X-rays of periodontitis before and after treatment. Symptoms and treatment of periodontitis. Signs of a toxic form

To make a preliminary or main diagnosis, dentists use the following features:

The disease goes through more than one stage of development, therefore, for convenience, several classifications of the disease have been developed by experts. Officially recognized and used in the documentation remains ICD-10. Periodontitis corresponds to the code K04 with the wording "Diseases of the periapical tissues".

Photo 1. Schematic representation of a healthy tooth (left) and with periodontitis (right).

Pathogenesis

The development of periodontitis is most often characterized by the entry of microorganisms into the periodontal gap, which have a toxic effect. With the weakening of immunological mechanisms, an acute diffuse inflammatory process develops, which leads to the appearance of abscesses with characteristic signs of general intoxication of the body.

There is damage to the periodontal connective tissue. As a result, microcirculation is disturbed, all five signs of inflammation appear: pain, edema, hyperemia, local temperature increase, dysfunction.

If the process is observed in a diseased tooth, experts state chronic inflammation, often asymptomatic. With a weakened immune system of the body, the chronic process is exacerbated with the manifestation of all the characteristic signs of acute periodontitis.

Causes of inflammation

Experts urge visits to the dentist's office every six months.

Such prevention is necessary for the timely detection of many diseases.

Damage teeth, for example, chips, other damage to the enamel, create conditions for the penetration and development of infection in periodontal tissues.

Reference. Periodontitis is the result of inflammation periodontal disease, gingivitis, pulpitis and others).

There are several reasons:

1. Infectious: causative agents of inflammatory processes enter the gums with the bloodstream of internal organs in case of infectious diseases (ARVI, tonsillitis, sinusitis, influenza, measles).
2. Contact: food particles and pathogens from saliva get into the crowns destroyed by caries. "Thanks" to this symbiosis, decay products accumulate in the dental canals.
3. Medical: often the cause of inflammation is an unqualified doctor who infects by performing dental manipulations on the gums.

Visual diagnostics

Periodontitis is an insidious disease, divided into different types and forms.

Experts note common signs for all stages of the disease: putrid breath, bleeding gums during hygiene procedures, pain of varying degrees, feeling of a grown tooth.

It is difficult to determine periodontitis in the early stages of the disease, but it is possible through careful visual inspection.

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What does the disease look like on an X-ray?

One of the leading methods of diagnosing a disease, experts call an X-ray examination.

Photo 2. X-ray of a tooth with periodontitis. The area of ​​inflammation is highlighted in red.

It is necessary in order to find out the condition of the jaw bone tissue, determine the presence of cysts or other formation and whether there is an opportunity to save the tooth.

Diagnostics

Periodontitis is an ailment that has similar symptoms to other diseases. Its diagnosis is complicated by the fact that the appearance of the periodontal fissure remains virtually unchanged, and the x-ray may not show any signs of illness. In order to correctly diagnose an ailment, specialists must remember the main distinguishing characteristics of diseases with similar symptoms.

EOD for diagnosis

Electroodontometry, or EDI, helps to identify the excitability of the dental pulp. The norm indicators are 6-8 uA. The higher they are, the more likely there is inflammation or even necrosis. The procedure is carried out using a special device.

Pathological indicators of EDI:

1. For chronic periodontitis: 100-160 µA.
2. For acute or aggravated: 180-200 µA.

Photo 3. Pathological anatomy or pathology of the tooth in chronic periodontitis. Dental tissues are shown under a microscope.

The danger of illness for pregnant women

Periodontitis - almost always a complication of caries. The inflammatory process, moving through the tissues, destroys the enamel, dentin and pulp. If treatment has not been carried out, the disease passes into a new stage - periodontitis. A focus of inflammation is formed at the very top of the root. This disease especially dangerous during pregnancy. The patient's general condition worsens, body temperature rises, lymph nodes increase.

Attention! It is dangerous for pregnant women to self-medicate, because. there is a risk of miscarriage.

With a complicated course of pathology, pathogens spread throughout the body, penetrate the placental barrier, threatening the unborn child.

Treatment for expectant mothers is severely limited, this applies not only to medicines, but also to research methods. Therefore, you need to be prepared for complications, since it is not possible to carry out a full diagnosis in this position.

