August
12
19:53
Stomatology

Periodontitis.

tooth consists of hard tissues - enamel, dentin, cement.In the center it has a cavity in which are vessels and nerves - the pulp of the tooth.The tissues surrounding the tooth outside and below it, is called periodontitis.The inflammation is localized in this area - periodontitis.

Content

  • 1 main reasons for
  • 2 Types periodontitis
    • 2.1 As causal factors are distinguished:
    • 2.2 the flow and nature of fluid distinguish:
  • 3 Symptoms of acute periodontitis
  • 4 Chronic forms
  • 5 Treatment of periodontitis
    • 5.1 Medication
    • 5.2 Constant filling
    • 5.3 Resection

the inflammation surrounding the tooth tissuefor various reasons:

Acute periodontitis develops rapidly.There is a constant aching pain localized in the tooth at a serous inflammation, which is rapidly becoming more intense, throbbing, arching, sometimes radiate to the neighboring region (ear, the joint of the lower jaw, temple, eyes, maxillary sinus and chin).It indicates the appearance of purulent exudate in the

tissues.The duration of the acute period of from 2-3 days to 2 weeks.Patient notes not only pain, but also a sense of "growing up" tooth, its little mobility, a sharp pain when touched or swallowed food, the inability to clench your teeth.Can swell tissue near the tooth, gums and cheeks become congested (red), palpation of (indenting finger) painful.If the pus is released through the fistula formed in the course of the gingiva in the area of ​​projection of apex of the root causal tooth, blunted the symptoms, pain and swelling are reduced up to full resolution.In the acute phase of the regional lymph nodes increase, become painful.The body temperature can rise to subfebrile values.On radiographs of specific features is not revealed, in addition to reducing the figure definition of trabecular bone.

Chronic periodontitis develops as a slow-moving disease.For this to be the appropriate conditions: the presence of outflow of fluid through a deep carious cavity (or it happens invisibly in the defect filling, the development of caries under a seal), weak local immune response, receiving anti-inflammatory drugs (not necessarily at the dental indications), which indirectly reduce the activity of microorganismsand the degree of inflammation.Symptoms of chronic periodontitis are often absent.The patient may be concerned about the fact that the tooth has changed color, became gray, lackluster, "muddy."Occasionally, especially during the colds, the patient notes the emergence of "gravity" in the tooth discomfort in contact with a food or at the time of tightening the jaws.May indicate the periodic formation of a fistula on the gums (patients referred to his "bubble", ulcer, confusing sometimes manifestations of stomatitis).This is typical for granulating periodontitis.When tapping on the causal tooth and an adjacent clearly stands out from all periodontitny tooth.Sometimes, palpation of the gums around it also causes unpleasant or even painful to the patient.Distinguish 3 forms of periodontitis makes X-ray examination.When the fibrous form of a picture is determined by the extension of the periodontal ligament space at the apex of the root may be a message from the oral cavity of the tooth.The granulating form is characterized by not only the formation of a fistula on the gums, but also the different X-ray picture: center found bone loss in the area of ​​root apex with unclear and jagged, irregular shape.In some cases, you can determine the direction of the fistulous.In chronic granulomatous periodontitis in the picture reveals a clear focus of limited bone loss rounded shape (granuloma) to 0.5 cm in diameter.If this section takes 0.5-0.8 cm, it kistogranulema size even more - have a cyst.

exacerbation of chronic periodontitis often occurs as an acute, symptoms are similar to them.The only difference is that the patient marks pain in the past, and the picture of the X-ray confirms the existence of a chronic process in the bone.

principle of treating all forms of periodontitis is to remove the causes of inflammation.It is mandatory to delete all the tissue inside the tooth, clean the channels in the roots and carried them filling.During acute inflammation of the tooth can not be warm, and pain relief can provide a mouth rinse solution follows - 1 teaspoon of salt and soda dissolved in a glass of warm boiled water, in the absence of allergy in it add 1-2 drops of iodine.This helps exudate out of the affected tissues outside.

for medical treatment of oral use 3% solution of hydrogen peroxide, 0.2% solution of chlorhexidine, 1-2% solution of bleach, sodium hypochlorite and other drugs.Mechanical cleaning of the channels is performed by special endodontic instruments (manual or machine).As an additional method uses acoustic processing channels.By all ways and means to achieve the maximum purification of the pulp cavity.

If necessary tooth canals allowed therapeutic agents (calcium-based paste, iodine, iodoform, metronidazole) or liquid antiseptics on cotton turundas (dexamethasone, thymol, guaiacol, camphor, chlorhexidine) for several days.In severe reactions to inflammation (temperature, general weakness, headache), the doctor prescribes antibiotics, which are already receiving a day should give a positive trend.If there is no improvement, the drug selected must be replaced, t. K. In this case it is believed that the microflora in the hearth is resistant to the antibacterial agent.

Subsequently seal up channels of constant hardening paste with gutta-percha pins.Some dentists adhere to techniques for removing the paste to the tip of the root bone destruction.It depends on the material for sealing and the size of the fire.As a side effect of this procedure the patient can celebrate discomfort when biting on a tooth of treatment for a long time.

treatment of cysts and granulomas allow resection (excision) apex, followed by medication action on this area.The doctor determines in its sole discretion, what techniques and tools will give a positive result.In the case of excision of the root and bone recovery takes place in this area for several months.

In cases where it is impossible to carry out resection of the tooth and multiple conservative treatment of periodontal disease-resistant does not improve or if you experience frequent exacerbations, with the size of the outbreak continues to grow, this is recommended to remove the tooth.Granuloma may eventually grow into a cyst, the treatment of which has not only requires removing the cause of the tooth, but also a thorough "husking" changes of bone tissue.Daily oral hygiene, quality and timely dental treatment, the passage of the annual checkups dentist to minimize the likelihood of such diseases as periodontitis.