Periodontitis Apical

Inflammation of the tissues surrounding the apex of the tooth root. Etiology: infection (staphylococcus, streptococcus, anaerobes), mechanical trauma, including microtrauma (biting thread, catching nails with teeth, etc.), chemical.

Pathogenesis. Spread of the inflammatory process from the pulp through the apical foramen. Reaction to contact with a necrotic bullet, potent drugs, and damage to endocanal instruments.

Microbial and drug sensitization is important.

Symptoms, course. Acute periodontitis is manifested by sharp pain in the tooth area, aggravated by touching it. Swelling of lips, cheeks. The gums are swollen, hyperemic, infiltrated. The tooth is pathologically mobile. The submandibular lymph nodes are enlarged, painful on palpation, body temperature is 37-37.5 °C. Complications are possible in the form of perimandibular abscess, osteomyelitis of the jaw. With the formation of a submandibular abscess, the severity of symptoms decreases.

The chronic process is sluggish: there is a feeling of awkwardness when eating, bad breath, sometimes fistulas on the gums, less often on the skin of the face. Periodontitis periodically worsens. The affected tooth has a carious cavity or filling. The pulp is necrotic. With a traumatic origin of the process, the tooth crown is intact. Various forms are differentiated using radiography.

The disease can lead to the formation of a jaw cyst. It is a source of streptococcal sensitization in the body.

Treatment. An acute process requires urgent intervention - creating an outflow of exudate from the apical region, which is achieved by passing the root canal with an endodontic instrument and opening the apical foramen. The subperiosteal abscess is opened. In case of severe general phenomena, antibiotics are prescribed.

In a chronic process, the root canals are expanded