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Which bones contain alveoli? The cortical plate is thick. Alveolar eminences - Zygomatic bone

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X-ray method- one of the most important in the diagnosis and treatment planning of periodontal diseases. It is not the main one, since it does not always reveal periodontal pockets or the beginning of destruction of the bone tissue of the alveolar process, especially from its vestibular surface, and does not allow assessing the condition of the periodontal soft tissues and the level of epithelial attachment. However, periodontal radiography helps to detect a decrease in the height and type of resorption (vertical or horizontal) of the interdental septa, assess the condition of the interradicular septum and alveolar ridge, the length and shape of the roots of the teeth, the continuity of the cortical plate, the pattern of the bone beams, the width of the periodontal fissure, the presence of subgingival dental deposits , defects in the dentition and during dental restoration, as well as establish the absence of contacts between them and detect other pathological changes. The method is used to evaluate the effectiveness of the treatment.

To study the bone structure of periodontal tissues, various radiography techniques are used, which can be divided into two groups: intraoral and extraoral.

Intraoral are divided into contact, bite, interproximal. The advantage of such techniques is a detailed image of the interdental septa, root furcation area, periodontal fissure, and subgingival dental deposits.

They make it possible to detect pathological changes in the periodontal bone structure at the earliest stages.

However, due to possible projection distortions, not all contact radiographs are informative. Therefore, in periodontology, one should use the interproximal technique, or radiography with a parallel beam of rays, in which special film holders or an X-ray tube with a long localizer cone are used. The beam beam or central beam is directed perpendicular to the tooth and film. A clear, undistorted image of the interdental septa is obtained, although the apexes of the roots of the upper premolars are not projected onto the film.

Of the many extraoral x-ray techniques in periodontology, orthopantomography is most often used, which allows one to obtain a one-time image of the entire dental system as a single functional complex without angular distortions.

An orthopantomogram allows you to establish the nature of the pathological process in the periodontium, its prevalence in depth and extent, plan treatment, evaluate changes in tissues that have arisen during treatment and the manifestations of possible systemic diseases, see and analyze the condition of the temporomandibular joint, paranasal sinuses and much more. The disadvantage of the method is the unclear image of the frontal part of the upper and lower jaws, the inability to assess in detail the condition of the periodontal gap of the teeth and bones. Therefore, the method is used as an additional method to intraoral techniques.

Considering the possibility of the appearance of deep interproximal, narrow, convoluted bone pockets and the difficulty in assessing the degree of destruction of the lingual (palatal) and vestibular wall of the alveolar process of the jaws, contrast X-ray examination is used to clarify the clinical picture. For this purpose, before radiography, gutta-percha pins or softened gutta-percha (in cases of vestibular or lingual localization of wide bone defects) are inserted into periodontal pockets (in narrow spaces).

The bone tissue of the alveolar process on the upper and lower jaws is different in its structure and density. On the upper jaw, it is distinguished by a uniform, finely looped structure with a predominantly vertical direction of the bone beams. For the alveolar process of the lower jaw, the heterogeneity of its structure is typical: finely looped in the anterior section and with a larger pattern in the lateral sections. The direction of the bone beams is predominantly horizontal. The cortical plate of the alveolar ridge of the sockets is visible on the radiograph as a continuous, white stripe, most clearly visible in the area of ​​the incisors. But in fact, it is perforated by many small holes that allow blood and lymphatic vessels to pass through, which connect the ligamentous apparatus of the tooth to the bone.

The maximum height of the interdental septa is limited by the line connecting the enamel-cement border of two adjacent teeth. Given a certain curvature of the jaw, the configuration of the alveolar ridge on the radiograph may not be smooth, but curved. The shape of the interdental septa in the lateral jaw is trapezoidal or rectangular. In the anterior portion of the jaws, the apices of the septa are triangular or dome-shaped.

Between the central incisors there is often a bifurcation of the septum or the presence of a semilunar notch, especially with a diastema or trema. It must be remembered that the anatomical and radiological height of the interdental septum varies by 0-1.6 mm.

Depending on the age and degree of mineralization, x-ray anatomical signs of the bone structure of the alveolar process of the jaws can vary and be misinterpreted.

