensory nerve stimulated by the injury causes the release of the peptides by
another branch. This mechanism, in which excitation of sensory elements results in increased blood flow and increased
capillary permeability, is known as neurogenic inflammation