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Diseases of the Dental Body

Tooth decay

Tooth decay and disease Treatment

 

Dental Details

Diagnosis

It is a unilateral sinusitis, purulent, recurrent.

Clinical examination will generally find pus in the medium and can often identify the causal tooth.

An X-ray (panoramic radiograph, including the sinus) shows a complete opacity sinus with or without liquid level and the image in part will reflect a thickening of the sinus lining.

The dental origin is confirmed by radiograph.

Forms etiological

Differential Diagnosis

Cellulitis

Sinusitis original (bilateral sinusitis, allergic ground, etc.)

Maxillary sinus cancer (epistaxis, osteolysis radiological justifying the practice of a review)

Treatment

If the cause is dental, treatment is mostly extraction of the tooth.

If the cause is sinusitis, drainage of the sinus cavity and / or vestibular (intervention Caldwell-Luc)

In all cases, an antibiotic will be involved.

Osteitis of maxillary

The infection of the jaw bone or, more rarely of the jaw occurs most often among young adults due to an infection occurring at the apex of a mandibular molar.

The blood-borne osteo-myelitis is exceptional and occurs mainly in a small child.
Medical treatment is based on an antibiotic (in the absence of allergy: clavulanic acid). An anti-inflammatory treatment will never be prescribed in isolation.  An ice pack is an excellent complement for analgesic and anti-inflammatory effect.

Surgical treatment in simple cases (primarily cellulitis) will be the extraction of the tooth.  The extraction will take place under local anesthesia.  In complicated cases, general anesthesia is necessary for the evacuation, washing and draining the abscess dermal and / or vestibular and the extraction of teeth or the cause.

Sinusitis maxillary dental origin

“Sinus” teeth are the first molar, the second premolar, and more rarely, the second molar and the first upper premolar.  The apex is in intimate contact with the lining of the floor and so a sinus infection may spread across the alveolar bone lining.
A mortified tooth is the most common cause

Iatrogenic: pushing back the sinus by a root of a tooth extraction at a difficult apical overrun during a dental treatment with projection through channels in the sinuses, which produces a radio-opaque image of the bottom sinus; a very substantive characteristic. In this case it described aspergillosis sinusitis.

Oral Communication sinusitis

It is most often a complication of post-extraction allowing communication between the oral cavity and the sinus cavity (moving air and fluid).  A chronic sinusitis complicates this procedure.

Osteitis narrowly

Alveolitis post-extraction: a few days after extracting a molar very violent pain occurs in the cell, which is mostly dry, and becomes sometimes filled by a fleshy inflammatory bud.

The search for a small escrow bone or a root forgotten by a radiological exam will be systematic.  In this case, a revision will be the necessary cellular complement of medical treatment.

Osteitis broadcasts of the mandible

The clinical picture involves pain, often irradiating.  The symptoms are generally mandibular with moderate, painful mandibular swelling). They are very often treated with anesthesia on the lip and chin.

Treatment

Etiological treatment: the causal tooth extraction, revision of alveolar home, or new osteosynthesis as needed in the case of traumatic osteitis.

Medical treatment: it is based on a long course of antibiotics, if possible, adapted according to any susceptibility. The latter is not always possible and antibiotic probability will be lessened.  An example of antibiotic treatment is pyostacine for three to six months.

Surgical treatment: removal of receivers, stripping the outside of the mandible.

On the radiological, dental origin is more or less obvious (the tooth has to be extracted).  There is a modification of the skeletal frame that appears deleted.  At a later stage, a receiver bone may be observed.  A scan confirms the diagnosis and clearly fixes the stage as early or late.

Evolution

Chronic osteitis is the rule in the absence of suitable treatment.  The osteitis then moves along the course with advanced inflammatory periods regularly separated by an interval free more or less of symptoms.

The radiological image is increasingly evident with the appearance of one or more receivers that can sometimes be extracted.

Forms clinics

Osteitis traumatic: a mobile fracture or untreated infection after osteosynthesis.

Necrotizing osteitis iatrogenic led to secondary treatment doing root canal work with arsenous anhydride.

Dental cancer: see Chapter Cancer

Osteitis TB: exceptional

 

 

 

Tooth decay and disease Treatment