This ailment is popularly called flux. The word is borrowed from German and means flow or flow, and this translation ideally describes the process of periostitis itself. During the development of this disease, purulent discharges are rapidly flowing through the tissues, the process is very similar to how the rivers flow during flood. Therefore, it is extremely important to timely draw your attention to the alarming messages of the body and promptly seek the help of professionals.
The periostitis of the upper and lower jaws is also called periosteal inflammation, it is one of the most widespread complications resulting from the initiation of caries treatment. Dangerous disease is that inflammation develops asymptomatically and first covers the inner and then the outer layer of the periosteum.
The center of pus is first formed at the very root of the tooth, and later begins to accumulate under the periosteum, which leads to an inflammatory process occurring in the periosteum itself. During the formation of inflammation between the gums and the damaged tooth, the disease easily spreads and covers the soft tissues.
With an increase in the process of inflammation, the gums characteristically swell, causing a sharp pain, and then a flux occurs. This process is very serious and requires immediate dental intervention, as this disease can lead to blood poisoning and other dangerous complications.
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What is jaw periostitis?
Periostitis of the lower and upper jaw - an inflammatory-infectious process that takes place in the body of the jaw or periosteum of the alveolar process.
If you have periostitis, under no pretext do not self-medicate. It is forbidden to apply hot compresses to the swollen place, since this warming up will immediately accelerate the inflammatory process.
Periostitis is accompanied by the formation of an abscess:
- in the subperiosteal division;
- swelling of the soft periomaxillary tissues;
- pain turning into the temple, ear, eye;
- deterioration of the patient's state of health (fever, weakness, sleep disturbance, headache).
The diagnosis of periostitis of the upper jaw, as well as the lower one, is determined on the basis of palpation and examination data, confirmed by examination under an X-ray machine. Treatment includes first opening and then drainage of the abscess of the subperiosteal section, removal of the source of the infection itself - the tooth, mouth rinse, physical therapy, antibiotic therapy.
Periostitis of the lower and upper jaw - the process periosteum inflammation (periosteum) arc of the alveolar, less common - periostitis of the body of the lower or upper jaw of traumatic or infectious genesis.
In dentistry, periostitis of the jaw is diagnosed in six percent of patients with inflammatory processes in the area of the maxillofacial part of the head. In 95 percent of cases inflammation is acute and only in five percent proceeds in the chronic. Approximately twice as often the maxillary periostitis is localized in the lower region of the jaw.
The course of the disease in both the upper and lower jaws can be characterized by the uniqueness of the general and local clinical picture, the reversibility of the inflammatory process itself with timely treatment and the risk of serious complications of the purulent process with a progressive form of the disease.
Classification of periostitis of the upper and lower jaw
Depending on the possible type of infection penetration into the periosteum, the following forms of the disease occur:
- odontogenic (process associated with tooth disease);
- hematogenous (a process associated with the spread of infection through the bloodstream);
- lymphogenous (a process associated with the spread of infection through lymphatic connections);
- traumatic (due to mechanical damage of the periosteum itself).
Given the pathological picture of the inflammation itself and the clinical course, the periostitis of the jaw area can be chronic (ossifying or simple) and acute (purulent or serous).
Serous acute periostitis of the jaw accompanied by the process of infiltration of the periosteum and the formation of a small amount of exudate in the inflammatory focus. A purulent acute periostitis (flux) passes with the formation of an abscess of a limited subperiosteal type, the formation of fistulas through which the purulent discharges flow out.
The periostitis of the upper and lower jaws of a chronic form is characterized by sluggish inflammatory-infectious processes in the periosteum, accompanied by the emergence of young tissue on the surface of the upper or lower jaw bones. With normal periostitis the process of neoplasm of young bone can be reversible, but with the ossifying process, hyperostosis and ossification progress rapidly.
By type of distribution is:
- limited (in the area of one or more teeth);
- purulent (area of almost the entire jaw) diffuse periostitis.
Causes of periostitis in the jaw area
As practice shows, the periostitis of the jaw most often has odontogenic occurrence and occurs against the background of a disease of the jaw teeth.
The percentage of periostitis:
-
in 73 percent of cases associated with periodontitis in a chronic form; - in 18 percent - alveolitis;
- in 5 percent - inflammation of the impacted and polyurethinized wisdom teeth;
- 4 percent - suppurative cyst and periodontitis.
In these clinical cases, exudate inflammatory nature moves along the bone channels under the periosteum from the periodontal compact and spongy layer of the jaw bone.
Lymphogenous and hematogenous periostitis of the lower and upper jaws is usually formed after suffering from tonsillitis, tonsillitis, otitis media, SARS, influenza, measles, scarlet fever. This path of infection is most often observed in children.
Traumatic periostitis occurs due to the removal of a complex tooth, teeth trauma, surgery, open-jaw fractures, infected foci of the soft tissues of the face itself, and so on.
In most patients, there is a clear connection of the disease with previous overheating or hypothermia, physical or emotional overstrain.
