Ke pilikia nei ʻoe me kou iwi ʻauwae? E kamaʻilio kākou e pili ana i ka Osteonecrosis o ka ʻAuwae (ONJ)!

Ua loaʻa paha iā ʻoe kahi ʻeha ma kou waha i hoʻōla ʻole ʻia ma hope o ka unuhi ʻana i ka niho a i ʻole ke ʻoki niho, e waiho ana i kou iwi ʻauwae i hōʻike ʻia? A i ʻole he ʻeha mau a me ka pehu ʻana i loko o kou waha me ka wehewehe ʻole ʻia, ʻoiai ma ka ʻāpana ʻauwae? Hiki i kēia ke lilo i kūlana a mākou e kamaʻilio ai i kēia lā i kapa ʻia ʻo Osteonecrosis of the Jaw (ONJ) , kahi kūlana i manaʻo ʻole ʻia akā he mea nui loa e makaʻala. Mai hopohopo, e kamaʻilio maʻalahi kākou e pili ana.

He aha kēia onychomycosis o ka ʻauwae (ONJ)?

I ka ʻōlelo maʻalahi, ʻo ONJ ka manawa e make ai nā pūnaewele i loko o kou iwi ʻauwae . ʻO kēia no ka mea ʻaʻole lawa ka lako koko o ka iwi. E noʻonoʻo e pili ana, pono kēlā me kēia ʻāpana o ko mākou kino i ke koko e ola ai. No laila, inā pau ka lako koko i kahi ʻāpana o ka iwi ʻauwae, e hoʻomaka mālie nā pūnaewele ma laila e make. Ua kapa pū nā kauka i kēia ʻano he "osteonecrosis ." ʻO "Osteo" ke ʻano o ka iwi, a ʻo "necrosis" ke ʻano o ka make. I kekahi manawa ua kapa ʻia ʻo "avascular necrosis," ʻo ia hoʻi ka make ma muli o ka nele o ke koko ma o nā kīʻaha koko.

ʻO ka mea maʻamau e hana ʻia, ʻo ia ka hana ʻana o kahi ʻeha liʻiliʻi a puka paha i loko o nā ʻāʻī, e hōʻike ana i ka iwi ʻā. Ke hōʻike ʻia kēia, hoʻomaka ka iwi e make no ka mea ʻaʻohe ona lako koko.

Pehea ka maʻamau o kēia ʻano?

ʻAʻole maʻamau ka ONJ . Eia nō naʻe, hiki ke ʻike ʻia i nā poʻe e lawe ana i kekahi mau ʻano lāʻau lapaʻau (e kamaʻilio mākou e pili ana iā lākou ma hope) i hoʻohana ʻia e hoʻoikaika i nā iwi ma ke ʻano he lāʻau lapaʻau no kekahi mau ʻano maʻi kanesa (maʻi kanesa metastatic). ʻO ke ʻano kēia, aia ma kahi o ʻelua o kēlā me kēia 100 mau maʻi kanesa e lawe ana i kēlā mau lāʻau lapaʻau i loaʻa ka manawa e loaʻa ai iā ia. Hiki i nā poʻe ʻaʻohe maʻi kanesa a ʻaʻole lawe i kēlā mau lāʻau lapaʻau ke loaʻa iā ia, akā ʻaʻole ia he mea maʻamau.

He like anei ka ONJ a me ka osteomyelitis?

He mau ʻano ʻeha kēia mau mea ʻelua e hoʻopilikia ai i ka iwi ʻauwae. Akā, ʻelua mau mea like ʻole ʻo ONJ a me osteomyelitis . He maʻi iwi ka Osteomyelitis i hoʻokumu ʻia e ka bacteria a i ʻole ka fungi. Ke hiki kēia maʻi i ka iwi ʻauwae, hiki iā ia ke hana i nā hōʻailona like me ONJ. Eia nō naʻe, hoʻoulu pinepine ka osteomyelitis i ke kuni , ʻoiai ʻaʻole hana pinepine ʻo ONJ. Hiki i nā kauka ke ʻike i kahi maʻi ma ka hana ʻana i nā hoʻāʻo koko.