Causes of exacerbation

If there are many reasons leading to the appearance of periodontitis, then the factors due to which a chronic disease takes an acute form are experts distinguish two:

• The body's susceptibility to infections due to a decrease in immunity. SARS, various viral infections, stress, weakness and general unstable state reduce the body's resistance, which leads to the active reproduction of microorganisms and makes the patient even more vulnerable.
• The emergence of suitable conditions for the development of pathogenic bacteria. The reason is the accumulation of food debris, plaque inside the open dental tubule or under the soft tissues of the gums.

Complications of periodontitis

If periodontitis is not treated, there is a risk of serious complications.

Granuloma: what is it

Reminds me of a small bag about 0.5 cm), surrounded by granulation tissue like a capsule. Inside - inflammatory fluid. The location is the apex of the tooth. This is the epicenter of the disease. The task of such a complication is to destroy healthy tooth tissue. Inflammatory focus cannot be left untreated, since further inaction will lead to a violation of many body systems.

Photo 4. Granuloma due to periodontitis. It is a swelling on the gums.

Cyst

Benign inflammatory formation with very thick walls. It appears to protect the body from a developing infection. Reaches sizes up to 1 cm. The cyst can grow in size, destroying adjacent teeth. Rupture of the walls of the capsule in some cases can lead to infection of the patient's blood.

Gangrenous form

Inflammatory process, which is characterized by serious changes in the basal part of the gums, periodontium.

How is the disease treated in the acute stage

Methods for treating the disease in an acute chronic stage include:

1. Cleaning the canals of the tooth using aseptic preparations.
2. Into the holes place antiseptics to eliminate the infection.
3. Medicines are injected into the cavity of the tooth that speed up tissue repair.
4. The tooth is being filled using temporary material, and within a few months his condition is being monitored. If positive dynamics is noted during the recovery process, the temporary material is changed to permanent. Medicinal mixtures are often used as a temporary material.

1. In the treatment of periodontitis, various physiotherapeutic methods are used: UHF-therapy, electrophoresis, laser, microwave and magnetotherapy.
2. Antibiotics- are used in cases where surgical intervention is difficult or the disease is in a neglected state.

What do the statistics say?

Periodontitis incidence statistics are unfavorable: in children she is 20—30% , in the adult population 30-50%. Modern dentistry successfully treats this complex disease, but only on condition that the patient follows all the recommendations of the specialist. Pain, fear in the treatment of the disease are a thing of the past.

Modern methods and medicines help to cure teeth completely painless. It should be noted that unreasonable fears exacerbate the development of inflammation, in which periodontitis can result in a serious complication. Take care of your teeth and be healthy!

A visit to the dentist is quite an unpleasant procedure for many people, so in most cases they postpone a visit to the doctor, ignoring a toothache or trying to drown out the pain with various analgesics. This position is very dangerous, because the familiar caries, which in the early stages is easily treated for several hours in the chair at the dentist, in an advanced stage can gradually develop into granulating periodontitis.

Causes of chronic granulating periodontitis

Chronic granulating periodontitis is an inflammation in the connective tissues of the tooth (periodontium), which is characterized by the formation of granulation tissue at the apex of the tooth root and the destruction of bone tissue with deformation of the periosteum. The main cause of the inflammatory process is an infection that penetrates into the periodontal tissues from the root canal of the tooth (streptococci, staphylococci, yeast-like fungi, aerobic and anaerobic polyinfection).

If treatment is not started in time, inflammation and proliferation of granulation tissue will gradually spread to soft tissues, purulent fistulas on the gums, abscesses will appear. The ingress of waste products of pathogenic microorganisms into the blood can cause various diseases of internal organs (arthritis, glomerulonephritis, rheumatic carditis, etc.) and blood poisoning.

Granulating periodontitis is a fairly common disease and ranks third after caries and pulpitis in dental practice in terms of incidence. Most often, this form of periodontitis occurs as a result of neglected forms of the first two diseases or their poor-quality treatment.

There are several main reasons for the development of granulating periodontitis:

Symptoms of the disease

Granulating periodontitis is characterized by dynamic development, periods of exacerbation and short-term remissions, minor painful sensations in the diseased tooth, which are aggravated by tapping or biting.

