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Jaw osteomyelitis – it is purulent - necrotic process of the infectious nature which develops in bones, and also in fabrics, it people around. Inflammatory process begins to develop actively after the infection gets into a bone tissue.
Several types of osteomyelitis of a jaw taking into account an infection source are allocated. Dontogenous osteomyelitis of a jaw is serious complication of the started caries of teeth. Statistically, this type of osteomyelitis is diagnosed approximately in 75% of cases. The illness develops after the infection from a carious cavity gets into a pulp, and then into a fang. Further it also takes bone tissue. Approximately in 70% of cases osteomyelitis affects a mandible, in other cases the upper jaw is surprised. Influence of microorganisms of three groups becomes a basic reason of development of this disease: stafilokokk, streptococci, anaerobic bacteria. Disease-producing microbes get into a bone tissue on absorbent vessels and on bone tubules.
Hematogenous osteomyelitis – a bone tissue infection consequence with the infection transferred a blood flow from primary center in which inflammatory process developed. This form of a disease can develop owing to an adenoid disease, and also other centers of persistent infection. Acute infectious process, for example, diphtheria, scarlet fever and other diseases, can also become the jaw osteomyelitis reason. At hematogenous osteomyelitis the part of a body of a bone initially is surprised, and only after that the inflammation can affect also teeth. This form of a disease is widespread less.
Traumatic osteomyelitis is shown at the patient owing to fractures or wounds through which the infection gets. Prevalence of this form of an illness is small.
Jaw osteomyelitis is also subdivided into several types depending on features of a clinical picture. These are acute, subacute and chronic forms of osteomyelitis of a jaw. In this case expressiveness of inflammatory processes is estimated.
At development in sick acute osteomyelitis of a jaw the general pronounced reaction of an organism to an infection is observed. The person is disturbed by the general weakness, a headache, he sleeps badly. Body temperature increases up to 38 degrees, in certain cases it can rise above. If body temperature indicators at osteomyelitis of a jaw remain normal, then it can demonstrate that at the person the organism is weakened, and protective forces work insufficiently. At an acute form of an illness the patient can stay both in rather easy, and in a serious condition.
The first symptom of an acute form of dontogenous osteomyelitis are displays of pain in tooth which was infected. Pain considerably amplifies if on tooth to knock. At the same time its easy mobility is shown. The next teeth can move also also. Hypostases of a mucous membrane near tooth are visible, besides it becomes reddish and friable. Sometimes subperiostal abscess develops. Pain gradually from one affected tooth passes into next, signs of inflammatory process of a periodontium of teeth appear. Pain at the same time can give to an ear, a temple, an eye-socket. At osteomyelitis of a mandible sensitivity of part of an under lip, a mucous membrane of an oral cavity, chin skin can be broken. If at the patient purulent inflammatory process in okolochelyustny soft tissues develops, then pain goes beyond a jaw.
Lymph nodes in a neck are increased, at a palpation their morbidity is shown. Symptoms of intoxication of an organism are shown also in outward of the person: skin gets a gray shade, features are pointed. If in process of intoxication the liver and a spleen is pulled in, yellowness of a sclera of eyes can be noted. Damage of kidneys leads to emergence in urine of protein and erythrocytes. Fluctuations of arterial pressure – both rise, and decrease can be noted. At first it is difficult to diagnose jaw osteomyelitis because the general symptoms prevail over local signs.
Subacute osteomyelitis, as a rule, develops after subsiding of an acute form. In such condition of people feels that his state improves as there is a break of pus from bone tissue. At the same time inflammatory process continues, and destruction of tissue of bone does not stop.
Chronic osteomyelitis can proceed throughout the long period – for several months. Against external improvement of a condition of the patient osteomyelitis becomes aggravated, new fistula is formed, the died-off sites of tissue of bone are torn away, and sequesters appear. The jaw in the place of the pathological center is flattened, teeth remain mobile. At such development of a disease not always there comes independent treatment.
Osteomyelitis of a jaw can provoke complications which work great mischief to health of the person. At an advanced disease development of sepsis, inflammatory process of soft tissues of the face and necks (phlegmon) is possible. Also deformation or a fracture of a jaw can turn out to be consequence of osteomyelitis. If purulent process extends to area of the person, it can lead to development of sine of a firm cover of a brain, phlebitis of veins of the person. At the ascending distribution meningitis, brain abscess can develop. Sometimes complications lead to disability of the patient, and in especially hard cases – by a lethal outcome.
In the course of diagnosis of osteomyelitis of jaws the doctor initially studies a clinical picture of a disease, performing inspection and poll of the patient. Further X-ray inspection is conducted. But at osteomiyelitichesky process the spongy bone therefore information obtained when carrying out X-ray inspection not always happens full generally is surprised. If pathological process develops quickly, then there is a destruction of a cortical layer of a bone which can be determined by x-ray films. Important diagnostic value has detection of sequesters.
Treatment of osteomyelitis of a jaw is carried out right after carrying out diagnosis and definition of a form of a disease. If the patient has explicit symptoms of osteomyelitis of a jaw, it is necessary to take at once measures not to allow distribution of an inflammation on sites near the place of defeat. Regardless of that, damage of the lower or upper jaw takes place, at a dontogenous form of a disease tooth in which inflammatory process began is surely extracted. At a hematogenous or traumatic form of osteomyelitis initially it is required to remove a basic reason of an illness. Therefore, treatment of infectious diseases and injuries is made.
Thus, if acute dontogenous osteomyelitis is diagnosed for the patient, then the inflammatory suppurative focus in a bone and in the fabrics surrounding it is initially liquidated. Also the medicamentous drugs directed to improvement of a condition of a human body in general are appointed.
Surgical intervention also practices: at osteomyelitis upper and a mandible drainage of the center of an infection is carried out to bones. Tooth owing to which infection the illness was shown is initially extracted. If the patient has okolochelyustny abscesses and phlegmons, the section of soft tissues, and also the subsequent dialysis of a wound is carried out. If acute or chronic osteomyelitis of a jaw is diagnosed for the patient, carrying out antiinflammatory treatment by prescription of antibiotics is necessary. Such therapy is carried out in parallel with an operative measure.
Treatment of osteomyelitis of a jaw of an acute form is carried out only in a hospital. Except operational and antiinflammatory treatment the stimulating, fortifying, symptomatic therapy practices.
It is necessary to consider that the earlier tooth at an acute form of an illness is extracted, the risk of further distribution of inflammatory process will be smaller, and the inflammation will stop quicker. In the presence of mobile teeth for their strengthening the special tire or briquettes is used. If after an odontectomy there is a purulent wound, it is necessary to provide the correct care of it. Washing, an irrigation is for this purpose used by antiseptic solutions.
Complex therapy assumes reception of vitamin complexes which have to include vitamins of group B, ascorbic acid. In the course of treatment it is important to provide to the patient constantly e plentiful drink, and in a food allowance proteinaceous and vitamin-containing products have to prevail. Important every time after food carefully to carry out an oral cavity toilet.
Treatment of a chronic form of osteomyelitis of a jaw is carried out depending on manifestation of symptoms of a disease. If therapy of a disease is carried out timely and correctly, then it is possible to speak about the favorable forecast.
Preventive measures assume the general improvement, immunity strengthening, timely treatment of diseases of teeth, carrying out their prosthetics. Important not less once a year to visit the stomatologist for carrying out routine inspections. Also it is not necessary to delay therapy of infectious illnesses. In this case special attention should be paid on treatment of infectious diseases of upper respiratory tracts. Not less important preventive measure is ensuring daily qualitative hygiene of a mouth, and also protection against injuries of the person.