No laila, ua like kēia me ka osteoradionecrosis?

ʻAʻole, he moʻolelo ʻokoʻa kēlā. ʻO ka Osteoradionecrosis kahi maʻi e hiki ke ulu i loko o ka poʻe i loaʻa i ka radiation therapy no ke kanesa poʻo a ʻāʻī paha. Hiki i ka radiation therapy ke hōʻino i nā kīʻaha koko e hoʻolako koko i nā iwi. A laila make nā iwi me ke koko ʻole. He ʻoiaʻiʻo kēia inā ua unuhi ʻia kou niho ma hope o ka radiation therapy.

He aha nā hōʻailona o ka make ʻana o ka iwi ʻauwae?

Inā ua hana ʻia kekahi mea i kou mau niho i kēia manawa (e like me ka unuhi ʻana i ka niho, ka hoʻopihapiha ʻana i ka niho), e ʻike paha ʻoe i ka ʻeha ma kahi i hana ʻia ai. ʻAʻole paha e ʻike ʻia kekahi poʻe i kekahi mau hōʻailona i ka wā mua.

ʻO nā hōʻailona maʻamau o ONJ :

• ʻEha ʻauwae
• Nā niho palupalu
• Nā ʻeha waha - ʻoiai nā mea i ho'ōla ʻole ʻia
• Ka hoʻokuʻu ʻana e like me ka pus mai nā ʻāʻī a me ka waha
• ʻĀʻī pehu
• I kekahi manawa ua hōʻike ʻia ka iwi ʻauwae ma o nā ʻāʻī (iwi i hōʻike ʻia)

E noʻonoʻo, ua unuhi ʻia kou niho, a i ʻole ua hana ʻia kahi ʻoki liʻiliʻi ma ka niho. Akā inā ʻaʻole i ho'ōla pono ʻia ka wahi ma hope o nā pule, a aia kekahi ʻāpana iwi e puka ana mai loko mai, he ONJ paha ia.

No ke aha e hana ai ka onychomycosis o ka ʻāwae (ONJ)?

Hoʻomaka pinepine ʻia ka ONJ ma hope o ka unuhi ʻana o ka niho, ka hoʻokomo niho, a i ʻole kekahi ʻoki ʻana o ka iwi ʻāʻī. ʻO ka maʻamau, pono e ho'ōla koke ka ʻiʻo ʻāʻī a uhi i ka iwi. Eia naʻe, ma ka ONJ, ʻaʻole kēia e hana a ua hōʻike ʻia ka iwi ʻāʻī. A laila, ua hoʻonele ʻia ka iwi i hōʻike ʻia i ke kahe koko, a hoʻomaka nā hunaola iwi e make.

Eia naʻe, he mea paʻakikī loa, hiki i ka ONJ ke ulu me ke kumu ʻole.

ʻO wai ka mea i ʻoi aku ka nui o ka pilikia o ka hoʻomohala ʻana i ka ONJ?

ʻOiai hiki i kekahi ke hoʻomohala i ka ONJ, ʻoi aku ka nui o ka pilikia o kekahi poʻe.

• ʻO Bisphosphonates: He ʻano lāʻau lapaʻau kēia i hāʻawi ʻia e hoʻolohi i ka nalowale o ka iwi a hoʻoikaika i nā iwi. ʻO ka poʻe e lawe ana i nā bisphosphonates intravenously (IV) e hōʻemi i ka hōʻino ʻana o ka iwi i hoʻokumu ʻia e ka maʻi kanesa metastatic a pale i nā haki he nui ko lākou pilikia. Ua hōʻike ʻia nā haʻawina he haʻahaʻa ka pilikia o ka poʻe e lawe ana i nā bisphosphonates waha no nā kūlana e like me ka osteoporosis .
• ʻOiai ma luna o 65 mau makahiki.
• Lapaʻau chemotherapy.
• Loaʻa i ka maʻi diabetes (Diabetes Mellitus).
• He haki a ʻeha paha o ka maka.
• ʻO ka maʻi periodontal, ʻoi aku ka periodontitis koʻikoʻi.
• Ka hoʻohana ʻana i nā corticosteroids i ka wā lōʻihi.
• ʻO kekahi mau maʻi viral, e like me ke shingles.
• Puhi paka.
• Ke komo ʻana i nā niho kuʻi (ʻoiai nā mea i kūpono ʻole).

