Periostitis, or in simple terms, flux is a disease accompanied by an inflammatory process in the periosteum. Most often, periostitis is a consequence of other inflammations in the oral cavity, in the periodontal area or teeth.
Painful periostitis is associated with abscess formation of the lesion. At the same time, the patient develops palatine edema and body temperature rises. A person needs timely medical assistance, otherwise purulent accumulations can break out, causing such a complication as osteomyelitis.
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What is the periostitis of the upper jaw
The appearance of the disease is not excluded in all age categories, however, in children and the elderly, periostitis is not diagnosed as often, and its symptoms are scanty.
It is difficult to confuse flux with other diseases because it develops strong puffinesswhich is hard not to see. Mostly periostitis originates under the action of infectious agents that affect the chewing organs of the lower and upper jaw.
If the root apex is inflamed or the infection has affected the dental canals, the infection can spread to surrounding tissues: bone tissue, gingival mucosa. After a certain period strong suppuration occurs, and pus gradually seeps through the bone and mucous. The appearance of edema and severe pain is associated with this.
Periostitis of the upper jaw represents a great dangerrather than the lower, because along with the teeth and surrounding tissues, the sinuses may be involved in the inflammation, and the edema can cover up to half of the face.
There is a direct connection between the location of the edema and the damaged tooth. Puffiness often affects upper lip, the wings of the nose and cheeks, and at the same time the vestibular or palatal side of the oral cavity swells.
Statistics show that mandibular periostitis is most common and occurs in approximately 65% of cases. There have been cases when purulent inflammation affected up to ten teeth at once. Teething is often hampered by various diseases. For example, the so-called inflammation of the “hood” that needs to be cut through, or the wisdom tooth has to be pulled out.
Classification of periostitis of the upper and lower jaw
To classify periostitis allow several criteria. Depending on the level of infection involvement in the pathogenesis of the disease: aseptic and purulent.
According to the specificity of exudate: proliferative and exudative. By the nature of the severity of flow: acute and chronic.
Varieties of periostitis depending on the form of the disease:
- purulent;
- serous;
- ossificant;
- fibrous;
- plain.
Causes of periostitis
The reasons that underlie the development of periostitis of the upper jaw are varied. The main factor is the infection. Streptococci, staphylococci and other gram-positive bacteria are the most common infectious agents.
Penetrating into the periosteum in different ways, they provoke purulent processes. One of the main sources of bacteria are carious teeth. Late stages of caries, as a rule, are marked by the appearance of cavities inside the tooth.
The presence of pulpitis aggravates the situation. Bypassing this cavity, pathogenic microbes freely penetrate the root, gingiva and jaw bone, which, in turn, gives rise to the formation of inflammation and periostitis.
If exudate and pus accumulate in the periosteum area, then we are talking about purulent periostitis. Serve the cause of the development of periostitis of the jaw can not only caries, but a single human organ, which serves as a source of infection.
The disease provokes problems with the upper respiratory tract. The flux-causing infection travels through the circulatory system and reaches the circulatory tissue. In such cases, the diagnosis - lymphogenous periostitis. This is a very dangerous condition.
A huge role in the development of this disease is the immune defense of the body. Strong immunity is able for a long time to resist breeding bacteria that provoke flux.
Sometimes patients in dental offices have to re-seek help after they have undergone treatment procedures. Periostitis may occur due to non-observance by the dentist of hygienic rulesthen there is a risk of infection in the gums.
Basically, periostitis is formed on the background of any diseases of the teeth, but there may be independent causes that contribute to its appearance.
Types of periostitis
Depending on the etiological features, in medical practice there are several types of periostitis:
-
Inflammatory. As a result of a rapidly developing inflammatory reaction in the oral cavity, which is localized in the periodontal region. Symptoms are increasing gradually. - Toxic. It occurs in episodes when soft tissues are infected due to infection in the bloodstream. This picture is typical for patients suffering from systemic diseases of the body.
- Traumatic. A person can get an infection during traumatizing the jaw, gums or teeth.
- Specific. It is a companion of diseases such as tuberculosis or actinomycosis.
In the role of a process trigger can be:
- Problematic teething.
- Inflammation, affecting the polyurethane and the impacted teeth.
- Pus accumulated in radicular cysts.
- Odontomne growths.
- Paradontal diseases.
- Violation of the integrity of the gums during tooth extraction.
Acute purulent periostitis may occur under the influence of the following general factors:
- excessive physical exertion and overwork;
- hypothermia;
- exposure to stressful situations.
The clinical picture of periostitis jaw
The main symptom, which allows to suspect periostitis, is swelling of the gums. A pronounced pain syndrome will be observed with periostitis, which appeared on the background of caries or pulpitis. Acute periostitis develops instantly and is accompanied by such symptoms:
-
Soft gingival tissue gums. - Severe pain in the affected periosteum.