The main symptoms of the disease:

• periodic toothache, which can occur when a mechanical effect on a diseased tooth (during biting, chewing, cold or hot food);
• inflammation of soft tissues, swelling, hyperemia of the gums;
• slight looseness of the tooth;
• enlargement of the lymph nodes from the side of the infection;
• discharge of pus from under the dental crown;
• bad breath;
• general deterioration in health - weakness, nausea, loss of appetite, fever, drowsiness.

If timely treatment is not carried out, painful fistulas appear at the site of the infiltrate, from which pus or sulfur is released. Granulation tissue grows around the fistula.

Purulent formations can occur not only in the oral cavity, but on the face or neck. With the outflow of pus, the pain gradually subsides, the disease passes into the chronic stage.

Granulating periodontitis has several stages of development:

1. At the first stage, the gum swells slightly, sometimes it can bleed. Plaque appears, which eventually turns into tartar. Toxins and enzymes cause inflammation of the gums and lead to gingivitis.
2. A periodontal pocket appears on the gum, the necks of the teeth are exposed (more in the article: what to do if the necks of the teeth are exposed?).
3. The final stage is characterized by the acute development of the inflammatory process and the destruction of connective and bone tissues.

Diagnostic methods

To diagnose chronic granulating periodontitis, the following diagnostic methods are used:

X-ray allows you to make an accurate diagnosis even in the chronic form of the disease, if there are no pronounced symptoms. From the picture, you can determine the form of the disease (granulating periodontitis is characterized by the presence of layers in the periapical region of the tooth and an uneven contour of the spread of the inflammatory process - in the form of flames). Also, using this method, you can determine the cause of the disease (cracks in the teeth, fractures, medical errors when installing seals, the presence of fragments of foreign objects).

Electroodontometry (EOM) measures the level of sensitivity of the dental pulp when irritated by an electric current. Based on these indicators, it is possible to diagnose initial, medium and deep caries, pulpitis and periodontitis. Normal indicators vary between 6-8 μA.

Increasing the threshold of sensitivity allows you to determine the severity of the disease:

• 25-60 µA - pulpitis, more than 60 µA - the inflammatory process has spread to the root canals;
• 100 µA and more - complete destruction of the pulp;
• 100-160 μA - periodontitis in the chronic stage;
• 180-200 µA - exacerbation of the disease.

Features of treatment

Methods of treatment directly depend on the severity of the disease. The main task of the dentist when choosing a treatment method is to save the tooth. However, this is only possible if the patient is treated in the early stages of the disease. Otherwise, the tooth is removed.

Treatment of granulating periodontitis includes three stages:

If periodontitis has developed into a chronic stage, in some cases, a number of related procedures should be performed to completely remove granulating tissues:

• partial removal of the root of the tooth with an area of ​​​​inflammation;
• amputation of the tooth root (more in the article: how is the amputation of the tooth root performed?);
• hemisection of the tooth - removal of one of the roots of the tooth;
• interradicular granulectomy - removal of a granuloma between the roots of large molars;
• in extreme cases, the tooth is completely removed.

To prevent chronic granulating periodontitis, the following rules must be observed:

• meticulous care of the oral cavity;
• regular visits to the dentist - twice a year;
• timely treatment of pulpitis and caries;
• giving up bad habits - smoking, sugary carbonated drinks and coffee.

The modern level of development of dentistry allows you to save a person's natural teeth with timely access to a doctor. One of the diseases that can be cured without resorting to extraction is periodontitis of the tooth. For this reason, it is important to be able to recognize the symptoms of pathology, to know what the periodontal dentition looks like and to seek help without waiting for an exacerbation.

What does the term "periodontitis" mean?

The term "periodontitis" in medicine sounds like "periodontitis". What it is? The word is of Greek origin and consists of two significant parts: "peri" ("around") and "odontos" ("tooth"). If we turn to the literal interpretation, then we are talking about the inflammatory process "around the tooth" or infection of periodontal tissues.

