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Tooth pulpitis (sealing of channels)
June 19, 2013
The pulpitis is an inflammatory process which happens in a tooth pulp. Conditionally the pulp is called a tooth nerve. Most often symptoms of a pulpitis are shown as complication of caries. Sometimes the pulpitis is shown as an effect of the wrong manipulations from the doctor. It can be operation on a parodonta, poor established seals, effect of certain chemicals, turning of tooth for installation of prostheses.
The pulpitis of tooth can develop under the influence of different factors: its progressing is influenced by both acute, and chronic irritants. The pulpitis most often develops owing to action of microbes which are in the deep center of caries, and also because of a negative impact of their toxins. The infection can get into a pulp in the different ways. Most often it passes on dentinal tubules from a carious cavity. The injury during which there was a tooth fracture can also become the reason of development of a pulpitis. Most often owing to such injuries the pulpitis of foreteeth develops. If during such injury the pulp was bared, then the inflammation of a foretooth arises very quickly.
Quite often low-quality processing of a cavity of caries is the reason of a pulpitis. Sometimes it is difficult for doctor to make careful processing of lateral teeth, a wisdom tooth. Sometimes the pulp is infected also owing to infection with a hematogenous way when at the person the acute course of an infectious disease is noted. Sometimes the pulpitis of second teeth develops also in teeth which were not affected with caries. In that case the person can complain that to him the tooth seeming by sight to healthy hurts. Also to define a pulpitis of a milk tooth at children often difficult as it often proceeds without serious consequences. There is a pulpitis at children because of injuries, not cured caries and a tooth crown chip.
Except the specified reasons development of a pulpitis can provoke action of a number of chemicals, thermal impact, process of orthopedic dental care, treatment and operations on a parodonta.
What is going on?
The pulpitis can have the acute and chronic forms. Acute forms of a pulpitis is a consequence of hit of an infection in a pulp, and at the same time the pulpal camera remains closed. Infections gets through a thin wall of tooth which was destroyed by caries. Besides, destruction can happen owing to an injury (a traumatic pulpitis). The clinic of an acute pulpitis initially assumes focal defeat. The partial pulpitis develops at the patient as a serous inflammation in the beginning (this form is called a serous pulpitis). Later emergence of purulent exudate (an acute purulent pulpitis) is observed. When purulent exudate collects in the closed pulpal camera, very severe pain begins to disturb the person. If at the patient the acute general pulpitis develops, then pain proceeds longer and can be more intensive.
The chronic pulpitis, as a rule, is a consequence acute disease forms. The chronic pulpitis is subdivided on fibrous, hypertrophic and gangrenous. Chronic forms of a pulpitis cause complaints of the patient to periodic pain. The fibrous (idle time) pulpitis when connecting fabric expands is most often diagnosed. If at the patient the hypertrophic pulpitis is defined, then pulpal fabric expands hypertrophic, through an open carious cavity. If the gangrenous (ulcer) pulpitis develops, fabric in a coronal pulp gradually breaks up.
If there is an aggravation of a chronic pulpitis, then the condition of the patient considerably worsens. He is disturbed by pain attacks which can proceed several hours. The pulpitis in a stage of an aggravation can periodically be shown, and in intervals there is only an emergence of pain from irritants (hot, cold).
At a pulpitis of people suffers from very strong dentagra which can be as continuous, and to be interrupted periodically. Such pain most often disturbs the patient with night. At an initial stage of a disease the pulpitis at children and adults is shown by the periodic aching pains. More started cases, and also a pulpitis chronic at children and adults are followed accruing, more megalgias which can periodically be pulsing. The chronic fibrous pulpitis causes pain during the aggravation periods. At a purulent pulpitis pain arises already when on tooth a little to knock.
As treat at children and adult patients this disease and what its specific symptoms can be shown, envy for a form of the developed pulpitis.
So, at an acute focal and diffusion pulpitis of people suffers from severe pains which extend on trifacial branches. More often pain arises at night, at the same time the painful tooth shows high sensitivity to different irritants. If the irritant cleans up, pain does not abate but only becomes stronger.
The chronic fibrous pulpitis of the expressed symptoms, as a rule, does not cause. The patient can note rather small discomfort only periodically.
At a chronic hypertrophic pulpitis in a carious cavity there is a hypertrophied fibrous polyp. At such form of an illness morbidity at percussion can be noted.
At a gangrenous pulpitis very severe pains are noted, tooth is especially sensitive to heat, and here the cold helps to appease pain.
