Chronic periodontitis: symptoms, treatment, exacerbation of the disease
Causes, symptoms and treatment of chronic periodontitis
Chronic periodontitis is largely a consequence of acute inflammatory process or to develop independently, if a person has weak immune system.
Periodontitis is characterized by minor symptoms or none, for example, if you bite a person can experience some mild pain. The development of inflammation from time to time can worsen the deterioration of the immune system.
During exacerbation of symptoms of chronic periodontitis is always similar to the symptoms of acute forms of the disease. Such a reaction can provoke hypothermia or worsening of the immune system after SARS.
What forms of violations differ?
Just distinguish three forms of such diseases as chronic periodontitis, each with their own symptoms and features:
- And fibrous. For this form of disease is characterized by gradual replacement of the fibers of the ligamentous element of the tooth, connecting it to the bone (periodontal) connecting fibrous tissue. The disease is characterized by minimal expression of symptoms, as well as perhaps the complete lack of pain. Sometimes the dentist fails to diagnose fibrous periodontitis only after x-ray examination. The normal state of the periodontium is determined visually as a narrow strip between the roots of the teeth and bone. When this disease is characterized by the significant expansion of periodontal fissure.
- Granulomatous. Abscess, is typical of chronic granulomatous periodontitis, is a kind of SAC, composed of mucous membrane tightly filled with pus. If we consider the possible sizes of such purulent sacs can be divided into 3 main varieties of this form of the disease: granulomas, the size of which is up to 0.5 cm in diameter; cystogranulomas, the size of which ranges from 0.5 to 1 cm. cyst that measures more than 1 cm at the root apex. With the development of the granuloma develops into cystogranulomas, and thereafter to the basal cyst, which, in turn, can grow to 4-5 cm or more, the result often becomes the cause of fracture of the lower jaw. Such a cyst inside, too, filled with pus.
- Form of chronic granulomatous periodontitis. This is the most active form of all the existing manifestations of chronic periodontitis. It is characterized by the formation of granulation shell in the area of the root tips, which resembles a loose grained Burgundy cloth. For this disorders are characterized by accelerated growth that promotes active deformation of bone tissue and replacing it with fragments. The x-rays dentists record significant changes. On the tops of the roots, you can notice a slight dimming shape which visually resembles flames. Such obscuration suggests that in this region the bone is destroyed, and in its place now are the granulation of education.
Acute stage — in what its feature?
Exacerbation of chronic periodontitis in the clinical sense like a sharp purulent inflammation. For the most part before the stage of inflammation there is a minor symptoms that are characterized by self-extinction. In most cases, patients do not seek help from a qualified dentist.
For the acute stage of the inflammatory process, chronic character, characterized by increased granulation of the fragments in the tissues of the periodontium.
Such manifestations are often accompanied by pain while eating, feeling that the tooth is slightly enlarged, with swelling of the gums and face. Signs of such exacerbations are Dernovoy fistula, in-depth Karinna cavity, congested mucous.
Chronic periodontitis in some cases resembles acute sinusitis, maxillary osteomyelitis or other diseases. For proper diagnostics in modern dentistry developed accurate methods and used a sufficient number of technical means.
Causes and risk factors
Periodontitis is subdivided into infectious and noninfectious. In some cases, the disease develops because of infection in the tissue surrounding the upper part of the roots of teeth, some root canals.
Non-infectious type of violation may be due to the usual injury.
The reasons of the infection of periodontitis:
- Pulpitis was treated not in time. In some cases, the infection can move from the cavity directly into the pulp of the tooth, and then, passing through the openings of the channels on the upper parts of the roots of the teeth, it nestles in the periodontium, where there is an abscess formed purulent pouch. Making a radiograph, the dentist may notice a cavity, and periodontal abscess at the apex of the root in the form of a blackout.
- The root canals were poorly sealed. If in the process of treatment of pulpitis was not completely sealed root canals in the remaining cavities can develop infection. After some time the inflammation extends beyond the tooth, causing the formation of periodontal abscess near the root apex. The x-rays the process is determined visually as the intense shading around the top of the tooth root.
- Marginal periodontitis. With the development of moderate and severe disease between the bone and the tooth root is formed of the recess where they can spread the infection further in the periodontium, getting into the area of the tops of the roots. Because of the nature of education, this form of violation is called marginal.
Acute traumatic periodontitis is related to the diseases of non-infectious origin, and may be formed by simultaneously sports, domestic injuries. The disease may occur as a result of regular physical effects.
In such situations, it assumes a chronic form of traumatic periodontitis.
In some cases, patients can develop drug violation. Most often this effect is due to unskilled treatment of pulpitis on the stage of the sealing or the use of various medicines.
Sometimes medicamentous periodontitis occurs after penetration of the sealing means for the top of the tooth root. Often, patients have an allergic reaction after using dentists substances that can influence the development of immunological response.
A severe form of violation of short
The acute form of the violation may have the following clinical manifestations:
- root fractures
- is broken when the neurovascular bundle of the tooth crown can be painted in a distinctive pink color;
- dislocation of the tooth is always accompanied by his mobility and pain when biting.