Methods for classifying periodontitis

In dentistry, the classification of periodontitis can be carried out on the basis of the location of the pathology (marginal or apical), based on the characteristic symptoms (chronic or acute). The classification of periodontal diseases is based on the causes that provoked the development of the disease. In the latter case, we will talk about a traumatic, infectious or drug-induced form of periodontitis.

By location

When classifying according to the place of localization, apical (apical periodontitis) and marginal (marginal) type of pathology are distinguished:

1. when apical periodontitis develops, the inflammatory process is concentrated in the apical part of the affected tooth;
2. if marginal periodontitis occurs, inflammation is localized in the ligamentous apparatus of the tooth, in its cervical zone.

With apical periodontitis, there is often a feeling of a "grown" incisor or canine.

According to the form of flow

The disease occurs in acute or chronic form:

1. At the initial stage of periodontitis, the patient feels intense acute pain - many eliminate the symptom by taking painkillers, but ignore the cause. The disease can become chronic, it proceeds almost imperceptibly (with the exception of exacerbations of periodontitis).
2. The chronic form is divided into fibrous type, granulating form of periodontitis and granulomatous.

Fibrous type of periodontitis

Fibrous type of periodontitis does not have bright symptoms. This type of disease is characterized by gradual replacement of the periodontium with fibrous (connective) tissues.

Granulomatous type of periodontitis

Granulomatous form of periodontitis is a collection of pus near the root apex. Treatment of periodontitis of the granulomatous type depends on the volume of the abscess and is more often surgical. Depending on the size of the purulent "bag", this formation is called:

• granuloma - up to 0 (we recommend reading: tooth granuloma: what is it and how is this disease treated?). 5 cm in diameter;
• cystogranuloma - from 0.5 to 1 cm;
• cyst - the size of a purulent formation exceeds 10 mm in diameter.

Granulating type of periodontitis

The granulating form of periodontitis is characterized by the appearance of granulation tissue at the tops of the roots of the tooth, which has a porous structure. It grows rapidly and gradually replaces the bone. Granulating periodontitis in the picture looks like a darkening at the roots of the tooth.

For the reasons that caused the disease

Depending on what causes provoked the disease, experts distinguish between infectious, traumatic and drug-induced periodontitis. The latter can be found under the name "arsenic". In the adult population, the causes of periodontitis are:

1. Toxic drugs (medicated periodontitis) - during the treatment of pulpitis, medicines based on formalin or arsenic (arsenic periodontitis) can enter the periodontium, sometimes the development of the disease provokes exposure to phosphate cements. With drug-induced periodontitis, exclusion of the influence of the toxin is required.
2. Injury - this can be a long-term traumatic effect (biting threads with teeth, oversized fillings) or an acute one-time injury (during a blow or fall).
3. Infection - caries or pulpitis often leads to the development of periodontitis, if the diseases were treated poorly or not in full, then an iatrogenic form occurs. Requires infection therapy.

Symptoms of the disease with a photo

Symptoms may vary. What periodontitis looks like can be seen in the photo to the article.

• With granulomatous periodontitis, discoloration of the teeth is often noted.
• Granulating periodontitis is characterized by swelling of the gums. Pronounced signs are present only during the period of exacerbation of periodontitis. With granulating periodontitis, there may be slight discomfort when eating, sometimes purulent discharge or swelling of the gums appears.

Acute periodontitis is accompanied by the following symptoms.

• feeling of a grown tooth;
• acute intense pain;
• soreness of the tooth;
• fever, weakness, headaches;
• enlargement of the cervical lymph nodes;
• swelling of soft tissues, tooth mobility;
• granulating periodontitis is often accompanied by a fistula;
• the appearance of symptoms of vasoparesis.

The first symptom is characteristic of apical periodontitis. The course of acute periodontitis differs from pulpitis in its reaction to temperature changes. In the first case, the cold has a calming effect, and with pulpitis, on the contrary, it causes severe pain. The patient may confuse such symptoms of pulpitis with signs of one of the chronic forms of periodontitis. Typical symptoms are shown in the photo to the article.

Methods of differential diagnosis

The dentist can diagnose the development of granulating periodontitis (or another form) based on a comprehensive clinical examination of the patient. Methods for the differential diagnosis of periodontitis include interviewing the patient, visual examination of the patient's oral cavity, after which the doctor determines the degree of tooth mobility and probes the entrance to its cavity. The differential diagnosis is easier to make during an exacerbation.

