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"Kailan Pwedeng Lagyan ng Pustiso Pagkatapos Bunutan ng Ngipin?" by Dr. Charlie N....

"Kailan Pwedeng Lagyan ng Pustiso Pagkatapos Bunutan ng Ngipin?"  
by Dr. Charlie N. Atienza


Assistant Professor
Prosthodontics SectionDepartment of Clinical Dental Health Sciences
College of Dentistry
University of the Philippines Manila



Dalawang mahalagang bagay ang kailangang maintindihan tungkol sa katanungang “kung kailan nararapat magpagawa ng pustiso pagkatapos bunutan ng ngipin”:

1. Ang una ay ang pag-galing at paghilom ng sugat ng gilagid pagkatapos bunutan. Natural na magkakasugat ang gilagid kapag binunutan ng ngipin, at ang pagtuyo o paggaling nito ay umaabot mula isa (1) hanggang dalawang (2) lingo (1-2 weeks). Hindi pa maaring sukatan ang bibig kung hindi pa tuluyang naghihilom ang sugat. Maaaring makapagdulot ng hindi magandang resulta kung ito ay pipilitin, katulad ng pagdugo, pamamaga o impeksyon.

2. Ikalawa ay ang paglubog at pagbabago sa laki at hugis ng gilagid, dahil sa pagbabago rin ng buto sa ilalim nito pagkatapos bunutan. Ang buto sa ilalim ng gilagid ay sadyang dadaan sa normal na pagbabago pagkatapos bunutin ang ngipin na dating nakabaon dito. Ang tawag sa prosesong ito ay “bone resorption”. Dahil dito, magkakaroon ng unti­unting pag­lubog at kadalasan ay pag-nipis ng gilagid. Ito ay magdudulot ng tuluyang pagbabago ng laki, lapad at kabuuang hugis ng gilagid na malaki ang epekto sa magiging lapat ng pustisong gagawin. Ang pagbabagong ito ay umaabot sa tagal na humigit kumulang na tatlong buwan (3 months).

Dahil sa dalawang mahahalagang bagay na ito, mayroong tatlong (3) maaaring pagpiliang paraan (treatment options) na may kinalaman sa kung kailan pwedeng magpapustiso ang pasyente (pagkatapos bunutan o kaya ay may “plano” pa lamang bunutan ng ngipin).

1. Kung hindi pa nabubunot ang ngipin -may mga sadyang kaso o sitwasyong pwedeng mauna munang gawin ng dentista ang pustiso, bago pa man bunutin ang ngipin. Ang tawag sa prosesong ito ay “Immediate Denture Treatment”. 

Hindi lahat ng kaso ay pwedeng dumaan sa prosesong ito. Kinakailangan ng dentist na suriin at pag-aralan munang mabuti kung pwedeng gamitin ito para sa partikular na pasyenteng nangangailangan ng pustiso.
Madalas itong ginagawa sa mga kaso na kung saan ay hindi pwedeng lumabas ng clinic na “bungi” o “bungal” ang pasyente. Sa madaling salita, mayroong mahalagang rason ang pasyente na hindi sya pwedeng makitang walang ngipin, maaring dahil sa trabaho o anumang dahilang personal. Madalas itong ginagawa kung ang kinakailangang bunutan ay ang mga ngipin sa harap ng bibig (front teeth) na sadyang kitang kita ang pagkabungi ng pasyente. Kaya pagkatapos na pagkatapos bunutan, ay kinakailangang nakahanda na ang pustiso na isu-suot kaagad (immediate)M. arami pang ibang kadahilanan na mas makabubuti kung direktang maipaliwanag ng dentista sa isang pasyente sa pamamagitan ng isang konsultasyon. Iba-iba kasi ang sitwasyon sa bawat isang pasyente, kaya maaring ibaiba rin ang kadahilanan at indikasyon para sa pamamaraang ito.
Kailangan din natin malaman na meron din namang maaring mga problema at “difficulties” na pwedeng daanan ng pasyente, at maging ng mismong dentista na gagawa nito. Dapat ito ay maipaliwanag muna ng mabuti sa pasyente bago umpisahan ang proseso. Ilan sa mga madalas na problemang maaring maranasan sa pamamaraang ito ay ang mga sumusunod:

a. Minsan ay hindi makakapag “trial” or “try­in” ng pustiso at hindi mo makikita kung ano ang posibleng resulta o itsura nito bago tuluyang lutuin (process) ang pustiso.

b. Para sa iba ay mas mahirap ang dinadanas dito dahil sa isinusuot kaagad ang pustiso pagkatapos na pagkatapos bunutan kahit dumudugo at bukas pa ang sugat ng pinagbunutan. 24 hours na suot at hindi maaaring tanggalin ang pustiso at kinakailangang bumalik sa dentista kinabukasan. Ngunit para naman sa iba, ay mas mabuti ito dahil ang pustiso mismo ang nagpoprotekta sa sugat na nasa ilalim nito.

c. Dahil hindi pa magaling ang sugat, magbabago pa ang lapat ng pustiso hanggang 3 buwan dahil sa "bone resorption" na nabanggit kanina. Kailangan ng karagdagang treatment na tinatawag na "denture relining" na kung saan ay babaguhin ulit ang lapat ng pustiso. Ito ay may karagdagang gastos para sa pasyente.

2. Ang pangalawang paraan - ay uunahin ang pagbunot ng ngipin at pagkatapos hintayin ang paggaling ng sugat ng gilagid (2 weeks) at saka lamang gagawin ang pustiso. Sa pamamaraang ito ay:

a. Mayroong trial appointment, kaya maaring makita ang itsura bago lutuin ang pustiso. Maaaring dumaan sa normal na proseso ng paggawa ng pustiso.

b. Kelangan din ng karagdagang treatment (denture reline)para ayusin ang lapat ng pustiso pagkatapos ng tatlong buwan (3 months) dahil sa bone resorption. May karagdagan ding gastos ito.

3. Ang ikatlong paraan - ay uunahin din bunutin ang ngipin at tuluyang maghihintay ng tatlong buwan (3 months) bago gawin ang pustiso. Sa paraang ito:

a. Matagal na bungi o bungal ang pasyente (3 months).

b. May trial appointments at dadaan sa normal na proseso.

c. Hindi na kailangan ng karagdagang adjustment (denture reline) dahil nagbago na ang gilagid bago kinuhanan ng sukat.

Lahat ng pamamaraang ito ay maaaring mapag-aralang mabuti ng dentista at siya lamang mismo ang makakapagsabi kung ano sa mga ito ang nararapat na paraan para sa iyo. 

SUMMARY:


1. Immediate Denture: sukat --> proseso ng pustiso (trials kung maaari) --> bunot --> suot ng kaagad ng pustiso --> reline (3 months)

2. Bunot --> hilom (2 weeks) --> normal na proseso ng pustiso --> reline (3 months)


3. Bunot --> hilom (3 months) --> normal na proseso ng pustiso




CNADDM 06 13 2014


About the Author:

Dr. Charlie N. Atienza
Dr. Atienza is a Faculty member of the Prosthodontics Section under the Department of Clinical Dental Health Sciences, University of the Philippines Manila College of Dentistry.  














http://ngipinatbp.blogspot.com/2014/06/tanong-kailan-pwedeng-lagyan-ng-pustiso.html

 
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