Dental deposits. Supragingival calculus is usually localized on the lingual surface of the lower teeth and the vestibular surface of the upper molars. Due to the overlapping dense shadow of the hard tissues of the tooth, it is usually not visible on an x-ray until its amount becomes very significant. Subgingival tartar is visible on an x-ray even in very small quantities and is detected in the form of a small dense shadow on the lateral surfaces of the root in the interproximal spaces.

It is especially well determined on intraoral radiographs performed using a parallel technique. The discontinuity and blurring of the contour of the cortical plate is one of the early signs of the progression of chronic catarrhal gingivitis, its transition to periodontitis and indicates the beginning of the apical decrease in epithelial attachment, the inflammatory process in bone tissue and the formation of a periodontal pocket. The disappearance of the cortical plate is primarily noted on the medial or distal surfaces of the septum, then in the region of the apex of the septum.

The expansion of the periodontal gap in the form of a wedge in the area of ​​the tooth neck from the medial and distal surfaces also indicates the appearance of a periodontal pocket and the beginning of resorption of the bone tissue of the interdental septum. The top of this wedge is always directed towards the root of the tooth. At the same time, focal osteoporosis of the apexes of the interdental septa is noted.

Reduced height of interdental septa. For inflammatory changes in the bone structure of the periodontium, caused by the influence of the microflora of the dental plaque, the horizontal type of resorption of the interdental septa is typical. But the level of reduction and its height in different parts of the jaw can be different and depend on the severity of the inflammatory process. Clinically, this type of resorption corresponds to the formation of gingival pockets.

In cases where there are other factors that provoke inflammation in the periodontium (traumatic occlusion, overhanging crowns, fillings, lack of a contact point, etc.), the vertical type of resorption of interdental septa is more typical. This is a Y-shaped shadow localized on one or two surfaces of the tooth root, which is one of the walls of such a defect. Clinically, a bone pocket with 2-4 walls is always detected. You should pay attention to horizontal lines running across the root of the tooth, the presence of which indicates partial or complete destruction of the vestibular or lingual part of the alveolar process.

The appearance of vertical dark (“finger-shaped”) stripes in the center of the interdental septa is caused by deep penetration of the inflammatory process into the bone and is detected with a significant decrease in the height of the interdental septa and osteoporosis.

A periodontal abscess does not have specific radiological signs, and radiography is a method that allows one to clarify its location, the degree of destruction of bone tissue, the extent of the defect, and in some cases helps to make a differential diagnosis with a periapical abscess. The radiograph shows a Y-shaped defect in the bone tissue of the septum, surrounded by an intense and significant zone of osteoporosis. When a fistula tract appears, the presence or absence of communication between the abscess and the periapical tissues can be determined and treatment methods can be clarified by inserting a gutta-percha pin into it.

Occlusal trauma (primary) and parafunctions (bruxism) have a number of classical radiological signs: uniform expansion of the periodontal fissure, primarily in the vestibular direction, excessive deposition of cement in the apical third of the root, sclerosis of the bone tissue of the alveolar process in the periapical region. In the case of secondary occlusal trauma (loss of adjacent teeth, poor-quality prosthetics, etc.), signs of inflammatory changes appear: disruption of the discontinuity of the cortical plate and disappearance of the partitions, uneven decrease in their height.

X-ray signs of occlusal trauma must be compared with clinical symptoms (tooth mobility, the presence of facets on the tuberosities, periodontal pockets, tooth displacement) and with occludogram data. It is necessary to remember about the individual, age-related characteristics of the width of the periodontal gap. In this case, one should rely on a comparative analysis of the patient's radiographs over time. X-ray changes in periodontal tissues in systemic diseases are described in the corresponding section.

Radiological criteria for the stabilization of periodontitis are assessed together with clinical signs (absence of depression, pockets, stability of teeth, ideal oral hygiene). The radiograph shows the absence of osteoporosis and progression of destruction, a clear contour of the interdental septa, and in some cases the formation of a cortical plate at their apexes.

When analyzing radiographs, incorrect interpretation of data is possible due to projection distortions, technical defects in film processing, and the overlap of tooth shadows on the interdental septa. Therefore, surgical treatment often reveals greater bone destruction than was visible on the radiograph, which can change the intended plan and extent of the intervention.

