问题 问答题 简答题

简述无牙颌的口腔检查。

答案

参考答案:

1.颌面部检查患者面部有无畸形、缺损,左右是否对称,面下1/3高度与面长是否协调,颞下颌关节情况,上唇部的丰满度,上唇的长短是否左右相等,上唇运动时左右长短有无明显差别,因为上唇与排列上前牙密切相关。

2.牙槽嵴检查拔牙创口是否愈合,有无残根、骨尖、瘘管,下颌隆突或上颌结节是否过分突出,若有上述情况,须做外科处理。检查上下颌弓的形状和大小是否协调,上下颌弓形状、大小不协调会给排牙带来困难。

3.颌弓的大小和形态颌弓的形态一般分为方圆形、卵圆形、尖圆形三种,并有大、中、小之分,对选择人工牙的大小、形态和排列有重要指导作用。

4.上下颌弓的位置关系

(1)水平关系

①正常:上下颌弓前后位置关系正常,形状、大小大致相等。侧面观上下颌弓的唇面基本在同一水平面上,或上颌在下颌的略前方。

②上颌前突:上颌弓大,下颌弓小,上颌位于下颌的前方和侧方。

③下颌前突:上颌弓小,下颌弓大,下颌位于上颌的前方和侧方。

(2)垂直关系指上下颌弓的上下关系,在正中颌位时,上下牙槽嵴之间的距离即颌间距离。

①颌间距离大:牙槽嵴吸收较多,人工牙排列方便,但义齿固位、稳定性较差。

②颌间距离小:表明牙槽嵴丰满,有利于义齿的固位和支持,但排牙较困难,常需要磨改人工牙的盖嵴部。

③颌间距离中等:牙槽嵴有一定的高度和宽度,有利于人工牙的排列和义齿的固位及支持。

5.上下唇系带

注意位置是否与面部中线一致,附着点位置如何。如牙槽嵴低平者,肌、系带附着点离牙槽嵴顶近,甚至与之平齐。当肌、系带运动时,易造成义齿脱位。

6.腭穹隆

其形态与义齿的固位、稳定有很大关系。

7.舌体

由于失去了牙列的限制,无牙颌患者舌体常常变大,舌运动时易影响义齿的稳定。如果舌的位置不正常,处于后缩位,容易推动义齿脱位。故检查时,应注意舌的位置、形态、舌体大小和活动情况等。正常时,舌的前部边缘约停在下前牙切缘或牙槽嵴顶处。

8.旧义齿检查

对于戴过全口义齿的患者,要询问其重做的原因和要求,特别要了解患者对原义齿有哪些不满意之处,以便做新义齿时克服原义齿的缺陷。当然还要检查原义齿是否将患者的口腔黏膜压伤,有无溃疡,如有,应先停戴旧义齿,并等待黏膜恢复正常后再着手制取印模。

单项选择题
完形填空
Whenever we do something wrong, Jesus Christ sees it. He loves us and doesn’t say it. Perhaps he’s wondering how long we’ll keep our mind suffering. A little boy named Johnny was visiting his grandparents on their farm and he was given a slingshot(弹弓) to play with out in the woods. He  36  for some time but he could never hit the target he had set for himself. Getting a little  37 , he walked back to the farmhouse for dinner. As he was _   38 back, he saw Grandpa’s pet duck. Just out of   39 , he let the slingshot fly , hitting it in the head ,and killed it. In a panic, he    40 the dead duck in the woodpile, only to see his sister Sally   41  be watching him. Sally had seen all this, but she said _42 . After lunch that day Grandma said, “Sally, it’s your turn to wash the dishes.” But Sally said, “Grandma, Johnny told me he wanted to help in the kitchen.” And then she spoke _43 to him, “Remember the duck?” So Johnny did the dishes. Later that day, Grandpa asked if  44  wanted to go fishing, but Grandma said, “I’m sorry but I need Sally to help me make supper.” But Sally just smiled and said, “Well, that’s all right because Johnny told me he was too   45 to help you. And she whispered again, “Remember the duck?” So Sally went fishing and Johnny  46 to help make supper. After several days of doing both his 47 and Sally’s, Johnny finally couldn’t 48 it any longer. He came to his Grandma and told her that he had killed the duck .Grandma smiled and gave him a big 49 . “Sweetheart, I know. You see, I was watering the flowers at the window   50  I saw you shoot my duck with the slingshot, and I saw the whole thing. But because I love you, I  51 you. I was just wondering how long you would let Sally  52_ of you.”
In reality, no matter how  53__or how uncomfortable it is to admit our wrongdoing, we should always choose to  54 it and work it through instead of running away from it. Hard as it is, it  55  us and makes us who we are.
小题1:
A.promotedB.exercisedC.practicedD.consumed
小题2:
A.delightedB.upsetC.amazedD.scared
小题3:
A.runningB.rushingC.headingD.leaving
小题4:
A.sympathyB.prideC.impulseD.politeness
小题5:
A.hungB.presentedC.protectedD.hid
小题6:
A.shouldB.shallC.mustD.might
小题7:
A.nothingB.everythingC.somethingD.anything
小题8:
A.loudlyB.softlyC.guiltilyD.innocently
小题9:
A.SallyB.JohnnyC.the children D.Grandma
小题10:
A.reluctantB.willingC.curiousD.cautious
小题11:
A.kept upB.held backC.left behindD.stayed behind
小题12:
A.choresB.homeworkC.gamesD.sports
小题13:
A.acceptB.stand C.withdrawD.allow
小题14:
A.hugB.blowC.rewardD.award
小题15:
A.whereasB.asC.whileD.when
小题16:
A.appreciateB.admireC.forgiveD.force
小题17:
A.put the blameB.make friendsC.put pressureD.make a slave
小题18:
A.doubtfulB.gratefulC.harmfulD.painful
小题19:
A.reject B.controlC.faceD.witness
小题20:
A.developsB.shapesC.ruinsD.prepares