Many know the situation when the fear of treatment of teeth Makes postponing a visit to the dentist indefinitely. Maybe for some time do not disturb anything, but suddenly such unbearable toothachethat the sufferer immediately see a doctor. Often diagnosed - pulpitis. Pulpitis is the inflammation of the neurovascular bundle. tooth. It has a certain classification.
Causes of pulpitis
The causes of pulp inflammation are as follows:
- infectious;
- traumatic;
- retrograde;
- concusive.
Basically, pulpitis occurs in complicated caries, when the hard tissue of the teeth is very much destroyed. An infection in the carious cavity promotes pulp inflammation.
In addition, this disease is often resulting from medical error, for example, if the seal is installed poorly or when treating caries, the pulp was opened carelessly. Also, a tooth may be injured due to a stroke.
Very rarely, but the infection can penetrate through the vessels along with blood from the root.
Inside the tooth itself may appear a solid formation, which is called denticl. It also contributes to the inflammation of the pulp.
Symptoms
Inflammation of the pulp is accompanied by unbearable pain, which sometimes subsides. Especially the pain pesters at night and can increase body temperature.
In the initial stage of inflammation, periodic aching pains occur. The advanced stage is characterized by an increase in pain, which gradually becomes more and more pulsating. For the chronic form of inflammation, pain is characteristic only during exacerbation. Pus is formed, and if you slightly press on a bad tooth, pain immediately arises.
Classification
Modern dentistry has several dozens of various classifications of pulpitis. This is because there are a lot of pulp lesions, as well as the ways of their formation. Many in their own way determine the classification of pulpitis.
The most popular are the following classifications:
- Platonov's classification;
- ICD-10 classification;
- classification by gofungu.
Classification Platonov.
As a result of this classification, the pulpitis is divided into the following types and forms:
- acute (focal and diffuse);
- chronic (fibrous, gangrenous and hypertrophic);
- chronic in the acute stage.
Acute pulpitis is characterized by intense throbbing pains that occur with seizures. At first, the pain is short and the period of calm can last for a long time. Then pulp inflammation begins to progress, the pain becomes stronger and longer, and the period of calm - all shorter. A sick tooth begins to ache from interacting with hot water.
Chronic pulpitis proceeds sluggishly, almost painlessly. External irritants do not bother much the aching tooth. The color of the tooth changes, the pulp is considerably exposed, you can even consider the mouth of the root canals.
The exacerbation of chronic pulpitis has all the symptoms of acute. The only difference is that the pain practically does not pass. Externally, the tooth looks the same as in chronic inflammation of the pulp.
Classification according to ICD-10.
The World Health Organization offers the following classification:
- pulp inflammation;
- diseases of the pulp and periapical tissues;
- pulp hyperemia;
- acute;
- chronic;
- purulent, pulp abscess;
- chronic ulcerative pulpitis;
- reculse pulp;
- pulp polyp;
- other specified pulpitis;
- unspecified pulpitis;
- abnormal formation of hard tissue in the pulp;
- pulp degeneration.
This qualification has a distinctive feature - in a separate category identified changes in the pulp of the tooth, before the appearance of systematic pain.
Gofung classification.
The most popular classification among dentists is pulp inflammation. It perfectly displays all stages of the disease.
Acute pulpitis.
Partial. If acute partial inflammation has occurred, the changes in the pulp are completely reversible. If you immediately go to the doctor as soon as the pain appeared, then possible to cure a tooth and save the nerve.
Overall. Acute general inflammation of the pulp is characterized by diffuse inflammation, which entirely covers the pulp. The characteristic signs of acute common pulpitis. almost impossible to distinguish from the beginning of purulent destruction, therefore resort to a surgical method of treatment.
ABOUTgeneral purulent. This stage is characterized by the development of an irreversible pathology, it is because of this method of treatment that vital extirpation is considered. The physician should pay special attention to the prevention of periodontitis.
Chronic pulpitis.
Plain.
Hypertrophic. Both this and the first form are successfully treated surgically, preserving the root areas of the pulp.
Gangrenous. The most severe form of chronic inflammation. The treatment here is extrusive. This form is characterized by the maximum saturation of the root canal walls by the pathogenic microflora. The treatment is carried out in several stages. it promotes prolonged action of antiseptics, which reduce the risk of complications after filling.
Classification MMSI.
It is very similar to the Gofung classification, only some points of exacerbation of chronic pulp inflammation are added and the peculiarities of the occurrence of inflammation in a previously treated tooth are taken into account.
- acute (serous, focal purulent, diffuse purulent);
- chronic (fibrous, gangrenous, hypertrophic);
- exacerbation of chronic pulpitis (fibrous, gangrenous);
- condition after pulp removal - partial or complete.
Exacerbation of fibrous pulpitis does not usually have such a destructive effectlike exacerbation of gangrenous. In the latter case, the degree of complication from the periodontium is high.
The tooth begins to strongly resist filling the canals, severe pain appears when it is filled with a temporary filling. This is due to the fact that the anaerobic microflora feels great when isolated from the external environment.
It often happens that the removal of part of the pulp does not relieve inflammation. This happens because the diagnosis is incorrect or the treatment technology is violated. In this case, helps complete removal of a tooth together with the roots.
Thus, we conclude that the treatment of pulpitis at an early stage contributes to nerve conservationwhich nourishes the tooth and ensures its vital activity. Therefore, at the very first signs of pulpitis, you should immediately contact your doctor.
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