Traumatic pulpitis clinic diagnostics treatment. Pulp injury. After running all tests

Self-ligating braces are a design that has many advantages. For example, due to the features of fastening the arc, the size of the braces themselves is somewhat smaller than that of the ligature ones. They are more convenient to clean, they do not cause much discomfort to the patient. There are no additional small details in the structure of the structure, which minimizes the accumulation of plaque and food debris.

The arc is attached to the castle itself without any additional elements. Therefore, such designs are easier to adjust for your doctor. An indisputable plus for the patient is the reduction in the duration of the appointment with the doctor and the number of visits. Correction in this case is required once every 6-8 weeks, which is half as often compared to ligature systems.

This bracket system has a sparing effect on the teeth of a child, a teenager. The bite treatment using this technology is less painful, which is especially important for the successful completion of the course.

Using classical systems, it is often necessary to replace ligatures due to their color change or weakening. There are practically no disadvantages for non-ligatures.

Types of non-ligature braces

There are several types of structures without the use of ligatures:

1. Classic. Made of metal, silver color.
2. Partially aesthetic. Consists of metal and ceramic elements. They are not as noticeable as classic ones, but they are still visible.
3. Aesthetic. They have sapphire or ceramic mounts. Virtually invisible on the teeth.

All three types of systems do an excellent job with their main duty - to make the teeth even, to correct the bite.

Choice of non-ligature braces

Clear guidelines for the selection of a particular type of construction have not yet been developed. However, any professional doctor focuses on a specific case, taking into account the financial capabilities of the patient, his psychological state. While the course of treatment is calculated over the years, it is important for many to know in advance what effect braces will have on appearance.

If the possibility of selecting several systems is allowed and visualization is possible, it is necessary to agree on this with the attending physician. This way you will be able to estimate in advance how your face with braces will look. Self-ligating ceramic braces are considered optimal in terms of price-appearance ratio. For adults, designs with sapphires are most in demand.

It is worth remembering that the final choice of a particular system depends on factors such as crowding of teeth, bite condition. A combination is possible: metal structures are put on the lower jaw, and sapphire ones on the upper jaw. The decision on a specific type is made by the doctor and the patient together.

Dental care and braces

As in the case of classical systems, care must be taken to carefully care for the oral cavity and the installed fasteners. A special orthodontic brush should be in your arsenal, and an irrigator will not be out of place to remove small particles.

However, it cannot be said that caring for your teeth is much more difficult than usual. If we compare the two types of braces, then things are even better here, because. the design itself has fewer elements.

In any case, you need to take good care of your teeth, then the time spent in braces will pass without problems.

The cost of non-ligature braces

Non-ligature structures are more expensive than conventional ones. This is understandable, because here a more complex system of fasteners is used, aimed at preserving the aesthetics of the teeth.

The price is made up of several components. In many ways, the cost is affected by the material. So, conventional metal braces will be cheaper than aesthetic sapphire models.

The cost of non-ligature braces made of metal is approximately 25,000 rubles per jaw (exactly the same ligature system will cost about 18,000 rubles). Sapphire self-ligating braces have a price already closer to 30,000 rubles, while classic systems with sapphire fasteners are estimated at 25,000 rubles.

Inflammation of the pulp can manifest itself not only as a result of an infectious lesion, sometimes this process can cause various injuries or mechanical damage. Especially often with this form of damage, children turn to dentists who have inflammation and pain in the tooth area due to various injuries. In dentistry, this form is called traumatic pulpitis. This type of lesion has certain features and symptoms.

There can be a large number of reasons that can cause a traumatic form of pulpitis, but they are not related to the internal pathological processes of the tooth and other pathologies of the body. Usually this form is caused by external factors. The main reasons for the appearance of traumatic pulpitis include the following reasons:

• occurrence of a crown fracture. In these cases, the area of ​​the pulp is exposed and its further infection is observed;
• Getting a tooth injury as a result of a strong blow or fall. Usually, with this type of traumatic injury, units of the anterior dentition suffer;
• Mistakes of specialists during general health-improving surgical interventions to improve the tooth. During these procedures, pulp exposure or some traumatic injury may occur.

As a result of a chipped tooth, saliva with various bacteria and microbes enters the tooth through the destroyed edge, which leads to inflammation of the pulp tissue and the development of traumatic pulpitis.

