Perikoronarit (some sources - "pericoronitis") - is an inflammatory process that takes place in the gingival hood and soft tissue around the erupting wisdom teeth, mainly on the lower jaw.The process is complicated by purulent (suppurative perikoronarit), the spread of infection in surrounding areas, purulent dissolution of bone tissue.
Perikoronarit occurs most often in eruption of wisdom teeth, especially in the lower jaw.Problems arise with them in 4 out of 5 cases.Since wisdom teeth erupt in the last instance, they bring people to the most discomfort, as in the jaw are located in different ways (vertical, inclined or horizontal), often grow up not completely (may seem like a third or half the value of the tooth crown) and damage the surrounding softtissue and adjacent teeth.
Why teething wisdom so problematic?This is explained by the physiology of the body: the modern human jaw is much smaller than that of their ancestors, and the size of the t
perikoronarit But why there?Perikoronarit always appears when a cluster of plaque in the space between the tooth of wisdom and covering his gum - gingival hood.Plaque, including leftover food and clusters of bacteria on their own can not be removed completely.Chronic injury site of mucosa during chewing contributes to inflammation of soft tissues.Inflammation results in swelling and pain of the mucosa.
perikoronarit To no surprise, you should regularly visit the dentist.He will be able to assess the condition of wisdom teeth and gum hoods over them.If necessary, the doctor will prescribe X-ray examination, the results of which will determine the direction of growth of the wisdom teeth and the possibility of gingival inflammation hood.
perikoronarita Symptoms depend on the stage of inflammation.At initial perikoronarite detect signs is not easy, but possible.These symptoms are the following:
- Swelling of the gums.Most often, the symptoms appear one of the first.Around the wisdom tooth and the gums above it increases in size.It is felt when closing the mouth when the teeth are closed, and the last teeth of the upper jaw are pressed against the swollen gums.
- Pain when brushing your teeth and when you touch.When chewing, and with the active brushing hurts inflamed gingival hood, which is accompanied by unpleasant or painful sensations.
- Bad breath.Remains of food that fall under the hood gum, bacteria begin to be processed.Products microorganisms produce a characteristic putrid odor.
If pain in the erupting wisdom tooth has become a constant, it can be argued on the further development of the process and the transition to the next stage perikoronarita.Also, there are new symptoms:
- In the place of tooth eruption occurs chronic aching.Pain can give in the ear or head.
- The mouth can be opened with difficulty, because it swells the masseter.
- When swallowing food as there is pain due to swelling half peripharyngeal space and reduce the lumen of the pharynx.
- Swelling of soft tissue becomes more noticeable swelling of the cheeks externally.
- Submandibular lymph nodes are increased, painful when touched.
- The general condition of the body's weakened, the temperature can rise to 37-38 degrees, a headache.
If the inspection in the mirror you see that the last tooth in the lower jaw partially or fully closed gum - swelling, reddened, you should consult your dentist to confirm the diagnosis and determine the treatment strategy, and to see a doctor to comply with treatment recommendations perikoronarita homeconditions.
virtually all dental inflammatory processes perikoronarit has two forms: acute and chronic.
The acute form is characterized by primary perikoronarita rapidly developing symptoms.2-3 days pain or discomfort in the wisdom tooth in nature becomes dull and acute.From under the inflamed gingival hood covering the tooth pus with a characteristic unpleasant odor.Touching the gums cause an acute attack of pain radiating to the ear, temple and upper jaw.Chew on the side of the erupting tooth becomes difficult because the opening of the mouth and swallowing becomes painful.Lymph nodes are increased, painful when touched.
Improper tactics of treatment, prolonged treatment at home or untreated, acute perikoronarit becomes chronic.Then the inflammation subsides periodically, then it escalates.In remission complaints are virtually absent.Number of symptoms becomes smaller.There is an enlarged, painful when touched podnizhechelyustnoy lymph node.Roth offers free, painless.Gingival hood and surrounding the wisdom tooth gums reddened, but not painful or slaboboleznenna.Periodically from the gingival hood appears certain amount of serous fluid.
for acute stage characterized by symptoms of acute perikoronarita.From under the hood regularly published pyogenic liquid, because that feels typical breath.Wisdom tooth and the neighboring teeth become mobile, as due to inflammation underneath resorbed bone tissue.The mucous membrane around the wisdom teeth reddened, swollen.Because of the chronic injury of the mucous membrane outflow of pus from the gingival hood may be impaired.This often becomes a cause of the spread of purulent inflammation and in the surrounding tissue space.
infection, which is in the mucous membrane of the gingival hood when distributing the neighboring area, can cause serious complications:
- abscesses (suppurative focus when encapsulated) and cellulitis (inflammation becomes purulent diffuse);
- suppurative lymphadenitis (infection of the lymphatic vessels penetrate into the lymph nodes, causing their inflammation);
- osteomyelitis of the mandible (purulent inflammation and softening of the bone);
- actinomycosis (education in the soft tissues of multiple granulomas and fistulas granulemnyh);
- ulcerative stomatitis;
- periodontitis of wisdom tooth and the adjacent, standing in front of the second molar.