In a laboratory study of inflammatory exudate with purulent periostitis of the lower and upper jaws, a mixed (anaerobic - 75 percent and aerobic - 25 percent) microflora, which was provoked by staphylococci, streptococci, gram-negative and gram-positive rods, putrefactive microbes, was found.
Symptoms of periostitis
The course of the disease depends on the location and form of inflammation, the immunity of the patient's body itself.
Serous acute periostitis is characterized mainly by local manifestations:
- swelling soft tissue;
- hyperemia of the mucous in the area of the transition fold;
- regional lymphadenitis;
- There is usually a tooth with periodontitis or pulpitis in the mouth.
Purulent acute periostitis occurs due to the independent pathology of the independent course of the disease or in the process of the occurrence of osteomyelitis of the jaw itself. This the form of the disease goes along with the body's processes, such as: subfebrile condition, weakness, headache, chills, loss of appetite and sleep.Patients indicate a sharp pain in the jaw area, rolling in the temple, ear, neck and eye socket, soreness when opening the mouth, restriction of movement of the jaw itself, the pathological mobility of a sick tooth.
On examination, the doctor reveals a swelling of the cheek itself, a visible change in facial features due to swelling of the soft tissues in the periomaxillary region of the head. Edema in purulent course of the disease has a characteristic area:
- during lesions of the upper incisors of the jaw, a swelling in the upper lip is formed;
- with the defeat of the premolars and upper canines - zygomatic, buccal, infraorbital areas of the face;
- upper molars - chewing-parotid region;
- With a disease of the lower jaw, swelling is traced on the lower lip and chin.
With periostitis of the lower jaw, changes are found on the inner side of the oral cavity, such as hyperemia of the mucous membrane, the presence of a painful densely expressed infiltrate or a roller-shaped form of swelling with the area of fluctuation - subperiosteal abscess. In the advanced form of the development of the disease exudate flows under the mucous membrane of the gum itself, forming a subgingival (submucous) abscess, from which the pus itself can be gradually released through the fistula hole into the oral cavity, while bringing an imaginary temporary relief.
Chronic disease passes with intermittent pain in the place of the causal tooth, thickening of the jaw itself, a slight but visible change in facial features, enlarged lymph nodes in the mandibular region, hyperemia and puffiness with a cyanotic shade of the mucous membrane from the oral cavity.
Diagnosis of the disease
On examination at the dentist, the characteristic symptoms of the disease (infiltration, hyperemia, fluctuation, etc.) are detected. With an odontogenic infection in the mouth there is a badly damaged coronal area of the tooth, which served as the source of the infection itself, with root canals and carious cavity, filled with purulent formations due to the breakdown of soft tissues. With the percussion of the tooth itself there is a strong pain reaction in the patient.
When examining an x-ray in a patient with acute periostitis, there is no change in bone tissue, however, granulating or granulomatous periodontitis, impacted teeth, and odontogenic cysts are found. With the chronic course of periostitis of the mandible, newly formed young bone tissue is radiologically detected.
Purulent acute periostitis of the jaw should be distinguished from acute periodontitis, osteomyelitis, sialoadenitis, abscess, periomaxillary phlegmon, lymphadenitis, sinusitis, etc.
Treatment of the disease
In the stage of advanced inflammation, complex treatment of periodontitis or pulpitis, physiotherapy of UHF, mouth rinse with disinfectant solutions is applied. As practice shows, conservative measures in many cases is sufficient for localization and victory over infiltration.
Purulent acute periostitis of the jaw requires only surgical treatment - the opening of a submucosal or subperiosteal abscess. Periostomy performed under conduction or infiltration anesthesia through an incision inside the oral cavity. To ensure the outflow of purulent accumulation, the wound is drained by a rubber or gauze graduate. After the operation, antiseptic rinses are shown, a sparing diet, antibiotics, hyposensitizing, detoxification, symptomatic therapy.
As for the causal tooth in the acute form of periostitis of the jaw, then:
- permanently destroyed and milk teeth should be removed;
- teeth that retain functional value require treatment.
For the purpose of treating inflammatory processes, physiotherapy is prescribed: fluctuation, UHF, ultrasound, lydase electrophoresis, laser therapy. Recovery of the patient occurs in about a week.
Treatment of the chronic form of periostitis of the jaw includes physiotherapy and drug therapy, and the removal of the tooth itself.
Prevention and prognosis of the treatment of the disease
If you detect signs of periostitis of the jaw, you should immediately consult a dentist. Otherwise possible formation of severe consequences and complications (osteomyelitis, sepsis, phlegmon of the neck), which pose a threat to your life. It is easier to treat serous acute periostitis of the lower jaw. Purulent type of periostitis requires surgical intervention with subsequent postoperative treatment.
Prevention of jaw periostitis consists, as stated above, in timely treatment of pulpitis, caries, periodontitis (odontogenic foci), professional oral hygiene, sanitation of purulent chronic foci, regular dental examination at least once every six months.
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