It is worth noting that most often traumatic pulpitis is encountered by pediatric dentists, because it is children who are often exposed to various injuries in which damage to the maxillofacial part is observed. This disease in children can manifest itself both with milk and with permanent bite. In most cases, damage to the upper central and lateral incisors is observed, sometimes damage to the lower units of the dentition can be observed.

Symptoms

In addition to the reasons for the appearance of this form of pulpitis, it is imperative to know what symptoms it is accompanied by. Symptoms will help identify the presence of this disease. But still, only a dentist should diagnose and treat this form of damage.

Important! The most striking and most noticeable sign of the presence of traumatic pulpitis is the appearance of a sharp pain while eating. A painful reaction can occur when exposed to absolutely any irritating factors.

Therefore, with this form, the use of hot tea or cold water will be very difficult, and sometimes simply impossible.

Traumatic pulpitis is a type of non-infectious disease, it occurs as a result of mechanical impact on the tooth in domestic conditions, for example: chipping when eating or injury when falling.

Pain can occur with a slight touch to the tooth. Another characteristic sign of the presence of this form of pulpitis is manifested - the appearance of a sharp putrefactive odor from the mouth. Usually this symptom indicates the presence of damage to the wisdom tooth. At the same time, no hygiene products can eliminate this smell - neither toothpastes, nor balms, nor sprays.

How to treat

If you suddenly notice signs of traumatic pulpitis, it is better to immediately consult a doctor. The dentist can diagnose and treat accordingly.
Therapeutic therapy is carried out according to the following scheme:

1. First of all, the doctor does anesthesia so that pain does not occur during treatment;
2. Next, the cavity is cleared of lesions;
3. Be sure the doctor must treat the affected area with antiseptic drugs;
4. After that, a calcium hydroxide gasket is installed;
5. Next, a temporary filling is installed;
6. During prolonged pulpitis, the canals are sealed and a permanent filling is installed.

Attention! Traumatic pulpitis, like other types of pulpitis, is a serious damage to the tooth, which must be identified and eliminated in a timely manner. You should not delay the treatment, it is better to carry it out at an early stage, when the process has not yet gone so deep.

Students

You can use this article as part or basis of your abstract or even thesis or your website

Save the result in MS Word Docx or PDF, share with friends, Thanks:)

Categories of articles

• Students of dental faculties of medical universities

Non-infectious (traumatic) pulpitis

The cause of acute non-infectious pulpitis is most often an acute mechanical or thermal injury to the hard tissues of the tooth. Mechanical impact is possible:
1) upon impact with or without spalling of a part of the hard tissues of the tooth;
2) with improper preparation of carious cavities (opening the pulp horn with medium or deep caries due to ignorance of the topography of the tooth cavity, tooth dislocation or individual characteristics;
3) during mechanical processing of the tooth crown for orthopedic
designs.
Thermal pulp burn occurs due to non-compliance with the rules for working with rotating instruments during mechanical processing of hard tooth tissues. Acute pulpitis may occur when potent drugs are used to treat deep caries, overdrying of exposed dentin under glass ionomer cements and dentin primers.
Clinical manifestations of acute non-infectious pulpitis are identical to acute infectious pulpitis (history of trauma). Treatment of acute non-infectious pulpitis is possible both with the preservation of the tooth pulp and with its extirpation. Indications for treatment with a biological method are similar to acute infectious pulpitis (in the presence of a carious cavity). When the hard tissues of the tooth are broken off with exposure of the pulp or when the cavity of the tooth is opened during processing for an artificial crown, vital amputation or vital extirpation is indicated (in accordance with the indications for these methods of treatment). Treatment of acute traumatic pulpitis without exposure of the pulp is carried out according to the plan of acute traumatic periodontitis, with which it is most often combined.
Causes of chronic inflammation or necrosis of the dental pulp can be:
1) overheating of significant layers of dentin when working with bur without cooling;
2) excessive pressure on the bottom of the carious cavity;
3) treatment of the carious cavity with a strong antiseptic;
4) application of medicines irritating the pulp to the bottom of the carious cavity;
5) the use of toxic filling materials in the absence or insufficient isolation of the tooth pulp from them;
6) lack of adequate therapy for deep caries;
7) complication of the conservative treatment of pulpitis.
In chronic non-infectious pulpitis, soon after tooth filling, patients experience pain on a cold, and in some cases, on a hot stimulus. The pain does not go away after the stimulus is removed. Often these manifestations of pulpitis are transient. With pulp necrosis, the patient does not complain after filling the tooth. Pain may be noted in the anamnesis, mainly from thermal stimuli. The color of the crown of the tooth can be changed, especially with pulp necrosis, to grayish-dim. The electrical excitability of the pulp is reduced (with pulp necrosis up to 100 μA). Comparative percussion of the tooth may be positive. Pulp necrosis is usually discovered incidentally or during an exacerbation of chronic apical periodontitis.
Treatment of chronic non-infectious pulpitis involves complete extirpation of the tooth pulp and canal filling. In the event of periapical lesions - treatment of the appropriate form of periodontitis in compliance with strict asepsis rules.
To prevent damage to the pulp, it is necessary to strictly observe all the rules for processing hard tooth tissues (changing the speed of rotation of the bur in accordance with the stage of processing, eliminating excessive pressure on the bottom of the carious cavity, cooling the hard tissues of the tooth). It should be borne in mind that when working with a larger bur, there is more tissue heating than when working with a small one. Prolonged contact of the rotating burr with dentin also leads to overheating. Excessive polishing of the filling can have the same effect. Prolonged ischemia of the pulp during inadequate anesthesia can aggravate the effect of the above adverse factors. Toxic effects on the dental pulp can be prevented by following the rules of drug treatment of deep cavities, not using drugs when the patient is sensitized to them, and by following the rules for applying a lining and filling.