Inspection

Diagnosis of granulating periodontitis (another form) begins with an examination. Signs include tooth mobility, swelling of soft tissues. If periodontitis has become chronic (for example, fibrous), then the doctor will notice that the tooth has changed color. Can detect swelling of the gums in the place of accumulation of pus. If you press on the gum near the tooth, then the recess is not immediately leveled - this is a symptom of vasoparesis.

x-ray

With periodontitis, X-rays should not be taken by pregnant women. In the acute form of periodontitis of the tooth, this type of study is ineffective, since changes in the periodontium are not visible in the picture. As part of the differential diagnosis of periodontitis, X-ray examination allows you to determine the form of its course:

• granulomatous periodontitis - the granuloma is clearly visible on the x-ray (on the x-ray, a rounded darkening with clear and even boundaries);
• granulating periodontitis - the picture shows deformations of the periodontal gap, you can see that the bone density has decreased, the granulations have fuzzy boundaries;
• fibrous periodontitis - in the picture, the lumen of the periodontal gap is unevenly changed.

Treatment of periodontitis in adults

Can one of the types of periodontal inflammation go away on its own? Periodontal disease is characterized by severe course and complications. It is impossible to do without the use of conservative surgical methods. The doctor determines the form and type of the disease. Then the specialist proceeds to the choice of methods for the treatment of periodontitis - for acute and chronic it will be different. With exacerbation of periodontitis, treatment depends on its form. Stages of the treatment process:

With arsenic periodontitis, treatment has its own characteristics. The list of steps will be the same. The first step is to remove the source of the toxin. Physiotherapy treatments are also effective. In the treatment of apical periodontitis, it is necessary to proceed from what factors provoked it.

Antibiotics and other drugs

With periodontitis, as part of conservative treatment, antibiotics are often prescribed, for example, they are treated with Amoxiclav. When taking Amoxiclav with granulating periodontitis, attention should be paid to contraindications (including age-related ones).

As part of conservative therapy, the following antibiotics are indicated: Ofloxacin, Amoxicillin Sandoz, Amoxiclav. If periodontitis is diagnosed, it is strictly forbidden to exceed the dosage during antibiotic treatment:

• Amoxiclav. 1 tablet 3 times a day
• Ofloxacin. 1 tablet 2-3 times a day.
• Amoxicillin Sandoz. 500 mg 3 times a day.

Anti-inflammatory, antipyretic and antihistamine drugs can also be used, the dosage is selected by the doctor.

Surgery

With periodontitis, the dentist makes every effort to save the tooth. If the case is neglected and the use of conservative methods of treatment does not give an effect, the doctor will decide on the need for surgical intervention. With periodontitis, tooth extraction is a common operation. Of the methods of treatment, they often resort to an incision in the gums. Surgery is required for patients diagnosed with granulomatous periodontitis. The following types of surgical treatment can be performed:

Fighting illness at home

It is possible to fight the disease on your own, at home. However, such therapy shows high efficiency when used in combination with drug therapy prescribed by a doctor. With the development of granulating periodontitis, treatment with folk remedies gives a temporary effect. You can rinse your mouth or apply something to the gums after consulting a specialist. Below are the most popular folk methods and remedies:

• cranberry drinks (juices);
• an aqueous solution of potassium permanganate;
• tea applications;
• honey ointments;
• lemon salt paste;
• baking soda paste.

Possible Complications

After the end of treatment, intense pain or a feeling of "twitching" may occur. If the discomfort continues for 5 or more days, then we are talking about a relapse of the disease. You should contact your dentist immediately.

In addition to recurrent periodontitis, the patient is faced with a number of complications, the causes of which are most often poor-quality or untimely treatment:

• the spread of pathology to the periodontium of neighboring teeth;
• sepsis;
• the transition of pathology into a chronic and / or purulent form;
• phlegmon;
• osteomyelitis;
• periostitis.

Preventive measures

It is possible to cure the disease - although it is difficult, long, expensive and painful. If a pathology is detected at the initial stage, several unpleasant procedures will be required.