A. S. Artyushkevich
Periodontal diseases

The parts of the jaws on which the teeth are located are called alveolar. They consist of bone tissue (its compact and spongy substance). They contain holes in which the rudiments of teeth are born. They grow over time. It also develops around it so that the teeth have additional support. This area of ​​the jaw is called

If we consider the area by segments, then for each tooth we can distinguish the hole in which it is located, and the bone formations around it with mucous membranes. Feeding vessels, nerves and bundles of connective tissue fibers fit into the hole.

Alveolus

What is a hole for attaching a tooth? This is a depression in the bone tissue of the jaws that forms at birth. The difference in the teeth on the bottom is practically unnoticeable. They differ more in purpose: incisors, canines, molars. Different groups perceive different loads when chewing food.

In front, the alveolar processes of the jaws are thinner, and on the sides (places for chewing) they are thicker and more powerful. Tooth sockets also differ in shape. They may have partitions located slightly deeper than the side partitions. This division is associated with different teeth. Some of them may rest on one trunk, or they may have two or three.

The alveolus exactly matches the size and shape of the tooth. Or rather, it grows in it, increases in size, changes the direction of the root canals. The bone tissue of the alveolar processes surrounding each tooth, adapting to it, grows in the same rhythm. If it does not fit tightly, then very soon the incisors and molars, which take the greatest load, will begin to wobble and fall out.

Alveolar processes

Normally, these areas of bone tissue around the teeth develop in every person as they grow older. However, in some genetic disorders, the alveolar ridge may not grow.

One of these cases is a pathology in which tooth germs are not formed at all during embryonic development. Such situations are quite rare. Naturally, the teeth do not grow. Part of the jaw bone, which under normal conditions would become a platform for the alveolar processes, also does not develop. Actually, the boundary between these formations is practically lost during normal development. The bones of the jaw and process actually fuse together.

From this we can conclude that the process of their formation is directly related to the presence of teeth. Moreover, when they fall out or are removed, the bone tissue in this place gradually loses its properties. It softens, turning into a gelatinous body, decreases in volume, reaching the edges of the jaw bone tissue.

Peculiarities

The alveolar process of the maxilla consists of an internal (lingual) and an external (labial or buccal) wall. Between them there is a spongy substance, similar in composition and properties to bone tissue. The jaw bones vary. From above they are formed from two fused halves. A bridge of connective tissue runs down the middle.

In terminology you can also find the concept of “alveolar part”. In this case, a process on the lower jaw is implied. Its bone is not paired and has no connection in the middle. But other than this, the processes differ little in structure. Below, the lingual, labial and buccal walls are also distinguished.

It can be noted that the alveolar process of the lower jaw is less susceptible to fractures. On the one hand, this is due to the fact that in most people, the upper teeth cover the lower ones and are the first to bear the traumatic load. On the other hand, the walls of the anterior processes from above are slightly longer and thinner. In addition, the dense compact substance of the tissue in this place is more permeated with pores for the passage of blood vessels and nerve endings. Therefore it is less dense and durable.

Problems: diagnostics

Teeth undergo changes throughout a person’s life. Not only are there fewer of them, but their mobility also increases. The bone tissue around them slowly degrades (resorption). The part that takes the load is more susceptible to this. In case of fractures, to determine the degree of damage, it is often not possible to palpate the alveolar processes of the jaws without pain relief. These areas are densely permeated with a network of nerve endings and are therefore painful.

Such areas, as well as foci of age-related destruction (destruction), sclerotic changes (replacement of bone connective tissue) and manifestations of osteomyelitis are diagnosed by radiographs in various projections. In some cases (tumors), MRI and examination of the maxillary sinuses using a contrast agent are prescribed. Obvious problems in the growth and development of the jaws, as well as their processes, are comprehensively diagnosed.

Atrophy

The processes of the jaws are bone formations that support the teeth in their sockets. If they fall out, the need for shoots disappears. There is nothing left to support; the spongy substance, not feeling the stress, collapses. With anodontia (genetic pathology of the absence of tooth germs from birth), the alveolar processes do not develop, although the jaws are formed.

Atrophic processes occur with individual characteristics. For some, height decreases faster, for others slower. Atrophy of the alveolar process in the upper jaw leads to the formation of an almost flat palate. From below, this leads to a noticeable protrusion of the chin. The jaws close more and, without prosthetics, acquire a characteristic “senile” appearance.