If at the patient the aggravation of a chronic pulpitis, then pain in the affected tooth very intensive is noted, its strengthening happens under the influence of external irritants. Pain irradirut on a trifacial, at a nadkusyvaniye on the affected tooth it amplifies.
The retrograde pulpitis on a surface of the teeth affected with an illness is not shown at all. The pulp is infected through an apical opening if in fabrics there take place the pathological processes connected with some diseases nearby. This form of a pulpitis most often proceeds without symptoms. But at the started retrograde pulpitis its signs are similar to manifestation of a purulent pulpitis.
At a traumatic pulpitis of display of a disease are very similar to signs of an infectious pulpitis. The affected tooth very accurately reacts to irritants.
The pulpitis of milk teeth very often proceeds without the expressed symptoms therefore at children with milk teeth the pulpitis very often passes into a chronic form.
The pulpitis of a wisdom tooth is shown by the same symptoms, as a disease, the striking other teeth. If tooth correctly is located in an oral cavity, it is tried to be cured. However most often wisdom teeth which quite often are underdeveloped just delete.
If does not occur adequate, and, above all — timely treatment of a pulpitis, then periodontitis can become complication of this state. The same complication often develops if root channels were processed poor, and seals, tabs, crowns are established nonhermetic.
To avoid serious effects, than the wrong diagnosis is fraught, the doctor has to approach very carefully a question of survey and establishment to the diagnosis to the patient with suspicion on a pulpitis. The specialist has to consider that some patients at a pulpitis have no throbbing pain, or it is expressed slightly. Therefore for confirmation of the diagnosis the patient needs to conduct a X-ray analysis. Careful visual survey, poll of the patient about symptoms is not less important. It is important to define what character of pain is observed at the patient — cutting, pulling, pricking. Analyzing all these moments, the doctor will manage to define precisely about what illness of teeth there is a speech.
Treatment of a pulpitis of tooth is appointed depending on a form of a disease and extent of defeat. Conservative treatment allows to keep a pulp of viable. Most often stomatologists practice such method if young people need to treat a pulpitis. In that case stages of treatment of a pulpitis are similar to algorithm of therapy of caries. It is very important to process carefully struck surface medicamentally. Antiseptic agents, antibiotics, etc. are for this purpose used.
Treatment of an acute pulpitis is often carried out by a surgical method. In this case there is a removal of the inflamed pulp and sealing of the channel of a root of the affected tooth.
It is possible to remove a pulp in two ways. Use of a vital method provides anesthesia use (the general or local). At use of a devitalny method killing of a nerve is initially carried out. But anyway the specialist after carrying out careful diagnosis has to select methods of treatment. Treatment of a pulpitis in house conditions can lead to negative effects. At the wrong approach to therapy serious complications after treatment of a pulpitis among which periodontitis, and also a pulp necrosis is most often noted develop. Therefore, the doctor has to define surely how the tooth pulpitis treats and to urgently carry out all necessary procedures.
By means of sealing of channels of tooth it is possible to recover functions of tooth. In the course of sealing special material fills root channels of tooth which remain empty after removal of a nerve of tooth. The main difficulty at such treatment is the fact that the channel of a root difficult gives in to research. In this case it is important to conduct a X-ray analysis to determine length of the channel.
Treatment of a hypertrophic pulpitis provides partial or full excision of a pulp. The doctor defines what needs to be made in a specific case, considering as far as the neurovascular bunch was struck.
Sometimes the patient complains that at first there is pain after treatment of a pulpitis. Such phenomenon is not considered pathological as approximately in a day pain completely passes.
Treatment at children of this disease is carried out by the same methods. However at the same time the doctor should consider some subtleties. So, at treatment of milk teeth it is necessary to pay special attention to a dosage of medicines, and also to consider that at milk teeth wider root apical opening. Besides, it is necessary to pay attention to that the anesthesia did not do harm to a children's organism.
For prevention of manifestation of a pulpitis, first of all, it is necessary to follow all rules of hygiene of a mouth, and also in time to treat hardly developed caries of teeth. Therefore recommendations of stomatologists that to visit the doctor for routine inspection and treatment of hardly developed caries are quite reasonable. There can sometimes be mechanical injuries of teeth, and also chemicals or differences of temperatures act on them. At the first signs of such influences it is necessary to see a doctor as on their background the pulpitis can develop very quickly. Self-treatment in this case is inadmissible.