Fibrous periodontitis requires treatment for several weeks. The therapy of the chronic form (if granulating or granulomatous periodontitis is diagnosed) can take months, sometimes years.

How to prevent the development of periodontitis - prevention is necessary:

1. visit the dentist regularly;
2. rinse your mouth with special means - you can use folk recipes;
3. carry out sanitation of the oral cavity;
4. lead a healthy lifestyle, eat a balanced diet;
5. avoid excessive loads on the dentition;
6. do not neglect the full and timely treatment of dental diseases.

Almost every person faces dental diseases, and not just once in his long life. Fortunately, in many situations, an experienced dentist can easily make a correct diagnosis and immediately begin competent treatment, but sometimes for diagnosis it is necessary to take a photo of the teeth through x-rays. Let's look at what granulomatous periodontitis looks like on an x-ray, as well as the granulomatous form of the disease.

What it is?

Periodontium is the tissue that surrounds the roots of the teeth and holds it inside the alveoli. As for periodontitis, this name is the inflammatory process that occurs within this tissue. The focus of the inflammatory process can be located on different parts of the tooth, so experts distinguish several main types of the disease: marginal or apical periodontitis. The apical form of the disease is characterized by the fact that the lesion is observed near the very top of the roots of itching, which is almost always accompanied by a serious infection of the tissues.

Such manifestations occur due to infection in the pulp, and this causes decay, the products of which begin to exit through the hole that has arisen on top of the tooth root. Experts mention that apical periodontitis is very often a complication of unbaked pulpitis, which was not cured in time. As for the marginal inflammatory process, otherwise it is observed directly from the edge of the gums for the following reasons:

• Gingival injury. A similar problem is the most common cause of marginal periodontitis, gum injury can occur for various reasons, for example, as a result of biting something hard (nuts, some inedible objects) or an unsuccessful attempt to hold an object in the teeth.
• Allergic reaction. The consequences of this kind of allergy are quite rare, but it can still lead to periodontitis. Most often this occurs due to an allergic reaction to strong drugs.

The disease is also usually divided into acute periodontitis and chronic periodontitis, which is a consequence of the lack of competent therapy in the acute form. Another disease is divided into the following types:

• purulent form of periodontitis;
• serous periodontitis;
• granulating periodontitis;
• fibrous form;
• granulomatous periodontitis.

Let's take a closer look at the granulating and granulomatous forms, considering their main features and differences.

Granulosis of the tooth.

Granulomatous periodontitis

The human body strives to defeat any infection that enters the body, even if it is dental. If periodontitis of a tooth of this kind begins to develop, then this indicates an infection of the periodontium, as a result of which the body has taken these actions, enclosing the infection in a kind of "capsule", each of which is commonly called a granuloma. It allows you to stop the spread of infection and toxins throughout the rest of the body, and such a manifestation is called granulomatous.

A granuloma is a certain number of young fibers related to the connective tissue, that is, they contain vessels. When an infection is detected in the body, the immune system begins to work hard, activating all protective functions, which leads to the appearance of strands, but the granuloma still poses a serious danger. The fact is that there are cases when granulomas turned into cysts that can provoke the process of bone tissue decay (as you might guess, in this situation, such a problem can lead to tooth loss or even several of them). Dangerous situations during periodontitis are also associated with the fact that granulomas simply open up, this ends not only with such consequences as extremely high fever, suppuration and headache, because as a result an abscess may appear and even an infectious form of endocarditis may develop.

The course of the disease and its manifestations on x-rays

The initiation and development of a granuloma is a rather slow process, so this form of periodontitis often develops asymptomatically until the capsule becomes large and there is a feeling of swelling of the gums. A similar process is accompanied by pain when biting, the enamel also sometimes darkens and symptoms of a fistula are observed.

When performing radiography at this stage, it will already be possible to diagnose granulomatous periodontitis, despite the fact that granulation tissue is very poorly visualized in the photo. The focus of inflammation will be characterized by an oval or even round shape, and the diameter in such situations already usually reaches at least 5 mm. The boundaries of such a granuloma are extremely distinct, and tooth decay has not yet been observed. Let us also mention that resorption of the root apex is almost never observed, and sclerosis of the layer can sometimes be seen.