The development of an inflammatory process in the pulp chamber of the tooth, the cavity where the nerve endings and blood vessels are located, loose connective tissue, may be the result of mechanical action. A tooth injury, even one that is not accompanied by a crown fracture, requires the attention of a Good Dentistry specialist. Timely seeking medical help allows you to save the tooth in the jaw, prevent the death of the nerve and the transition of the inflammatory process to periodontal tissues.

Causes of acute traumatic pulpitis

A pathological process develops in the pulp in the following cases:

• violation of the integrity of the crown, in which the pulp can be exposed and additionally infected;
• impact on the surface of the tooth;
• exposure and injury of the pulp during dental treatment.

Most often, nerve damage during dental procedures is observed in the treatment of deep caries. It can be difficult to remove all destroyed tissues and not damage the walls of the pulp chamber. If the doctor penetrates the tooth cavity with a drill or a probe, then they try to save the nerve. And only in the event that the biological method of treatment turned out to be ineffective, then the tooth is depulped with further filling.

More often than others, incisors and canines are damaged, since it is on the front teeth that the most injuries occur. The inflammatory process with equal probability can develop both in permanent and milk teeth.

Symptoms

• The inflammatory process in the injured tooth is manifested as follows:
• there is discomfort and pain when biting;
• temperature sensitivity is significantly increased;
• pain and discomfort at rest with the rapid development of the pathological process.

When a crown or root is fractured, there is no need to wait for symptoms. This condition in itself requires seeking medical attention. In other cases, after an injury, it is permissible to observe the condition of the tooth.

Treatment

Medical tactics in identifying traumatic pulpitis is determined by many factors, the decisive of which is the degree of involvement of the nerve and blood vessels in the pathological process, the likelihood of infection of the contents of the pulp chamber.

At the stage of examination and diagnosis, the use of painkillers and anti-inflammatory drugs is permissible. However, it should be remembered that they are not able to lead to recovery, but only alleviate the patient's condition for a while.

Also apply:

• conservative method of treatment;
• complete or partial removal of the pulp, followed by filling.

Conservative treatment (biological method) has its indications and a number of limitations. The chances of saving the nerve are diminishing by the hour, so putting off seeing a doctor when symptoms appear is hurting yourself.

The biological method involves the use of drugs with antibacterial and anti-inflammatory effects. They are applied to the pulp exposure area under a temporary filling. Additionally, a physiotherapeutic effect can be prescribed, aimed at subsiding the inflammatory process and stimulating regeneration.

Within a few days after the installation of a temporary filling, the patient is under the supervision of a doctor. The appearance of pain and other unpleasant symptoms in the tooth indicates ongoing inflammation in the pulp chamber, which requires complete or partial removal of the nerve. The subsidence of inflammation allows you to install a permanent filling, keeping the tooth alive.

Surgical treatment involves removal of the pulp, cleaning of the root canals and filling. This method of treatment is not a priority in dentistry, since a “dead” tooth is less resistant to physical stress and more fragile. However, in most cases of late seeking medical attention, the dentist is left with no choice.

An alternative to the complete removal of the pulp can be a partial depulpation method, in which only part of the nerve is removed from the pulp chamber, and the nerve fibers and vessels located in the root canals remain intact.