Pehea e ʻike ʻia ai kēia maʻi ONJ?

Hiki i kāu kauka niho a kauka waha paha ke kānalua iā ONJ ma muli o kāu mau hōʻailona.ʻO ka mea nui loa, ʻo ia ke ʻike koke i ke kauka niho ke manaʻo ʻoe he pilikia kou, ʻoiai inā he mau kumu pilikia kāu i ʻōlelo ʻia ma luna.

Inā ua hōʻike ʻia ka iwi ʻauwae no nā pule he 8 a ʻoi, he hōʻailona koʻikoʻi ia o ONJ. ʻO ka wikiwiki o kou ʻike ʻia ʻana a me ka mālama ʻia ʻana, ʻo ka nui o ka hiki ke hoʻopakele i kou iwi ʻauwae a me kou mau niho.

He aha nā pae o ka maʻi ONJ?

Hiki ke hoʻokaʻawale ʻia ka ONJ i ʻehā mau pae (0 a 3). ʻO ke kahua 0 ka mea ʻoi loa ka ʻino, a ʻo ke kahua 3 ka mea ʻoi loa ka ʻino. E haʻi aku kāu kauka iā ʻoe i ke kahua āu i loaʻa ai ke ʻike ʻia ʻoe.

• Pae 0: Ke lawe nei ʻoe i nā bisphosphonates intravenous, ʻeha kou ʻāwae, akā ʻaʻohe iwi ʻāwae i hōʻike ʻia. ʻAʻohe hōʻailona ʻē aʻe o ONJ. I kēia pae, hiki ke kumu ʻia kāu mau hōʻailona e kekahi maʻi ʻāʻī ʻē aʻe, e like me ka periodontitis .
• Pae 1: Ua hōʻike ʻia ka iwi ʻauwae, akā ʻaʻohe ʻeha a i ʻole nā ​​​​hōʻailona ʻē aʻe.
• Pae 2: Ua hōʻike ʻia ka iwi ʻauwae, a aia nā hōʻailona o ka ʻeha, nā ʻāʻī pehu, a me ka maʻi.
• Pae 3: Loaʻa nā hōʻailona āpau o ke pae 2, a ua laha ka make o ka iwi i nā sinuses a me nā ʻāpana ʻē aʻe o ka maka.

Pehea e mālama ʻia ai kēia maʻi ONJ?

Hoʻōla ʻia ʻo ONJ e nā kauka niho waha a me nā prosthodontists, nāna i loea i nā kūlana niho a me ka ʻāwae paʻakikī. ʻOkoʻa nā koho lapaʻau ma muli o ke kahua o ka maʻi.

Lapaʻau no ke kahua 0

I kēia wā, nānā ke kauka i nā hōʻailona a kōkua i ka kaohi ʻana iā lākou.

• Nā lāʻau lapaʻau
• Holoi waha antiseptic
• Nā mea hōʻoluʻolu ʻeha

Lapaʻau no ka Pae 1

Maanei, e ʻoki ke kauka i nā hunaola iwi make i hōʻike ʻia. Ua kapa ʻia kēia he "debridement." Pale kēia i ka make hou ʻana o ka iwi a kōkua i ka ho'ōla ʻana o nā ʻāʻī ma luna o ka iwi. A laila e hāʻawi ʻia iā ʻoe nā lāʻau antibiotic, nā mea hoʻomaha ʻeha, a me kahi holoi waha kūikawā.

