Periodontitis of the tooth
Causes and symptoms of acute and chronic periodontitis
Definition of periodontitis
Periodontitis is an acute or chronic inflammatory process of the root of the tooth and surrounding tissues. Most often, the disease occurs with prolonged caries, and the development of periodontitis is possible even after the treatment of caries, if the focus of infection has not been completely eliminated. The causes of acute and chronic periodontitis
depending on the localization of inflammation distinguish: apical (apical) periodontitis, when the focus of infection is located between the wall of the dental alveolus and the tip of the tooth root, as well as marginal (edge) periodontitis, in which inflammation begins from the edge of the injured gum. According to the nature of inflammation and tissue reaction, a serous and purulent acute form of the disease, fibrous, granulating and granulomatous chronic periodontitis are distinguished. The main causes of acute periodontitis are:
· acute inflammation of the pulp, which occurs in the presence of caries, as the pulp and periodontal tissues are cramped
· the use of arsenic preparations for devitalization (partial removal) of pulp, resulting in inflammation of the pulp tissue due to toxic effects of arsenic paste. The inflammatory process can move from the root pulp to the periodontium.
· the introduction of potent antiseptics and cauterizing agents into the root canal for the purpose of sterilization, which also causes inflammation of the surrounding tissues.
· periodontal injury treatment of pulpitis due to the ingress of excessive amounts of filling material into the periodontal space. / h
Approximately 1.5-2 weeks after the onset of the first symptoms of the disease, it passes into a chronic form. The main cause of chronic periodontitis is also neglected caries, and as a consequence – pulpitis – inflammation of the neurovascular bundle of the tooth. / h Symptoms of acute and chronic periodontitis
Acute periodontitis is characterized at the initial stage by sudden severe pain in the area of inflammation, there is a feeling of “grown” (lengthened) tooth, because of what many people are sick even have liquid dishes. When applying to a sore spot cold, the pain can briefly subside. If a person does not consult a doctor, then at the next stage of the disease, the pain becomes pulsating, and there may be swelling in the face. This stage is also characterized by swelling of the lymph nodes and the appearance of low-grade fever (37.2-37.7 ° C).
Chronic periodontitis can be accompanied by a change in the position of the teeth, due to their mobility and the formation of interdental gaps. Gums bleed even in the absence of mechanical influence on them, pus is constantly allocated and acute toothache is observed. In the period of exacerbation, the pain becomes pulsating and especially sharp with a tapping of the tooth, the closing of the teeth is quite painful.
Periodicity is typical for chronic periodontitis, when the exacerbation of the disease is replaced by the attenuation of the inflammatory process and the patients calm down, once again postponing the visit to the dentist, although at this stage the doctor’s help is very important. Diagnosis of acute and chronic periodontitis
The diagnosis of the disease is based on a clinical examination, which includes:
· Survey of the patient,
· visual examination of the oral cavity,
· sounding of the entrance to the tooth cavity,
· determination of the tooth mobility
For more accurate diagnosis in dentistry is used X-ray examination, radiovisiography, transillumination and electrodontodiagnostics. With acute inflammation on the X-ray, you will not see any changes in the periodontium, but with the chronic course of the disease, the X-ray will be, very, even by the way. It is with his help that you can determine the form of chronic periodontitis.
. So, in case of fibrous periodontitis, uneven changes in the lumen of the periodontal gap are seen in the picture, sometimes a thickening of the root in the apical region occurs. In some cases, sclerosis of the alveolar bone tissue is noted around the lesion.
– Granulating periodontitis manifests itself in more or less extensive granulations (growths) in periodontium, usually rounded with fuzzy boundaries. Also, the picture shows a pronounced deformation of the periodontal gap and a reduced density of bone tissues.
– With granulomatous periodontitis, it is evident that the proliferating granuloma (rounded with clear boundaries) gradually destroys the bone tissue of the alveoli, growing into a cystogranuloma, and then into a cyst that starts to grow from the tip of the tooth towards the bone tissue. Such a pathological process usually requires surgical intervention. In case of untimely treatment, a fracture of the neck of the tooth and a number of other complications are possible in the future. / H
Treatment of acute and chronic periodontitis
When treating acute periodontitis or exacerbation of the chronic form of the disease, the doctor is the first thing cleans the root canal to ensure free outflow of exudate. If necessary, the soft tissue and periosteal sheath are also cut in the projection of the apex of the root along the transitional fold to provide drainage. Orally (internally) one of the antibiotics is appointed – lincomycin, metronidazole, fusidine-sodium or others.
With apical periodontitis, the root canal channels are treated instrumentally, with the removal of the infected dentin layer, after which drugs are introduced into them. Treatment of edge periodontitis is directed, first of all, to the elimination of the traumatic factor. At the same time, the gum margin is treated with antiseptics (hydrogen peroxide, iodinol) and antibacterial solutions (furacilin, inhaliptum, furagin). With a chronic form, curettage (cleansing) of the periodontal pocket is performed.
Chronic periodontitis with extensive destructive changes is treated with preparations based on calcium hydroxide, introduced through the root canal into the lesion. An important point in the treatment of a tooth is a correctly completed canal filling, which is desirable to be performed as soon as possible after endodontic treatment. Naturally, if there is no bleeding and exudation from the canal.
As additional measures for periodontics, physiotherapy, which has an anti-inflammatory and analgesic effect, is used. If the tooth is still possible to save, then the doctor will do everything possible for this. Prevention of periodontitis
In the absence of proper treatment periodontitis is fraught with complications such as periostitis, abscess, phlegmon of the peri-maxillary tissue, sepsis, osteomyelitis of the jaw. The constant presence of infection in the body can negatively affect the work of the kidneys, heart and other internal organs.
In order to prevent the onset of acute and chronic periodontitis, it is only necessary to treat carious teeth in a timely manner and to use a protective pad when sealing to prevent toxic effects on the periodontal tissue.