Periapical disease

Introduction to apical periodontitis Periapical diseases include acute and chronic apical periodontitis, which refers to periodontal tissue confined to the apex of the apex, including inflammation of the cementum, periodontal ligament and alveolar bone. Sexual and suppurative apical periodontitis. basic knowledge Sickness ratio: 0.5% Susceptible people: no specific population Mode of infection: non-infectious Complications: abscess, jaw osteomyelitis, cavernous sinus thrombosis

Cause of periapical disease

Infection (35%):

The most common infections come from rickets, pulp disease, followed by periodontal disease through the apical foramen, lateral root canal and dentinal tubules, blood-borne infections are relatively rare. The main pathogens of periapical infection are the result of mixed infection of root tip microorganisms, of which P. gingivalis is the main pathogen. Bacterial and bacterial metabolites such as endotoxins cause apical periodontitis through pathological immune responses.

Trauma (30%):

The teeth are subjected to external forces such as blows, collisions, falls, etc., which can cause damage to the hard tissues, periodontal tissues and periapical tissues of the teeth. Biting a hard object, such as a bite that is bitten into the rice, or a bottle cap, can cause periapical damage.

Odontogenic factors (10%):

The pulp and root canal are over-sealed, and the root canal instrument wears the root tip. Improper orthodontic force, rapid separation of teeth, and inadvertent injury to adjacent teeth can cause sharp-onset injury.

Tumor (5%):

Tumors that affect periapical lesions include squamous cell carcinoma, lung cancer and breast cancer metastasis, jaw osteosarcoma, myeloma, and ameloblastoma.

Apical periodontal disease prevention

The most important thing to prevent dental disease is daily tooth cleaning: brush your teeth correctly, you should use the upper and lower vertical brushing method, brush your teeth in the morning and evening, brush each tooth 8-10 times; rinse your mouth after meals; use floss to clean the adjacent tooth gap Chewing xylitol chewing gum for about 20 minutes; changing a new toothbrush every month; seeing the dentist every 3 months, treating the disease, preventing disease; paying attention to the amount of fluoride toothpaste (especially children), general pea size You can brush your teeth properly. If you use a toothbrush that has bristles, you should replace it. If you don't have periodontal disease, you can go to the dentist every year to wash your teeth. You should go to a dental chair with a good disinfection facility to avoid getting hepatitis B and AIDS. In addition, pay attention to drink less carbonated drinks.

Periapical disease Complications, abscess, osteomyelitis, cavernous sinus thrombosis

The alveolar process of the maxillary central incisor is very low and the root is long, and the pus penetrates through the bottom of the nose;

The apex of the maxillary lateral incisor is often biased to the lingual side, and the pus can penetrate the temporal bone plate to form the temporal abscess;

The root of the maxillary posterior teeth is close to the bottom of the maxillary sinus, and sometimes the pus can penetrate into the maxillary sinus;

The maxillary molars have a root abscess that can even extend from the subperiosteal to the soft palate;

The mandibular incisor can cause swelling of the ankle;

When the root of the mandibular molar is long, the pus is spread under the lingual muscle of the jaw and the muscle to the soft tissue of the mouth, causing severe cellulitis of the mouth, osteomyelitis of the jaw, and occasionally causing a cavernous sinus thrombosis.

Symptoms of periapical disease Common symptoms Gingival swelling abscess Submandibular lymphadenopathy Hyperthermia fever with chills Gingival itching gingival painful purulent secretions chills Lymph node swelling displacement

1. Pain, bite pain.

2. The teeth are loose and stretched.

3. The patient can clearly indicate the tooth.

4. The root tip is red and swollen, the tenderness is obvious, and the migration groove becomes shallow.

5. Persistent spontaneous pain, late pulsatile pain (jumping pain).

6. There is fever, chills, and some body temperature rises.

7. The lymph nodes are swollen and tender.

8. Tooth discoloration.

9. The pulp has no vitality and is not sensitive to temperature and electrical measurement.

10. The tip of the fistula, red and swollen, with purulent secretions.

11. The apical period of the apex of the apex, ping-pong, tooth displacement, loose teeth, severe, facial deformation.

12. Osteoporosis puncture has viscous cyst fluid and cholesterol crystals.

Examination of periapical diseases

1. Blood routine examination.

2. General photo inspection.

3. Secretion and tissue culture + drug sensitivity.

Diagnosis and diagnosis of apical periodontitis

Differential diagnosis

The periapical periodontitis itself needs to be identified, including the identification of periapical abscesses, periapical granuloma and periapical cysts.

Diagnosis depends mainly on X-rays, in addition to medical history and examination characteristics.

The abscess type showed that the boundary of the apical projection area was unclear on the X-ray, the shape was irregular, and the osteoporosis around the projection area was cloud-like.

The granuloma type is characterized by a circular or elliptical projection area at the apex of the apex, with clear boundaries, normal or dense surrounding bone, and a small lesion range.

The cyst type shows a large circular projection area on the X-ray film, the boundary is clear, and the surrounding bone is dense and clearly reflects the white line.

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments.