Exacerbation of chronic periodontitis: chronic periodontitis in the acute stage
Acute purulent inflammation and exacerbation of chronic periodontitis may become intolerable, causing severe pain in the mouth. Is called periodontitis inflammation of the periodontium. On the light stage may be small characterizing disease signs or lack of them. During the formation of the inflammatory process, and weakening of the immune system possible transition to the stage of chronic disease. When sharpening at this stage, the person is pain, and show signs inherent in the acute form of the disease. To characterize the severity of chronic periodontitis, it is necessary to understand how it occurs, what types and manifestations can be, what causes illness, etc. Need to be aware of the real threat of complications that may be like ignoring a visit to the dentist, and after treatment.
What is periodontitis and its stages of
Periodontitis from the factor of origin is divided into infectious, traumatic, and medical. Depending on the origin of the disease develops with different speed, has different pain. Periodontitis is an acute form or chronic. The first in turn of the extent of occurrence and the nature of the damage is divided into the following types.
The course of the disease is almost asymptomatic, at which the impact of the canal pulp inside the tooth. If you make a collection of tests, it turns out that the course of the disease tooth is long lasting, but the identify phase is determined by granulating later. Symptoms become unpleasant rotten smell from the mouth, bleeding and feeling pain in the area of root canals. Also during the inspection the dentist can be identified fistulous course, formed on the gums of the infected area, which may eventually become evident, with the further possibility of healing. In this case, you should not rely on vyzdorovleniya process, on the contrary, after the closing of the fistulous canal inflammatory reaction will increase with the presence of pain.
Due to the appearance of granulomas, which becomes a cause of inflammation of the root canal. The body builds a barrier of the periodontal tissues, not allowing to produce isolation of the infected area. Compared to granulomatous periodontitis, the disease runs a less active, quiet, does not cause large destructive effect has a meaningful impact. Thus, there is the so-called zapisannoe education, which in turn is divided into several forms.
At this stage the seal of the periodontium, which promotes the growth of tissue and the formation of the site runs continuously. This is because the cellular effects and toxic effects of the channel region of the root is constant. The result of this action begins to form a cavity connecting tissue, which is filled with granules. There is accumulating fibrous elements of the procedure, saturated the area with microbes, both living and dead. Plus, this set is complete with cells, which are responsible for immune component.
The consequences of the development of granulomas. The point is that the periodontium has epithelial cells, which begin to develop very quickly, thus become irreversible in the formation of cysts. Thus, the centre of inflammation is filled acidic environment, which inhibits the cells responsible for forming bone tissue and cause activation of cells that destroy tissue. Cystogranulomas reaches sizes up to 8 mm, so for example, if the granuloma this figure does not exceed 5 mm.
Extreme stage at which the full grown of cavitary education. It has a capsule covered with cloth with the inner mucosal tissue. Thus, a pressure applied to the bone tissue, which causes its destruction. In the liquid, which filled the inner part, there are particles of cholesterol, which is an important indicator in the differential diagnosis.
The form of periodontitis, when there is a degeneration of the tissue. As a result of this education appears fibrous tissue. A distinctive feature of the symptoms is a sluggish process of the disease, which makes it difficult to diagnose.
Sharpening phase of periodontitis
A chronic disease with exacerbation of symptoms is common with acute periodontitis. Is swelling of the soft tissues, the tooth is set in motion, when pressed, pain is felt, etc. Maybe even a rise in body temperature, the presence of illness. But there was a difference, namely, that chronic periodontitis is manifested in the form of cyclical education. Thus, after the exacerbation there may come a sedative phase, characterized by the disappearance of pain and cessation of purulent manifestations. But this condition and symptoms were not talking about the cessation of the inflammatory process. In practice, it is the course of the disease gives the person some slack when it incorrectly decides that the disease goes away. Actually it isn’t, periodontitis passes to the next stage, treatment which can only occur with surgery, involving the removal of a tooth. Therefore, having the presence of typical symptoms, should not postpone a visit to the doctor to independently not to aggravate the condition.
The symptoms of acute illness
Indifference towards themselves during exacerbation of periodontitis can not do. There is pain when pressed, and eventually she adopts the status of autonomy and begins to dramatically increase. Flow pain can last from several hours to days. To endure such an impact people can not, because anyone, even a light touch will be given to unbearable pain. It is at this stage necessary to see a doctor, because diagnosing the disease is easy by resorting to early treatment.
