The periostitis of the tooth affects the periosteum (periosteum) of the jawbone, which is a connective tissue film covering the bone from above. The resulting inflammation of the periosteal tissue manifests itself as a characteristic clinical picture and requires adequate timely therapy.
Perioditis - the causes of
The pustule plays an important functional role, acting as the source of the formation of new bone tissue, providing nutrition to the bone due to the blood vessels passing through it and connecting the bone with other structures (muscles, ligaments). Often, inflammation with periosteal tooth develops in the outer or inner layer of the periosteum, after which the pathological process can transition to the bone tissues of the lower or upper jaw, which is an even more serious case.
- carious lesion of the tooth, affecting enamel and dentin, not received timely treatment;
- pulpitis (inflammation of the neuromuscular bundle inside the tooth);
- periodontitis - inflammation of the connective tissue located between the bone of the hole and the cement of the tooth root;
- parandontitis - inflammatory processes in the tissues of the periodontal surrounding the tooth and retaining it in the alveolus;
- various traumatic injuries in which the epithelium of the oral cavity is affected (tooth extraction, jaw fracture, impact on the cheek or chin area, injections);
- infections of different localization in the body, penetrating into the periosteal tissue through the blood or lymphatic system (tonsillitis, sinusitis , tuberculosis);
- a complex eruption of wisdom teeth (retina teeth).
Often diagnosed acute periostitis of the upper jaw, and in the development of infectious inflammatory processes in most cases involved a mixed microflora, including streptococci, staphylococci, putrefactive bacteria, gram-negative and Gram-positive rods. The disease develops rapidly, accompanied by pronounced symptoms.
The chronic form of pathology, which occurs in rare cases, is called sluggish. The widespread localization of the chronic form is the periostitis of the lower jaw. The development of pathology lasts from six months to several years, with symptomatic erased, periodic exacerbations with more vivid manifestations. Such a course can be noted in people with immunodeficiency states, after an incomplete acute process.
Inflammatory processes in the periosteum begin immediately after infection or traumatic injury, gradually affecting surrounding soft tissue. In this case, pathogenic microorganisms exert a toxic effect on the whole organism, and the infection is capable of spreading to other areas with a blood flow. When the periostitis of the jaw develops, the symptoms are noticeable during an ordinary dental examination. Often the following manifestations are recorded:
- redness and swelling of tissues in the affected area, gradually affecting the inner part of the cheek, lips, chin (depending on the localization of the focus);
- painful sensations that increase during opening the mouth, eating, talking, biting the affected tooth and tapping on it, giving in the ear, eyes, temple (can be noisy, pulsating, bursting character);
- the formation of an abscess, outwardly representing a cylindrical protrusion;
- mobility of the affected tooth;
- deterioration of general well-being, weakness, fever;
- an increase in the cervical lymph nodes .
Acute odontogenic periostitis is usually divided into two stages (forms):
In this form, acute periostitis of the jaw or exacerbation of the chronic process can begin. In this case, formation and congestion between the periosteum and the bone of serous exudate is observed, a fluid somewhat similar to blood serum. After a short time, infiltration of the periosteum occurs, impregnation of the bone tissue with serous fluid. This stage can last up to three days, accompanied by a mild symptomatology.
Much more severe acute purulent periostitis, associated with the development in the focus of inflammation of pyogenic bacteria. Pus permeates the periosteum, causes it to detach from the underlying bone, as a result of which the nutrition of bone tissues is disrupted, surface necrosis may occur. Further, the process may result in a breakthrough of accumulated pus through the fistulas or the spreading of pus on fatty tissue with the development of phlegmon. With the spontaneous release of pus, the symptoms subside, and relief comes.
Periostitis - diagnosis
There are situations when visual inspection for diagnosis, establishment of degree and localization of lesion is not enough. A more complete picture can be obtained by making an x-ray, a periostitis on which is visualized as a thickening of the periosteum. This examination should be carried out not earlier than two weeks after the development of inflammation, since before this time, pathological processes on bone tissues are not visible. In addition, a blood test can be prescribed, which, in pathology, will show an elevated white blood cell count and an increased ESR value.
Treatment of periostitis of the tooth
The methods used to treat periostitis depend on the causes of the disease, its stage and the severity of the process. After assessing the functional state of the affected tooth, the doctor determines whether to remove it or keep it by conducting appropriate therapy. When it is possible to save the tooth, it often requires cleaning the canal cavity from the affected pulp, sanation, nerve removal and sealing.
If the periostitis of the tooth is detected in the serous stage, surgical intervention is often not required. Only sometimes the doctor can consider it necessary to make a cut of the periosteum to relieve the tension of tissues in the area of inflammation. With purulent process, surgical methods are an obligatory part of complex treatment. Under local or general anesthesia, an opening, drainage and antiseptic treatment of the abscess is performed, with the mucosa and periosteum dissecting throughout the infiltration. For the outflow of purulent exudate, ribbon drainage is introduced for 1-2 days.
In addition, the periostitis of the tooth is treated with the following methods:
- taking systemic antibiotics;
- Applying a cold compress - to relieve swelling and pain;
- mouth rinsing with antiseptic solutions or herbal infusions with antibacterial properties (Furacilin, Chlorhexidine , Miramistin, chamomile broth, calendula, sage);
- taking painkillers (Nurofen, Lornoxicam, Paracetamol, Nimesil, Diclofenac);
- physiotherapeutic procedures to accelerate the elimination of inflammation and tissue regeneration (laser therapy, ultrasound or alternating current, etc.);
- observance of a sparing diet, providing for the refusal of hard, hard, spicy, sour and salty foods.
Antibiotics for periostitis
Periostitis in dentistry - one of the diagnoses, in which in most cases, the appointment of antibiotics for oral administration. Wide-spectrum drugs are used, able to accumulate in the right amount in the jaw tissues, affecting the pathogenic microflora. Treatment of periostitis of the jaw can be carried out with the help of one of the following medicines:
- Tsiprolet ;
- Metronidazole in combination with Clindamycin and others.
Periostite - folk remedies
If there is a question on how to treat a periostitis, you can not rely on self-medication and folk methods, otherwise it can lead to aggravation of pathological processes, the development of complications. Any home methods can only be used as an auxiliary to the basic treatment prescribed by the doctor, and necessarily with his permission. It should be noted that in case of periostitis, the warming of the affected area is contraindicated. The safest home therapies are rinsing with herbal preparations. For example, you can prepare an effective infusion.
- sage - 1 table. a spoon;
- oak bark - 1 table. a spoon;
- St. John's wort - 1 table. a spoon.
Preparation and use
- Connect the herbs, mix.
- Take 2 tablespoons of the collection, pour a liter of boiling water.
- Insist on a water bath for half an hour, strain, cool to 25-27 ° C.
- Apply to rinse every 40-60 minutes.
Treatment of periostitis after tooth extraction
If conservative therapy does not give the expected results, odontogenic periostitis is treated with an operation to remove the causative tooth. Further treatment is determined by the doctor, based on the situation. Often the same methods are used, which are shown after the filling of the affected tooth. Improvements should be expected after 2-3 days, full recovery - on 7-10 days.