Periodontitis apical

Periodontitis apical - inflammation of the tissues surrounding the tip of the root of the tooth.

Etiology: infection (staphylococcus aureus, streptococcus, anaerobes), mechanical trauma, including microtrauma (snapping of the thread, grasping of nails, etc.), chemical.

Pathogenesis. Spreading through the apex of the inflammatory process from the pulp. Reaction to contact with necrotic pulp, potent medications and damage by endocannular tools. With microtrauma, the vascular-neural bundle is broken. Microbial and drug sensitization is important.

Symptoms, course. Acute periodontitis is manifested by sharp pain in the area of ​​the tooth, which is strengthened by touching it. Swelling of the lips, cheeks. The gums are swollen, hyperemic, infiltrated. The tooth is pathologically mobile. Submandibular lymph nodes are enlarged, painful on palpation, the temperature is 37-37.5 g. C. There are complications in the form of a maxillo-abscess, osteomyelitis of the jaw. With the formation of submandibular abscess, the severity of symptoms decreases. The chronic process proceeds sluggishly: there is a feeling of embarrassment when eating, an unpleasant odor from the mouth, sometimes fistulas on the gum, less often on the skin of the face. Periodontitis is aggravated periodically. In the affected tooth, a carious cavity or a filling. The pulp is necrotic. At a traumatic origin of process the crown of a tooth is intact. Different forms are differentiated by radiography. The disease can lead to the formation of the jaw cyst. It is the source of streptococcal sensitization of the body.

Treatment. The acute process requires urgent intervention - creating an outflow of exudate from the supra-intestinal area, which is achieved by passing the root canal with an endodontic instrument and opening the apical opening. Subperiosteal abscess is opened. At the expressed general phenomena antibiotics are appointed. In the chronic process, root canal enlargement, their antimicrobial treatment, affect the inflammation focus with medications or physical methods (electrophoresis, UHF therapy, etc.). Treatment is completed by filling the root canals with hardening plastic (phosphate cement, cebanite, endodent, etc.) or solid (pins of silver, plastic) materials. Applied and surgical methods of treatment - tooth extraction, root tip resection, tooth re-implantation, hemisection.