Atrophy can also be caused by inflammatory processes. The greatest dangers are periodontitis, osteoporosis, and osteomyelitis. Cervical caries also causes tissue degeneration. May cause atrophy and periodontal disease. Despite the apparent simplicity of this disease, in the absence of a response, the trophism of the mucous membrane and processes is disrupted, interdental pockets appear, the neck of the tooth is exposed, it begins to loosen and falls out.

This pathology appears at the stage of embryonic development. At about two months after conception, the bones of the skull are formed. By birth, they close and fit tightly to each other. Only a small depression (canine fossa) remains on the surface of the front of the jaw.

A combination of various factors (heredity, drug exposure, pesticides, alcoholism, smoking during pregnancy) can cause a situation where the paired bones of the palate do not connect and grow together, a cleft is formed. It can be localized on the soft or hard palate, jaw bones, or spread to the lip (cleft lip). There are complete or partial nonunion, lateral or median.

The alveolar process of the maxilla with a cleft, as a rule, is a continuation of the unfused bones of the upper palate. Separately, such a pathology is rare. The cleft is almost never found on the lower jaw and its alveolar part.

Fracture

A jaw injury often results in a knocked out tooth. The causes may be mechanical injuries, unsuccessful falls, blows with a fist or a massive object. If the area of ​​impact is larger than the area of ​​one tooth, a fracture of the alveolar process is possible. The crack often has an arched shape.

There are complete, partial and comminuted fractures. According to its location, it can affect the roots of the teeth, fall on their necks, or be located above the zone of the alveolar processes - along the jawbone. The prognosis for natural fusion of bone tissue is complex and is given depending on the severity of the condition and location. Fragments with damage in the root area most often do not take root.

In addition to pain and swelling of the affected area, its symptoms may include: malocclusion, distortion of speech, and difficulty chewing. If there is an open wound and the blood has a foamy structure, fragmentation of the walls of the maxillary sinuses is also expected.

They include correction of conditions for congenital jaw pathologies, plastic surgery for fractures, and augmentation of bone tissue for prosthetics. The absence of a tooth over a long period of time leads to atrophy of the bone tissue of the area. Its thickness may not be enough when installing reinforcement for mounting a false tooth. When drilling, a perforation into the area of ​​the maxillary sinuses is possible. To prevent this from happening, plastic surgery is performed. The alveolar process can be built up by placing an onlay on the surface of the jawbone, or by cutting it and filling it with biomaterial.

Fixing fragments in fractures is usually done using splints and wire staples placed on the teeth. Fixations can be used through through holes in the bone using a nylon ligature. Contour plastic surgery when correcting defects of embryonic development consists of closing the opening by moving adjacent tissues to the required position and using implants. The operation should be carried out as early as possible so that the child has time to develop

Alveolar processes are the parts of the face to which teeth are naturally attached. Such formations are located on both the upper and lower jaws.

Structure

The maxillary part of the human skull bones is a pair, located in the central part of the face. In its structure, there are 4 types of processes: frontal (runs upward), alveolar (looks down), palatine and zygomatic. The total weight of the upper jaw is small (although visually it seems that it is heavy), this is due to the presence of many cavities (sinuses) in it.

The alveolar process of the maxilla (shown in the photo above) consists of two wall coverings - the outer (includes the labial wall) and the inner (lingual cavity). Each of the presented areas is an arch, a sinus in the direction of the jaw endings. AO is a special recess designed for attaching a tooth.

In its upper part, the walls of the alveolar process of the lower jaw begin to touch from the second large molar, and in the lower part they transform into a jaw branch with an opening of several millimeters. In the cavity between the outer and inner coverings there are sinuses, holes, cells (holes). The teeth are located in the alveoli.

Atrophy is caused by a bay of the upper or lower jaw. The alveoli are separated from each other by dental bony septa. In the area of ​​holes with a large number of roots, interroot partitions are present.

Thus, several parts of the joint-stock company are anatomically distinguished:

  • external - that is facing the cheeks, lips, towards the vestibule of the oral cavity;
  • internal - located closer to the tongue and palate;
  • the segment on which all the alveolar openings (sockets), as well as the dental units themselves, are directly located.