If you find symptoms of early stage perikoronarita, you can try to remove them at home before visiting a dentist using anti-inflammatory drugs and herbal antispticheskih drugs.All solutions should be necessarily room temperature so as not to provoke a burn inflamed mucosa.It is also possible to carry out application of anti-inflammatory gels and ointments on the hood of the gingival and the surrounding tooth gum.
is important to remember that any home treatment only leads to withdrawal symptoms perikoronarita.Completely remove plaque from the gingival hood, thoroughly clean and rinse the space underneath can only dentist.
Treatment perikoronarita in a dental clinic will depend on the stage of the disease.At the initial stage of gum pocket under the hood washed with mild antiseptic solutions (furatsillina, Potassium permanganate, chlorhexidine digluconate, Miramistin and others), prescribed rinsing the mouth trays and applications of anti-inflammatory gels and ointments.
In more severe stages perikoronarita need dental intervention.Dentist inspects and assigns X-ray examination (intraoral sighting shot ortopantomogrammu or CT scans) for diagnosis and exclusion of dental diseases with similar symptoms (chronic pulpitis, chronic periodontitis, neuralgia third branch of the trigeminal nerve).On the X-ray image perikoronarit confirmed if inflammatory changes around the root of the wisdom tooth missing.Also, X-ray diagnosis is needed to determine the direction of tooth eruption.
If a wisdom tooth erupt upwards, has an antagonist in the upper jaw and can participate in a full act of chewing, the dentist holds excision of gingival hood.This manipulation includes anesthesia and cutting portion mucosa covering the tooth.Excision is performed with a scalpel, laser or machine electrocoagulator.When excision with a scalpel should be kept on the wound gauze for 30-40 minutes to stop the bleeding.Preferably performed by laser excision or electrocoagulator to produce the sealing of blood vessels.Excision of such methods minimally traumatic and discomfort after the procedure the patient is experiencing.This will open the chewing surface and the plaque and bacteria cease to accumulate under the hood.After that, the recommendations are assigned to relieve inflammation in the surrounding soft tissue - rinses the mouth trays and applications of anti-inflammatory ointments.
If wisdom teeth erupt is not up and at an angle (leaning on the adjacent tooth in the buccal, lingual side) or "lies" in the jaw bone, which is confirmed by X-ray, is not involved in the act of chewing, does not have enough space for the eruption, theremoves the tooth.
is believed that wisdom teeth should be left as a reserve as the support under the prosthetic.It is a common misconception, because chewing load that can carry the wisdom teeth - only 2%.If the wisdom tooth is used as a support for the prosthesis at the loss of the lower posterior teeth, the excessive load will increase the mobility of the abutment teeth and their subsequent loss and replacement of the prosthesis.Therefore, leaving a wisdom tooth at indications for its removal, it must be remembered that this is a risk.
After the withdrawal symptoms of acute perikoronarita performed tooth extraction, purification and its closure of wells.The operation is performed under local anesthesia or general anesthesia, depending on the complexity of the operation and the patient's wishes.Wisdom tooth can be removed completely (for example, at an appropriate position of the roots) or partially (if branched roots polugorizontalnom or horizontal arrangement of the tooth in the socket).After extracting the tooth is placed in the hole osteoplastic material or platelet plasma for rapid recovery of bone tissue.In such cases, it is often necessary closure of the wells, but in a simple tooth extraction may leave it for self-healing.Closure of the wells after removal usually takes two to three weeks.After surgery, it is important to follow the recommendations of a dentist - antibiotics, antihistamines, oral anti-baths and application of ointments.
To avoid all the problems associated with the eruption of wisdom teeth, you should regularly visit the dentist.The doctor can detect early inflammation of the gingival hood of a wisdom tooth, to carry out X-ray diagnosis and choose the right tactics treatment.Tooth extraction, carried out on time, get rid of the discomfort associated with difficult eruption and to avoid re-excision of the permanent way of the hood.