Periodontitis: Symptoms and Treatment, photos

GENERAL

Periodontitis is called the connective tissue that fills the space between the tooth and his bed, suffused with blood, lymph vessels and nerve fibers. Due to its structure, the function of periodontal tooth power, and provides cushioning and uniform load distribution during chewing.

On the upper part of the roots of the teeth are the outputs of the root canals, through which infection often penetrates. This is where periapical abscess is formed in the form of purulent sac.

Feature periodontal in children is its loose structure to the content of a large number of cellular inclusions abundantly permeated vessels. The structure and thickness of this layer during the formation of the temporary and permanent teeth are unstable, so children are particularly susceptible to occurrence of inflammation in the area.

According to statistics, periodontitis occupies more than 40% of all cases of treatment for dental care, with half of patients - children. Not long ago, this diagnosis was the indication for tooth extractionNow the possibilities of modern dentistry provides a chance to save it in the course of a thorough treatment.

CAUSES

Since the tip of the tooth called the "apex" in the practice of dentists prefer to use the term "apical periodontitis." In addition to infectious causes of periodontal lesions, there are cases of medical and traumatic etiology of periodontitis.

The main causes of periodontitis:

• Infection. The inflammatory response occurs in response to the attack of pathogens. Among the pathogens can be isolated staphylococcal, streptococcal, spirochetal, fuziobakterialnuyu fungal and yeast microflora. In addition, these pathogens damage the tooth enamel, they are able to penetrate through the root canals and gum pockets. The decay products of the pulp and toxins released pathogens, even more aggravate the inflammatory response. Pathogens intradentalno penetrate from the caries process and ekstradentalno from the surrounding tissue in the sinus, osteomyelitis, flu, rhinitis, Periodontitis and other diseases.
• injuries. As acute traumatic lesion protrudes injury, stroke, damage from solid objects in the food during its mastication and during sealing of the channels. Chronic trauma is due to improper filling of the tooth (inflate the seals), the pressure of the prosthesis, malocclusion, bad habits professional and influences related to the uneven distribution of the load on the set of teeth (e.g., playing a musical wind instrument). Long term adverse influence on the initial stages is compensated, but later results in inflammation tissues.
• Drugs and chemicals. As they propagate inflammation can occur in periapical tissue. Such substances include: resorcinol, formaldehyde, phenol, arsenic, chlorhexidine, iodine, Eugenol, paratsin, trikrezorfol. This is often the treatment of pulpitis and periodontitis, because the substances included in the seal material and pharmaceuticals. Allergic reactions as a reaction to dental treatment with antibiotics is also related to manifestations of drug-induced periodontitis.

Precipitating factors for the development of periodontitis:

• lack of oral hygiene;
• bad habits;
• chronic disease;
• complications of dental diseases;
• mechanical injury;
• deficiency in the diet of vitamins and minerals;
• poor-quality dental care.

CLASSIFICATION

Periodontitis requires systematization, as in various forms of periodontitis treatment course it will be different.

According to the clinical manifestations and pathological changes:

• Acute. Characterized by purulent or serous discharge. Identification of one form or another is difficult because of the fact that the serous form can quickly jump to purulent.
• Chronic (Granulating, granulomatous, fibrotic). It may develop as a consequence of acute inflammation. As a rule, the patient complaints of minor discomfort when tapped on the tooth. Typically, such a tooth has previously responded to treatment, is partially destroyed with altered enamel color.

granulating

When X-ray observed unevenly expanded in the periodontal crevice root tip size of from 1 to 8 mm without clear outlines.

Graulematozny

The picture shows the edge of the area of ​​bone tissue destruction and a clear contrast. The affected area can be located at the tip of the root, and cover its bottom third. The development of the pathological process in the future leads to the formation of radicular cysts.

Fibrous

Periodontal evenly expanded throughout the affected area, or only in the area of ​​the root tip, the sparseness of the root and bone alveoli lacking. Normally, the patient does not complain. The cause of fibrotic lesions can be traumatic articulation or the consequences of the loss of a large number of teeth, which are accompanied by an overload of the remaining.