The upper part of the joint is called the alveolar ridge; it becomes clearly visible after teeth have been lost and the alveolar sockets have become overgrown. In the absence of functional loads on the ridge, its height gradually decreases.

Atrophy (destruction) of the joint is understood as pathological changes in the structure of a given anatomical unit, which can subsequently lead to a wide range of dental problems

The alveolar process has other anatomical features. The bone tissues of the upper and lower jaw are subject to constant changes throughout human life. This is explained by the physical and work loads that occur on the teeth.

Such transformations provoke a fracture of the alveolar process of the upper jaw, as a result of which the patient may need correction (plasty) of this anatomical unit. As teeth age, they wear down the active surface area. In this case, the parties facing each other suffer. Corresponding changes occur in the alveolar covering, which can lead to damage.

Possible injuries

Natural aging, physical stress, fracture and alveolar bone cancer are all abnormal processes that can affect the upper and lower jaws. Each of them can develop not even as a result of an intense blow or mechanical trauma, but on its own, with a not very strong bite (and the duration of pathological changes can be very diverse).

With age, the risk of damage to the alveolar process naturally increases, especially the cleft of this formation (the most fragile part) suffers. To prevent such problems, it is necessary to regularly visit the dentist and resort to appropriate treatment and preventive measures.

AO restoration methods

Jaw fractures and other injuries require subsequent correction of both the alveolar processes and the teeth themselves; this is necessary to preserve the “healthy” functioning of a person.

The list of restoration measures is as follows:

  • group of surgical methods - filling, after removal - prosthetic appendices;
  • the use of special preparations that strengthen the enamel, hard tissues of teeth, sinuses;
  • the use of compounds to additionally protect the integrity of teeth - this is necessary for people engaged in active physical labor and athletes.


Surgical intervention is the only therapeutic measure for AO injuries

Correcting the condition of teeth in this case is much more problematic than any other type of prosthetics. Restoration can involve both the root part and the sinuses, other fragments, or even the entire jaw and oral mucosa.

Important! Small height (that is, in fact, a lack of bone tissue volume) is a limitation for dental implantation. To subsequently secure the prosthesis, the patient first undergoes bone grafting.

As you can see, the alveolar processes are important anatomical structural units of the upper and lower jaw, which, in fact, are the basis for the attachment of teeth. AO injuries are a direct indication for bone grafting and dental prosthetics.

A fracture of the alveolar process occurs as a result of exposure to a powerful traumatic factor on the jaw. This could be a blow with a fist or a heavy blunt object, a blow to a surface when falling, etc. As a rule, the walls of the maxillary sinus and the condylar process of the mandible are also damaged.

Anatomical features of the upper and lower jaw

Human jaws are divided into paired (upper) and unpaired (lower). They differ in their structure.

The bones of the upper jaw participate in the formation of the nasal cavity, mouth, and orbital walls and are tightly connected to the skull. Unlike the lower jaw, its parts are motionless. Despite their apparent massiveness, the bones are light in weight, since there is a cavity inside.

The jaw consists of a body and four processes:

  • the palatine connects to the zygomatic bone and is a support during the chewing process;
  • the frontal is attached to the nasal and frontal bone;
  • the zygomatic separates the infratemporal part of the jaw, has a convex shape and four canals for the alveoli (recesses for the roots of the teeth), they contain large molar chewing units;
  • alveolar - there are sockets for teeth on it, separated by walls.

The lower jaw is the only movable bone in the human skull; muscles responsible for chewing food are attached to it. It consists of a body that includes two branches and two processes: condylar and coronoid.

The tuberous side of the mental foramen is called the masseter, and the pterygoid serves to attach the muscle of the same name. It contains the sublingual groove, which in some cases turns into a canal, and openings for the nerves.


For more details on the structure of the jaw, see the photo. However, the anatomical features of the jaw are individual. For this reason, sometimes even a specialist with impressive experience is not always able to identify pathologies.

Alveolar process - description

The alveolar process bears the teeth. It includes two walls: outer and inner. They are arches located along the edges of the jaws. Between them are the alveoli. In the lower jaw, the corresponding formation is called the alveolar part.

The bone of the appendix consists of inorganic and organic substances. Collagen predominates - a substance of organic origin that imparts plasticity. Normally, the bone must adapt to the constantly changing position of the tooth.