It is important to understand that the granulomatous forum of prostatitis can appear not only on teeth prone to caries at the moment, it can also begin to develop on previously filled teeth. In the presence of a carious cavity, it does not always communicate with the cavity of the tooth. If the specialist taps, he will be able to identify a low degree of sensitivity of the tooth. Also in such cases will be:

• almost completely absent reaction to probing;
• redness appears in the place where the inflammatory process is localized;
• there is increased electrical excitability;
• no tooth decay.

Note! Granulomatous or granulating periodontitis on an X-ray can only be determined by a qualified specialist, in no case do not try to make a description of the picture yourself, because even with the correct interpretation, it will be impossible to cure periodontitis without dental intervention.

The x-ray shows purulent periodontitis.

Treatment

The treatment process for granulomatous prostatitis is quite lengthy, because you will have to visit a dentist at least 3 times. At the first appointment, the doctor will clean the tooth, which is prone to inflammation, using special tools, and antifungal therapy is also required at this stage. As a result, a special paste will be introduced into the root of the tooth, which is necessary to create a temporary filling. During the 2nd appointment, the specialist will begin opening the hole on top of the tooth root in order to perform exudation. At this stage, antibiotics should be used, as well as antiseptics, but the drugs should not be too strong, otherwise the process of tissue repair after periodontitis may be slowed down.

You will also need other medications, for example, hyposensitizing drugs. The fact is that the granuloma can cause high allergic sensitivity, and these drugs are able to cope with this. You will also need drugs that can stop the growth of the granuloma and have the effect of tissue regeneration.

The essence of the third visit to a specialist will be the installation of a seal and the completion of treatment. When a cyst is found, which is not so rare, it must be removed, and sometimes it has to be done surgically (with a large size of this neoplasm).

Granulating periodontitis

You should also consider such a type of disease as acute or chronic granulating periodontitis. In this case, periodontal deformation occurs as a result of tissue growth. Such manifestations are easy to explain, because with their help the body seeks to destroy the source of infection (in most situations of a bacterial nature). These bacteria enter the periodontium through a hole located at the top of the tooth root, which is a complication of caries associated with infection in the pulp. Granulations in this case will grow very quickly, simultaneously destroying the alveolar process. As a result of this, a channel may open, through which pus will begin to come out, and there may even be several of them.

Features of the course of the disease and its diagnosis

Dentists always characterize granulating periodontitis with the appearance of pain sensations of a periodic nature, and they can manifest themselves arbitrarily. Pain can also occur when biting something. The tooth can even become a little mobile, but here are the rest of the clinical manifestations of this form of periodontitis:

• the appearance of bad breath;
• the appearance of fistulas and purulent discharge;
• significant redness of the mucous membrane.

As for the mucous membrane in the place where it develops into fistulas, it becomes much thinner, and when the canal is closed, a scar of a rather large size is formed. At this stage, you can’t hesitate anymore, you have chosen any dentistry where you should go.

X-ray is one of the main methods necessary for the diagnosis of chronic periodontitis.

An examination by a doctor never begins with an X-ray, because a description of the condition is made first. In the process of diagnosis, the specialist will detect many clinical manifestations observed in granulating periodontitis. For example, when probing, most likely, an internal cord will be detected, which is always the result of a fistula, the connective tissue near which is seriously compacted. It is important to understand that fistulas can appear in absolutely different places, even on the face and neck, which often surprises patients.

As for how the picture will look, in which granulating prostatitis is observed, its main features will also be in granules and pathological formations, separated from all tissues. Inside such formations, granulation tissue appears, which is rather poorly visualized, as mentioned earlier. In those places where inflammatory changes occurred, connective tissue will appear, which will take up a relatively large amount of space, which simplifies its identification.

Important! Radiography is an indispensable study in many situations of this kind, but conducting such a study without a contrast agent may not give the desired results, especially when it comes to the early stages of the development of the problem, when the formation is still quite small. In any case, you should consult a doctor when the first symptoms appear, otherwise you can lose precious time, which will help to more accurately establish the diagnosis and begin competent therapy, preventing possible complications and dangerous consequences.

