Tooth decay:
The cavities of the enamel (1st degree) asymptomatic, succeeds caries (2nd
degree) to a dentine caused pain.
Pulpitis (3rd degree) causes a spontaneous pain sometimes violent ("rage
teeth"), irradiation of an intermittent nature, and associated reflexes of
a pulsate nature. If pulp necrosis is
not treated it will inevitably lead to stage post-caries (4th degree), which is
that of local complications, loco-regional and distance.
Periodontal
diseases:
The periodontal syndrome is clinically
manifested by gingivitis that is not relieved by brushing. Another characteristic symptom is gingival
recession coupled with denudation of the root.
This leads to the development of mobility with premature dental loss of
the tooth. The emergence of pockets is a
periodontal sign of local infection and can evolve into gingival abscesses.
Radioactively: there is a progressive analysis of the alveolar bone loss with
septal inter-dental
On the therapeutic plan, the possibilities are reduced (periodontal surgery);
preventive treatment is most effective.
Diseases
of the dental body
Pathological
body of dental can be achieved:
Either at the level of hard tissues of the tooth
by progressive destruction from outside to inside enamel, dentin and cement:
dental caries.
Either by slow absorption of tissues supporting the teeth (periodontal) leading
to partial or total loss of teeth: periodontal diseases.
Both diseases are sometimes intertwined complex physiological mechanisms
involving bacterial agents, metabolic factors (slow sugars, Hypovitaminosis,
pregnancy), salivary factors (xerostomia post-radiation), toxic factors, and
hereditary factors.
Poor oral hygiene is often associated.
The local
complication most usual is the emergence of an apical granuloma often
asymptomatic, sometimes to an apical mono-arthritis (spontaneous pain, teeth
slightly mobile, painful to percussion, enlargement of ligaments on the
retro-radio alveolar).
The regional complications are cellulitis, sinusitis and osteitis.
The complications are mostly general cardio-vascular (endocarditis infected patients
or valves carrying a congenital malformation). Other abuses of an inflammatory
nature have been described: articular manifestations, kidney, eye, skin
etc. In all these cases, setting an oral
statement is part of the treatment process.
Dental
origin cellulitis peri-maxillary:
This is an infection more or less circumscribed to the soft tissue
peri-maxillary, originating from oral germs.
Etiology
The cellulitis complicates mostly pulp necrosis, the infection spreading across
the alveolar bone and beyond the muscle or fat.
Other causes requiring dental treatment are possible complications from
periodontal diseases.
The non-dental causes can be varied, including fractures, osteitis, and
infectious cysts
Clinic
Stage edematous involves pain, swelling of the
inflammatory sub-lining and subcutaneous, moderate lockjaw. This stage has very characteristic pain that
continues with the lockjaw. The general
signs include voluminous swelling. It
evolves most often to spontaneous fistulisation that may precede the transition
to chronicity.
Diagnosis
The dental origin is confirmed by clinical examination (history, discovery of a
mortified tooth). This review is difficult when lockjaw is present.
In all cases radiography is indispensable, as it confirms typical dental
pathology or the existence of an included tooth.
It is usually easy to eliminate a phlegmon sub-mandibular, pathology of
salivary origin (sub-mandibulite), and osteitis.
Evolution
Fistulisation with chronic or persistence of a nodule subcutaneous.
Worsening signs, both local and widespread, especially when certain factors are
present such as diabetes or decreased immunity.
Dissemination performing a facial cellulitis involving loco-regional signs
(pelvic infiltration, cervical infiltration), and general signs of septic
shock. The evolution can be fatal
without prompt, well-led, treatment.
Topographical forms
They are very numerous and depend on the location of the apex dental compared
to the cortical bone and muscle insertions.
Broadly speaking, one can distinguish:
the mandible forms vestibular temporomandibular masseterine, pelvi-mouth
addition and sub-mylohyoidienne, sub-mandibular.
the jaw forms palate, and jugale when the tooth is the causal canine or
premolar.