It consists of several elements:

  • external, directed towards the cheeks and lips;
  • internal, oriented towards the palate and tongue;
  • alveolar openings and teeth.

The upper part of the alveolar processes of the jaws decreases if they do not receive the necessary load. For this reason, its height depends on age, oral defects, previous diseases, etc.

Signs of an alveolar bone fracture

An alveolar bone fracture can be identified by the following symptoms:

  • change in bite;
  • speech disorder;
  • difficulty chewing;
  • sometimes – bleeding or blood in saliva;
  • attacks of pain originating from above and below the jaw;
  • increased pain when closing the teeth, the patient keeps his mouth half open;
  • swelling of the inside of the cheeks;
  • lacerations of the oral cavity in the cheeks and lips.

A few signs are enough to sound the alarm and immediately send a person to the hospital or call an ambulance. You cannot make a diagnosis or attempt treatment on your own.

Methods for diagnosing the problem

To begin therapy, it is necessary to make a correct diagnosis. Fractures of the alveolar process are similar in symptoms to pulp injuries or bruises, so a set of measures must be taken to identify the pathology.

First, an examination is carried out, during which the dentist is able to assess the general condition of the patient. It is based on the following features:

  • the patient cannot open his mouth wide;
  • redness is noticeable around the lips;
  • there are mucosal injuries;
  • when closing the jaw, violations of the dentition are visible;
  • dislocations of incisors;
  • bruising in saliva;
  • mobility of large molars in the damaged area.

Using palpation, the doctor finds moving points that are displaced. After pressing on the alveolar process, acute pain appears.

To make a diagnosis, the patient needs to have an X-ray of the jaw. The damage to the alveolar process of the upper jaw in the image has torn, intermittent edges. Due to differences in structure, the fracture of the other jaw in the area of ​​the alveolar process has clearer edges.

Computed tomography helps determine where the hematoma is located. Electroodontodiagnosis shows the condition of dental tissues; it is prescribed several times during the course of treatment.

Fracture treatment

The first thing to do is to put the broken section in the correct position. You absolutely cannot do this on your own. An exceptionally qualified doctor is able to perform this procedure and performs it under local anesthesia. After this, a smooth splint-brace or splint-kappa is applied. The first is used when healthy teeth remain near the fracture. Fixation is recommended for a period of one to two months, depending on the severity of the fracture.

If the teeth fall into the fracture line, and the ligaments holding them in the alveolus are damaged, they are removed. In another case, the vitality of the pulp (the tissue that fills the tooth cavity) is checked. If it is dead, it undergoes endodontic therapy (“treatment inside the tooth”; usually the pulp is removed, and the vacant space is filled with filling material). If the tissues are relatively healthy, they are constantly monitored and checked for viability.

Wounds received along with a fracture of the alveolar process are treated and freed from small fragments. In some cases, stitches are required.

Particular attention is paid to children whose permanent teeth are located in follicles. First, their viability is checked: if they are dead, they are removed.

Treatment can be carried out either inpatient or outpatient, depending on the severity of the injury. For about a month after damage to the upper or lower jaw, eating solid food is contraindicated. It is also necessary to carefully monitor oral hygiene.

Prognosis for recovery

Fractures of the alveolar process are divided into fragment, partial and complete. The prognosis is determined by the severity of the injury, its type, etc. Often doctors rely on damage to the roots of the teeth when making a prediction.

The prognosis is favorable if the fracture line of the alveolar process does not affect the roots of the masticatory elements. In such a situation, timely contact with a specialist can reduce the period of formation of callus (a structure that appears at the initial stage of bone fusion) to two months.

Delayed or improper treatment of an alveolar process fracture increases the likelihood of complications: osteomyelitis, pseudarthrosis, etc. The recovery time increases; it is no longer possible to count on treatment lasting several months.

Accordingly, if damage to the alveolar process of the jaw affects the roots of the teeth, the prognosis is unfavorable. In some cases, complete bone fusion cannot be achieved. After an alveolar bone fracture, it is not recommended to eat solid food for several months. It is also necessary to carefully monitor oral hygiene.