Similar to the biological method of treatment, after partial removal of the pulp and the installation of a temporary filling, the patient spends several days under observation. The treatment is considered complete if the patient has no manifestations of the inflammatory process and a permanent filling can be installed. The ongoing inflammation requires cleaning of the canals and filling them.

Prevention

It is not always possible to prevent tooth injury in everyday life and in sports. However, it is in our power to contact Good Dentistry at the Ozerki metro station in a timely manner for treatment. The sooner caries is treated, the lower the risk of developing traumatic pulpitis. The sooner the treatment of pulpitis is started, the higher the likelihood that it will be possible to save the neurovascular bundle that feeds and innervates the tissues of the tooth.

Prices for dental treatment

The pulp of the tooth can become inflamed due to infection, as well as as a result of mechanical trauma. A disease characterized by inflammation of the tooth due to various kinds of damage is traumatic pulpitis. Often, young patients turn to the dental office with such a problem, but there are also cases of treatment in order to cure this ailment also for adults.

Traumatic acute pulpitis

The disease, called traumatic acute pulpitis, is the result of an injury to the tooth. Damage factors may vary.

There are 3 different forms of manifestation of traumatic pulpitis.

Accidental opening of the pulp horn can occur during treatment if the doctor has caught the pulp in the affected cavity. The fact that an injury has appeared can be understood by the occurrence of pain at a certain point in the dental cavity. Bleeding may also occur or the pulp horn may be visible.

If the pulp is injured during treatment, it is better not to probe the tooth, because this will further injure the neurovascular bundle and complicate the situation. It is better to use the biological method of therapy.

If the dentist touched the pulp with an instrument during the treatment of a tooth, its infection is almost inevitable. After all, very close there is a cavity affected. With it, the instrument can easily transfer harmful microorganisms to the pulp tissues. In such a situation, the dentist will see a pulp horn at the bottom of the cavity, which bleeds. With such an injury, the pulp can be cured with a biological method, or it can be amputated.

Causes of the disease

The causes of acute traumatic pulpitis can be different. The peculiarity is that they are external factors and have no connection with the internal pathologies of the dental organ and the human body as a whole.

Consider the most basic causes of such a disease:

1. Crown fracture. In this case, the pulp is exposed, causing its subsequent infection.
2. Tooth injury due to a fall or a strong blow. Teeth in the smile zone are most susceptible to such damage.
3. Medical error in the implementation of surgical intervention during treatment. The pulp can be exposed and injured due to certain actions of the doctor.

A chipped tooth can also cause traumatic pulpitis. In the place where the destruction appeared, saliva accumulates, which may contain microbes and bacteria. For this reason, the pulp can become inflamed and traumatic pulpitis occurs.

Most often, this disease affects children of childhood. After all, it is they who are more susceptible to various kinds of injuries that cause damage to the jaw. The disease develops both in milk teeth and in permanent teeth.

Most often, the upper incisors in the center and on the sides are affected. Less often, the dental organs of the lower jaw are damaged.

Symptoms of traumatic pulpitis

The main symptoms indicating traumatic pulpitis:

• sharp pain while eating;
• pain when exposed to temperatures (the tooth reacts strongly to cold and hot);
• pain when touching the tooth organ.

Treatment of the disease

Pulpitis, in comparison with other dental diseases, is accompanied by the most severe pain. For this reason, it is important to first drown out severe pain, and only then proceed to treatment.

Thanks to the latest technologies in the field of dentistry, today it is possible to save the teeth affected by pulpitis and their functionality. At the same time, you need to consult a doctor in time and start treatment.

The main technique used for the treatment of traumatic pulpitis is biological, which is also called conservative treatment.

On a note: It is important to apply this technique at an early stage of the disease, when it is reversible. The disease that does not have complications is best treated. In this case, the nerve is not removed.

During treatment, the damaged pulp is treated with antiseptics, a pad with calcium hydroxide is applied to it, then it is placed in the cavity.

An excellent result of such a disease is observed in the treatment of the disease at its mild stage. However, you still need to control the situation, periodically taking x-rays.

The main stages of biological treatment technology:

1. The use of antibacterial drugs and medicines containing calcium.
2. Physiotherapy procedures to restore the reaction inside the tooth.
3. Regular examinations and taking an x-ray in order to identify possible complications in time that can develop into a chronic form of the disease.

If the patient, after installing the filling, found a strong sensitivity of the tooth, it is quite possible that the disease has passed into the chronic stage. To treat such a disease, the pulp will need to be completely removed and.

Related videos