The development of this form of the disease is associated with congestion arising from mistakes in the process of medical procedures and prosthetics.
In some situations, dentists with a low level of professional training do not comply with the correct height of the seal.
This causes uneven clamping force, which is characterized by premature semen. When a person chews food, the constant pressure is often the cause of traumatic periodontitis.
In some cases, patients may experience an allergic reaction to the components of the mixture for sealing.
Approach to diagnosis
Violation is very difficult to diagnose dentists because of the lethargy of the disease and the almost complete absence of visible symptoms.
All doctors use the same common algorithm of examination of the oral cavity. Skilled professionals assess the results of all procedures, carefully inspect the oral cavity, conduct history taking.
The most effective technique for facilitating the identification of chronic periodontitis is the study of x-rays and visual inspection.
X-rays can be performed several times, for example, at the first visit, after the completion of therapeutic procedures in the process of endodontic treatment to determine the dynamics and effectiveness of our actions.
Clinical examination involves the following procedure:
- a careful examination of the oral cavity;
- percussion of the tooth;
- palpation of the oral cavity, as well as individual fragments of the periapical tissues;
- is determined by the degree of pain in the tooth channel during the passage of a special probe;
- temperature testing, yielding the best results in diagnosing the disease in adults;
- determination of the level of mobility of the tooth through the indigenous indentation and translational movements;
- it is possible to use radioviziografichesky, electroodontodiagnosis apparatus for quality assessment of vitalnosti pulp.
The primary goals and methods of therapy
The treatment of any form of periodontitis is aimed at destroying the primary tumor, the elimination of harmful microflora throughout the area of inflammation. Treatment usually starts with gaining access to the root channels.
To do this, the dentist will gently prepare charitou cavity, and then to get rid of outdated fillings in a patient. After that, the doctor should organize the outflow of fluid and thorough washing of the periodontium prepared with an antiseptic solution.
When this is washed not only the channel but also zapisannoe space.
The period of full recovery of damaged areas lasts up to 12 months, so the treatment of some forms of the disease can be quite long and complex. Tissue regeneration should always be carefully monitored by the technician through the study of x-ray images.
Additionally, patients can be administered physiotherapy and rinse oral cavity with antiseptic.
A method for the treatment of chronic periodontitis is always due to the degree of development of inflammation and the dentist chooses the most adequate and gentle method of stopping the pathological process.
Prognosis and complications
The prognosis of the disease is always due to the time of treatment to the doctor for professional medical help and, of course, the quality of the medical procedures.
Measures for prevention of such diseases involve frequent dental visits and careful attention to the condition of their teeth.
Of considerable importance is the proper execution of all dental procedures, as well as rational use of available drugs.
In medical practice known to the General and local complications of the disease.
The blow to the whole organism
A common result of intoxication, caused by the proliferation of harmful microorganisms, which can cause negative reaction of the human body when the penetration into the blood.
The impacts of local significance
Local represent fistulas or cysts of the teeth. Fistulous passages are often formed, as in the oral cavity and the location of the root apex of the affected tooth.
Such education can occur even on the skin, contributing eventually to the formation of the external defects of the face. When periodontitis develops, through the fistula appears purulent mass.
Such entities can be closed and open during exacerbation of the disease. A similar process is accompanied by scarring and the formation of a kind of funnel after retracting the tissue inside the fistula.
In some cases, fistulas may occur on the chin, in the cheeks, upper jaw, near the back of the eye. When granulomatous lesion extends to the periosteum or soft tissue areas, the formation of odontogenic granulomas, the development of which is the pressure on the bone tissue, which in result may lead to the destruction of their alveoli.
A cyst can be formed from the infected granulation tissues in the region of the root apex of the tooth.
A cyst formed as a result of the development of periodontitis, is one of the most complex chronic diseases in dentistry. Within this education are continuously taking place inflammation.
For this reason, the cyst can spread to healthy teeth as they grow. Most of this education occurs at the locations of the non-professional dental intervention.
If you do not follow the oral cavity hygiene, harmful microflora can penetrate unprotected nerve canals and lead to infection. When a cyst develops, patients occur in parallel, flux, sharp pain in the affected area, increased body temperature.
Such education grow slowly and up to a certain time difficult to detect by visual inspection of the oral cavity patients.
Actions taken to prevent the development of chronic forms of periodontitis mostly involve the prevention of pulpitis and caries.
To do this:
- carefully and constantly to care for the oral cavity;
- consider your diet and rather eat sweets;
- regular visits to the dentist from an early age, according to the results statistics, you can determine that the number of caries is reduced by 65-70% in the clinical examination;
- when there are warning signs, it is imperative to contact your dentist;
- you need to follow each recommendation of the physician in the treatment of disease.
In addition to attention to their own health, it is also important educational activities by qualified professionals.
Modern dentistry has long ceased to be so traumatic as it used to, so a visit to the dentist should not cause patients such fears, as it was a few years ago.
Regular checkups at the doctor are considered to be the primary method of disease prevention.