4. well-developed lymphatic system;

135. What is the MOST probable reason for the low effectiveness of infiltration anesthesia on the lower jaw?

1. jaw mobility;

2. abundant blood supply;

3. well-developed lymphatic system;

Small number of natural holes;

5. large muscle mass around the lower jaw

136 Which of the following nerves is blocked during mandibular anesthesia?

1. buccal;

2. lingual;

3. nasopalatine;

4.n. mandibularis

5. mandibular;

137. Which of the following nerves is blocked during mandibular anesthesia?

1. zygomaticofacial;

2. maxillary;

3. mandibular;

4. zygomatic-temporal

Lower alveolar

138. All of the following nerves are blocked during torusal anesthesia, EXCEPT?

1. buccal;

2. lingual;

3. mental;

4. mandibular;

5. lower alveolus

139. Which of the following nerves is blocked during torusal anesthesia?

1. buccal;

2. nasopalatine;

3.n. mandibularis

4. mandibular;

5. maxillary;

140. Which of the following nerves is anesthetized during torusal anesthesia?

1. lingual;+

2. nasopalatine;

3.n. mandibularis

4. mandibular;

5. maxillary;

141. During which of the following anesthesias is the pterygomandibular fold an anatomical landmark?

1. torusal;

2. mental;

3. mandibular anesthesia by extraoral method;

4. mandibular anesthesia using the intraoral digital method;

Mandibular anesthesia using the intraoral apodactyl method.

Topic No. 5. Tissue anesthesia during surgical interventions on the upper jaw. Working on phantoms.

142. During tuberal anesthesia, the superior alveolar nerves are blocked:

1. rear;

2. medium;

3. lateral;

4. lower;

5. front.

143. A 20-year-old boy was given anesthesia. At the same time, the following were anesthetized: the first, second, third large molars of the upper jaw, the periosteum of the alveolar process and the mucous membrane covering it from the vestibular side in the area of ​​these teeth, the mucous membrane and bone tissue of the posterior outer wall of the maxillary sinus. What kind of anesthesia was performed by the doctor?



1. palatal;

2. incisal;

3. tuberal;

4. infraorbital;

5. infiltration.

144. A 40-year-old man came to the dental clinic for the purpose of sanitation of the oral cavity before prosthetics. It is necessary to remove 1.1,1.2 intact teeth, III degree of mobility, exposure of roots to 1/3 of the root length.

Which of the following should be blocked for painless tooth extraction?

1. superior posterior alveolar;

2. lower alveolar;

3. superior anterior alveolar; +

4. upper middle alveolar;

5. incisive branch of the inferior alveolar nerve.

145. For surgical intervention, a 30-year-old man was anesthetized by the doctor using the following method: with the index finger of his left hand he felt a protrusion along the lower edge of the orbit, stepped back 0.75 cm downwards from it and marked the target point. With the thumb of his left hand, he pulled the lip upward, made an injection along the transitional fold between teeth 1.2 and 1.1, advanced the needle in the direction of the index finger, and released an anesthetic solution.

Which of the following anesthetics was performed by the doctor?

1. incisal;

2. according to Weisblat;

3. tuberal;

4. infraorbital;

5. infiltration.



146. When removing 2.2 teeth, the doctor administered anesthesia, made an injection on the vestibular side at the level of 2.1 teeth (the bevel of the needle is facing the bone), advanced the needle to 2.3 teeth, and released the anesthetic along the way. The second injection of the needle was made from the palatal side, in the projection of the roots of 2.2 teeth. The solution is released under the mucosa without advancing the needle.

What anesthesia did the doctor perform?

1. palatal;

2. incisal;

3. tuberal;

4. infraorbital;

Infiltration.

147. In a 66-year-old woman, objectively: facial asymmetry due to collateral edema in the area of ​​the upper lip on the left, in the oral cavity: tooth 1.2 is destroyed to the level of the gum, changed in color, percussion is painful, in the projection of teeth 1.1, 1.2, 1.3 from the vestibular side of the alveolar of the appendix, an infiltrate is determined, painful on palpation, the symptom of “fluctuation” is positive. On the intraoral radiograph: channel 1.2. The tooth is filled by ¼, curved, in the periapical tissues there is a loss of bone tissue with unclear boundaries.

Which nerves are MOST appropriate to block for further treatment?

1. zygomatic and posterior superior nasal;

2. posterior superior alveolar and palatine;

3. middle upper alveolar and incisive;

4. large rocky and deep rocky;