- Redness in the inflamed gingival area.
- Swelling of the face, lips or cheeks from the location of the flux.
- General weakness and malaise.
- Aggravation of headache.
- A marked increase in the submandibular and cervical lymph nodes.
- Decreased appetite.
- Slight increase in body temperature to 37.5–38.
The nature of the pain in periostitis can be pulling, cutting or pulsating.
Diagnose periostitis is necessary, based on clinical data and laboratory results. A similar clinical picture is present in other diseases that need to be distinguished, otherwise the chosen treatment strategy may not bring success, and even worse, harm.
Diagnosis of the disease
Differential diagnosis is carried out with such diseases:
-
Acute periodontitis.A distinctive feature is the location of the source of infection: the swelling in this disease does not go beyond the boundaries of the affected tooth, and with flux it is possible to cover several adjacent teeth. - Acute sialadenitis. Characterized by inflammation of the salivary glands. When sialodentitis from the ducts of the salivary glands purulent content is released, without affecting the dental structures.
- Acute osteomyelitis. With such a disease, general intoxication of the organism with products of the vital activity of bacteria is expressed. Characteristic symptoms appear: fever, fever, headache, chills and weakness. At the same time, an increase in the alveolar process can be seen on both sides, and not on one, as with periostitis.
- Abscesses, lymphadenitis, phlegmon. With these pathologies, palpation can detect dense formations in the depth of tissues in the neck and face. Of the other symptoms, hyper-hypersensitivity and tightness of the skin is noted.
Periostitis, in turn, is palpated as a softening of tissues. Fluctuation in the mucous membrane does not cause reddening of certain parts of the face, the skin does not stretch and does not shine.
Treatment of periostitis
In the event of an acute form of purulent periostitis, the main treatment will be surgical intervention. Its purpose is to open and drain the abscess. In parallel, they use conservative methods and prescribe medication to relieve the patient's condition.
In the early stages of the disease, when the serous form is not transferred to the purulent, the incision can be avoided by performing an opening of the tooth cavity, clean the channel and create conditions for the outflow of fluid. Some patients need to get rid of the affected tooth in order to ensure complete recovery.
To prevent the doctor from doing the pain, the patient is asked conduction or infiltration anesthesia. The transition of periostitis into a purulent form forces the doctor to perform periostomy - dissection of the periosteum in the inflamed area. For the implementation of such an operation using local anesthesia.
The injection with the drug is injected with a thin needle into the intended incision line, while it is unacceptable that the anesthetic gets into the purulent cavity. Such an oversight can significantly increase the swelling of the gums, and pain relief will not work.
After successful opening of the abscess, the patient is given a weak solution of manganese or sodium bicarbonate so that he can thoroughly rinse his mouth. Next, the doctor washes the cut chlorhexidine or other bactericidal solution.
A tooth that has evolved periostitis of the jaw is required to be removed if it does not represent functional importance for a person, has a carious lesion and violates the aesthetic appearance. An extracted tooth improves the outflow of purulent exudate, and the inflammation in the jaw gradually decreases.
If the preservation of the dental element is indicated, it is necessary to carefully endodontic treatment with the subsequent sealing, observing at the same time all norms of antiseptics.
Drug and physiotherapy treatment
Medications that are prescribed to the patient with jaw periostitis:
-
antihistamines; - nitrofurans;
- sulfonamides;
- antibiotics;
- calcium supplements;
- multivitamin complexes.
Recently, doctors have less confidence in sulfonamides, since the bacterial flora does not demonstrate high sensitivity to them. Instead of them, prescribe antibacterial drugs broad-spectrum and derivatives of nitazole.
The next day after surgery, carefully examine the patient's mouth and establish the degree of reduction of inflammatory processes.
If the patient sought help for acute purulent periostitis of the jaw, then he is given referral for physiotherapy treatmentwhich he can attend on the second day after surgery. The following procedures are recommended:
- UHF
- Microwave
- Laser therapy with neon-helium and infrared lasers.
- Fluctuarization.
- Antiseptic and deodorizing solutions as warm baths for the mouth.
- Tampons with sea buckthorn or camphor oil.
Predicting the outcome of the disease is quite difficult. In many respects it will depend on when the medical procedures were initiated and how effective they are.
If you follow all measures for the treatment of purulent periostitis at the very first stages, you can be sure of full recovery. Literally in five days the patient becomes able-bodied.
In case of an abscess abscess, the abscess can break through on its own, which will cause death in the jaw bone. Nonprofessional and unfair treatment leads to the chronic form of periostitis, allows it to go into osteomyelitis.
Preventive measures are in urgent treatment foci of odontogenic origin: pulpitis, caries, periodontitis. We must not forget about the daily hygiene of the oral cavity.
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