Lapaʻau no ke kahua 2 a me ke kahua 3

I kēia pae, pono ke ʻoki kino e wehe i ka iwi ʻauwae make a me nā niho i hoʻopili ʻia iā ia. Wehe ʻia kekahi mau ʻiʻo olakino e hōʻoia i ʻole e koe nā hunaola maʻi. I ke pae 3, hiki ke hana ʻia kahi ʻoki kino ʻokoʻa e wehe i ka iwi make i pālahalaha i nā lua ihu. Ma hope o ke ʻoki kino, pono ʻoe e hoʻohana i kahi holoi waha kūikawā, nā lāʻau antibiotic, a me nā lāʻau ʻeha.

Hiki iā mākou ke pale iā mākou iho mai ONJ?

ʻAe, i kekahi ʻano hiki.

• E mālama i ke olakino maikaʻi o ka waha: E palaki i ka waha, e hoʻohana i ka floss, a e hoʻohana i ka floss i kēlā me kēia lā.He mea nui loa ka hoʻomau ʻana i ka hele ʻana i nā hoʻokolokolo niho.
• Inā loaʻa iā ʻoe ka maʻi ʻāʻī, e mālama pono ʻia.
• ʻO ka mea nui loa: Inā ʻoe e lawe ana i nā lāʻau anti-resorptive (e.g. bisphosphonates), e hōʻoia e haʻi i kāu kauka niho. A laila hiki iā ia ke koho i nā lāʻau lapaʻau ʻaʻole invasive no kāu mau pilikia niho. No ka laʻana, inā pono ʻoe e unuhi i kahi niho, ʻoi aku ka maikaʻi o ka hana ʻana i kahi mālama aʻa .

E hoʻomanaʻo, ʻo ka hoʻomaopopo ʻana i kāu kauka niho e pili ana i nā lāʻau lapaʻau āu e lawe nei hiki ke hōʻemi nui i ka pilikia o ONJ.

He aha ka mea e hiki mai ana no kekahi me ONJ?

Hiki i ka ʻike mua ʻana a me ka mālama ʻana ke kōkua i ka pale ʻana i ka ONJ mai ka ʻino ʻana a mālama i ka iwi ʻauwae. I nā pae mua, hoʻōla ka nui o ka poʻe me ka mālama ʻoki ʻole. Eia nō naʻe, inā lilo ka maʻi i mea koʻikoʻi, hiki iā ia ke alakaʻi i ka nalowale ʻana o ka iwi ʻauwae a me nā niho.

Āhea ʻoe e ʻike ai i ke kauka?

Inā loaʻa iā ʻoe kekahi o kēia mau hōʻailona, ​​e ʻike koke i ke kauka, ʻoiai ke kauka niho:

• Ke kahe koko, ka ʻulaʻula, a i ʻole ka pehu ʻana o nā ʻāʻī.
• Ka paʻakikī i ka ale ʻana i ka meaʻai.
• ʻEha ʻauwae.
• Nā niho palupalu.

He aha nā nīnau āu e nīnau ai i kāu kauka?

Hiki iā ʻoe ke nīnau i ke kauka i nā nīnau penei:

• He aha kaʻu e hana ai e pale aku iaʻu iho mai ONJ?
• ʻEhia pinepine e pono ai iaʻu e hoʻomaʻemaʻe i koʻu mau niho?
• No ke aha i loaʻa ai iaʻu ka ONJ?
• I ke kahua hea o ONJ aʻu e noho nei?
• E pono anei iaʻu ke ʻoki kino?

ʻO ka mea hope loa, nā mea e hoʻomanaʻo ai ...

. ‍ ONJ , ‍ . ‍ ‍ . , ‍ ONJ ‍ .

Inā ʻike ʻoe i kekahi mau hōʻailona ʻē e like me ka ʻeha o ka ʻauwae, nā niho palupalu, ka paʻakikī i ka ʻai ʻana, ke kamaʻilio ʻana, a i ʻole ke ale ʻana, e ʻike koke i ke kauka niho. Hiki i ka hana wikiwiki ke kōkua nui i ka pale ʻana i kou mau niho, iwi, a me nā ʻāʻī.

ʻO ka make ʻana o ka iwi ʻauwae, ONJ, ʻeha ʻauwae, pilikia niho, maʻi ʻāʻī, bisphosphonates, mālama ʻana i ka maʻi ʻaʻai