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Автор: Administrator   

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23.04.2011 17:03

style="text-align: center;">Физико-химическая теория кариеса Д.А. Энтина (1928 г.)

Физико-химическая теория кариеса Д.А. Энтина (1928 г.)- Д.А. Энтин выдвинул теорию кариеса на основании исследования физико-хи­мических свойств слюны и зуба. Он полагал, что ткани зуба являются полупроницаемой мембраной, через которую проходят осмотические токи, обусловленные разностью осмотических давлений двух сред, контактирующих с зубом: крови изнутри и слюны снаружи. По мнению автора теории, при благоприятных условиях осмотические токи имеют центробежное направление и обеспечивают нормальные условия пита­ния дентина и эмали, а также препятствуют воздействию на эмаль вне­шних неблагоприятных факторов. В свою очередь центростремитель­ное движение веществ, то есть от поверхности зуба к пульпе, считалось патологическим и имело непосредственную связь с заболеваниями не­рвной и эндокринной систем, наследственностью, нарушением мине­рального обмена, условиями питания, быта, труда, приводящих к на­рушению физиологических взаимоотношений в системе пульпа — зуб - слюна. При неблагоприятных условиях центробежное направление ос­мотических токов ослабляется и приобретает центростремительное на­правление, что нарушает питание эмали и облегчает воздействие на нее вредных внешних агентов (микроорганизмов), вызывая кариес.

Несмотря на прогрессивность, данная теория в настоящее время подвергается критике.

Отрицательные стороны теории Положительные стороны теории

1. Д.А. Энтин считал, что цент­робежное движение веществ в твер­дые ткани зуба есть физиологичес­кий процесс, а центростремитель­ное — основа для развития кариесогенной ситуации и кариеса. Но сейчас мы знаем, что основное по­ступление органических и неорга­нических веществ в эмаль зуба про­исходит центростремительным пу­тем из ротовой жидкости. Именно слюна осуществляет полную мине­рализацию эмали после прорезыва­ния зуба, а также обеспечивает вос­становление деминерализированных участков при кариесе в стадии белого пятна. Исходя из значимос­ти центростремительного движе­ния веществ в эмаль, были предло­жены новые методы профилакти­ки и лечения кариеса.

2. Недооценивал значение уг­леводов и микроорганизмов в раз­витии кариозного процесса. Сей­час доказано, что без микроорга­низмов и углеводов кариес не воз­никает.

1.Автор доказал тесную связь физиологии твердых тканей зуба со всем организмом.

2.  В возникновении кариеса значительная роль отведена слюне. Современные исследования показа­ли, что изменения состава и свойств ротовой жидкости под влиянием общих соматических заболеваний организма могут привести к кари­озному процессу. При ксеростомии (сухости в полости рта) чаще всего наблюдается декомпенсированная степень активности кариеса.

3. На процессы проницаемос­ти, минерализации, реминерализации твердых тканей определенное воздействие оказывает пульпа зуба как посредник в цепи физиологи­ческого соотношения: слюна — зуб — кровь.

И в то же время отдавать при­оритет пульпе зуба не следует, так как доказано, что зубы с удален­ной пульпой в сроки до 17 лет про­должают нормально функциони­ровать, депульпирование не при­водит к структурным и функцио­нальным изменениям в эмали зуба. Даже процес­сы реминерализации эмали депульпированного зуба протекают бо­лее активно, нежели в зубах с со­храненной пульпой.


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Обновлено 16.07.2011 16:08
 
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