SYMPTOMS

Manifestations of the disease are always dependent on the type of inflammation (acute or chronic).

Symptoms of acute periodontitis:

• Pain syndrome. Usually, the patient is suffering from acute pain directly in the affected tooth. With gentle tapping or biting felt its intensification. Going into serous purulent for it is accompanied by intense throbbing pain.
• puffiness. Painful symptoms can be accompanied by the formation of flux and mobility of the affected tooth. In some cases, there is swelling of facial tissues. In the projection root noticeable redness of the gums, touch to this place is painful.
• Deterioration of general condition. Increases lethargy and increased body temperature. A man loses his appetite, his sleep is disturbed. Nearby lymph nodes may be enlarged and painful.

Chronic periodontitis may be asymptomatic or with mild symptoms. Sometimes there is pain on the patient's tooth prostukivanii or during biting. Pain severity was moderate. Near the affected tooth to gingiva can be fistula opening with signs lean suppuration.

Prolonged chronic lingering processes may worsen, with symptoms becoming acute. fistula formation of pus allows exit from the cavity, whereupon the inflammatory process becomes chronic phase again.

Due to the lack of pronounced pain, many patients are in no hurry to seek assistance dentist, which later becomes the cause of tooth extraction due to the impossibility of treating chronic processes. For example, in the formation of cysts on the top of the root required drastic treatments, associated with its removal.

DIAGNOSTICS

The main criterion for the effectiveness of treatment of periodontitis is its correct diagnosis.

In the primary stage, inspection of the oral cavity. The X-ray examination method is assigned as a mandatory. To evaluate the acute condition is much easier than to diagnose latent chronic processes.

Examination for the diagnosis of periodontal disease:

• visual inspection;
• palpation;
• evaluation of occlusion;
• percussion;
• Root canal sensing;
• examination of facial tissues;
• radiovizionny method;
• termodiagnostichesky test;
• Local X-ray;
• ray imaging;
• ortopantomogramma;
• elektroodontometriya (EDI).

TREATMENT

The main goal of treatment of periodontitis is to suppress the inflammatory focus, maintaining tooth, as well as improving the patient's health.

The complexity of the manipulation determined by the age of the patient, the severity of the inflammatory process, its prevalence and the tooth structure. Any kind of periodontal treatment involves root canal, which is accompanied by X-ray control.

Stages of therapeutic measures:

• Mechanical preparation (local anesthesia, opening of the inflamed root canal, tooth cavity extension, providing access to the root canal unsealing, sensing, medical and mechanical cleaning Channel).
• Antiseptic treatment (removal of dead tissue).
• Temporary and permanent canal filling.

In that case, if conservative measures fail, resort to surgical removal of the tooth. In severe concomitant diseases, or major surgery prescribed course of antibiotics.

COMPLICATIONS

Inflammation of periapical tissues may cause local or systemic complications.

Common complications:

• resistant migraine;
• rise in body temperature, sometimes up to the critical parameters;
• intoxication;
• sepsis;
• development of autoimmune processes in chronic periodontitis.

Local complications:

• postplombirovochnye pain;
• appearance fistulae, cysts, abscesses;
• increase in pathological inflammatory focus in the root;
• odontogenic sinusitis;
• phlegmon neck;
• osteomyelitis.

The most dangerous in terms of possible complications is purulent process. At the same time there is the chance of spreading of pus in the bone of the jaw. Death of tissue may provoke the development of cellulitis in the neck.

A frequent complication in purulent process premolars and molars odontogenic maxillary sinusitis is the origin and submucosal abscess formation.

PREVENTION

Periodontitis prevention measures are in compliance with the rules of oral hygiene, regular visits to the dentist, a timely dental health and prosthetic teeth missing.

FORECAST FOR RECOVERY

Timely dental care with conservative therapies gives a higher chance of relief of inflammation and preserving teeth. In the absence of the necessary therapy suppurative process extends to the surrounding tissue, which increases the risk of inflammation of the maxillofacial department. Wrong tactics therapeutic measures in acute periodontitis facilitates the transition to chronic periodontitis, which worsens the prognosis of its treatment in the future.

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