It should be understood that periodontitis can be attributed to any other form, because in this material only two of them were considered in detail.

Granulating periodontitis on x-ray is defined as stratification in the periapical region. In pathology, fistulas with purulent contents are formed. foci of destruction with fuzzy and uneven contours are shown. In structure, they resemble "tongues of flame."

How to identify granulomatous periodontitis on x-ray

Granulomatous periodontitis on x-ray is manifested by granulomas and pathological formations that are separated from surrounding tissues. Inside this formation is granulation tissue, which is not very well seen on the x-ray.

The pathological process is the result of granulomatous or granulating. At the site of inflammatory changes, connective tissue is formed. Over time, it occupies large spaces, so it can be visualized on x-rays.

Orthopantomogram: cystic enlightenment in periodontitis of the lower jaw. Clearly traced metal seals

For differential diagnosis of chronic forms, X-ray examination is indispensable. In the treatment of pathology, it is not necessary to immediately make a diagnosis, since it becomes clear during the clinical examination of the patient's oral cavity.

What characterizes a granuloma on an x-ray

A granuloma on an X-ray is manifested by a zone of partial rarefaction of the bone structure. It has uneven and blurred contours. On an x-ray, these symptoms appear as "tongues of flame."

An x-ray examination of granulomatous periodontitis in the projection of the teeth shows granulomas. They are oval or rounded spots with clear and even contours. Foci of destruction are formations located near the top or under the root of the tooth. The sizes of the foci range from a couple of millimeters to 0.5 centimeters.

Granulomatous (fibrous) periodontitis in the picture is characterized by the following symptoms:

• an increase in the gap in the projection of the tooth apex;
• deformation of the tooth structure;
• detection of focal formations.

With the help of X-ray examination, it is possible to accurately determine the form of periodontitis in a patient. It shows the following changes:

1. carious cavities.
2. Enlargement of the gums.
3. Swelling of the mucous membrane.
4. Damage to the upper part of the periodontium.

In a clinical examination, the doctor can detect an internal cord. If there is a fistulous course with the closure of purulent cavities, such a disease in medicine is called a migratory granuloma.

What are the clinical symptoms of chronic periodontitis

Clinical symptoms of the disease are accompanied by the following signs:

• unpleasant pain in the mouth;
• a feeling of heaviness, awkwardness and bursting when biting on a bad tooth;
• severe destruction of tooth enamel;
• yellowing of the dentin;
• redness of the mucous membrane;
• deepening in the area of ​​the injury site;
• fistula in the area of ​​the diseased tooth;
• swollen lymph nodes.

When identifying the above signs, doctors must prescribe an x-ray examination in order to study in detail the features of the disease.

X-ray diagnostics of periodontitis granulating (fibrous)

Contact intraoral radiographs are used to diagnose the disease. They are performed according to the principles of isometric projection. To determine the relationship between the floor of the maxillary sinus and the root of the tooth, there are no better diagnostic methods and lateral radiographs.

What forms of periodontitis exist:

1. The acute apical form is manifested by the expansion of the periodontal gap. It is difficult to detect such changes in the picture.
2. The chronic form (fibrous, granulating) is accompanied by the growth of granulation tissue, which provokes severe pain. Granuloma is accompanied by corroded contour of the tooth and shortening of the root.
3. Granuloma is characterized not only by the growth of fibrous tissue, but also by the growth of strands of the epithelium. It turns into a cystogranuloma. With it, the morphological picture is characterized by the presence of several cysts, separated by coarse fibrous strands.
4. Fibrous periodontitis is the outcome of acute or chronic. With it, traumatic injuries are accompanied by coarse fibrous structures. The scar tissue on the X-ray can be traced as a thickening of the periodontium. In this case, there is an excessive layering of cement on the tooth surface (hypercementosis).

Thus, the typical signs of the disease are:

1. Expansion of the periodontal gap.
2. The formation of foci of sclerosis.
3. The appearance of purulent cysts.

Most often, the above changes can be traced in the region of the roots of the lower molars. Often, when analyzing radiographs, difficulties arise with the differentiation of pathological symptoms. In such a situation, an additional diagnostic method is a clinical examination.