People often refuse the intervention of a dentist using pain pills, and after the pain subsides and is quiet. It happens abruptly, without any reason, leaving only a small pain when strong pressure is applied on the tooth. Further, there is a rapid swelling in the area of the affected tooth and cheek is swollen. All is accompanied by a fever, you may receive the chills. Thus, the refusal of treatment to the doctor will cause complications of the disease and will lead to periostitis.
Chronic periodontitis in the acute stage is not independent and the simultaneous manifestation, it is a long disease process, which has complicated shape of the flow. For this reason, treatment should occur in two phases, the first of which is pain relief and the localization of the acute phase symptoms, and the second directly in the treatment. Moreover, the dentist should be assigned specific tasks in the treatment. Initially it is necessary to influence the microflora of the channels that are in the root system. Next, you need to localize the inflammatory process and to protect the hearth from the effects of biogenic amines. It is necessary to protect the periodontium from the receipt by him through a root canal infection, and also produce actions that will contribute to the regeneration of periodontal tissue. Also at diagnosis prior to treatment should be decided the question of the preservation of the tooth. To do this, the dentist applies an individual approach, aimed at analyzing the state of the tooth, painful sensations, the patient’s age, symptoms, etc.
Always spent x-ray to visually determine the stage and extent of development of the disease state, and also to see the placement of the tooth and root system.
Preparatory phase of treatment
Surgery involves local anesthesia, which involves the introduction of an anesthetic before the treatment. Inflammation in the mouth and the formation of pus inside the tooth, create a powerful clot pain, so the patient does not have the strength to withstand working conditions for the dentist without anesthesia. The priority actions of the doctor is to install a device to provide outflow of pus from the inflamed canal of a tooth, because the release of copious amounts of purulent accumulations is a major symptom of exacerbation of the chronic condition. The procedure is performed by opening upper channel, which allows good drainage and outflow of the content. Is that a direct outflow is impossible or difficult because of the curvature of the root canal. In this case, a doctor made an incision in the area of transitional fold, and treatment is postponed for a day.
Processing and filling of the root canal
Carry out any operating action is possible only after a quality cleaning, rinsing the canals. The use of specific antiseptic. Also patient prescribed antibiotics, and waits the time of decrease of the acute phase of periodontitis. After the channels are subject to sealing, which is laid in the tooth calcium hydroxide. It is necessary to start the recovery process of the periodontium is broken, and stopped the impact from negative microflora in the inflamed area. It is the calcium hydroxide maximally affects the flora, which is detrimental in a way ceases to exist, neutralizing the inflammation, eliminating acidic environment. In addition, the calcium in its composition has a recovery function of the bone elements. The dentist will have to use the material for sealing, which has antimicrobial properties. Clogging of the canal with a solution of ordinary sealing compounds not permitted. Term exposure seal lasts from 3 to 7 days. Thus, the elimination of periodontal treatment which is accompanied by further medication.
There are cases that the above-described procedure in which all limited incision transitional fold, not the end. Under certain circumstances, may require perforation of the bone with a special device. This is done when the standard procedure outflow of pus low due to the thick outer bony plates of the jaw Department. Perhaps that is a surgical action does not bring the desired results for the reason that granuloma and cysts are large. In result, resorted to the method of constant filling, using steklovarenie cement. And after the closure of the canal dentist doing a root apex resection.
The whole operation is performed only after complete removal of inflammatory processes. The operation involves the shortening of the working length of the root with one hand, and on the other eliminates an inflammatory lesion.
Then there is the possibility of exposure of an organism to self-recovery function of this field of destruction. Further treatment will consist of taking a course of medication to completely suppress the inflammation and restore the function of tissues.
Complications and recurrence
It is not excluded that as a result of improper or incomplete removal of purulent discharge will occur repeated inflammation. Also maybe in a complicated form to begin to develop osteomyelitis, or sinusitis. In these cases you will have to resort to tooth removal and continued treatment to prevent re-formation of pus and elimination of the inflammatory focus. After medical intervention, it is necessary to maintain oral hygiene, eliminating foods that may traumatize the mucosa and operated station. With food debris, can easily open, not healed the area to get infected, which will be the causative agent of the inflammation and exacerbation of periodontitis. Even with a light increase of the swelling and the manifestation of acute pain after visiting the dentist need to quickly repeat the visit to rule out complications that can cause additional tooth loss and discomfort for a surgical procedure, especially a dental treatment with the use of dental equipment is a stress to the body.