Periostitis: causes of inflammation in the upper jaw, symptoms, differential diagnosis and treatment methods

Periostitis, or simply speaking, the flux is a disease accompanied by an inflammatory process in the periosteum.Most often, periostitis is a consequence of other inflammations in the oral cavity, in the periodontium or teeth.

Painful periostitis is associated with abscessing of the lesion.In this case, the patient develops a palatial edema and the body temperature rises.A person needs timely medical help, otherwise purulent accumulations can break out, causing a complication, like osteomyelitis.

What is periostitis of the upper jaw

The appearance of the disease is not excluded in all age categories, however, in children and people of advanced age, periostitis is not diagnosed as often, and its symptoms are meager.

To confuse the flux with other diseases is difficult, because develops a strong puffiness of , which is difficult to not see.Primarily, periostitis originates under the action of infectious agents, which affect the chewing organs of the lower and upper jaw.

If the tip of the root is inflamed or the infection has affected the dental canals, then the infection can spread to surrounding tissues: bone tissue, gingival mucosa.After a certain interval of

, a strong suppuration of occurs, and the pus gradually seeps through the bone and mucous membranes.The appearance of edema and severe pain is associated with this.

Periostitis of the upper jaw represents a greater danger of than the lower one, as along with the teeth and adjacent tissues sinus can be involved in the inflammation, and edema can cover up to half of the face.

There is a direct link between the localization of edema and the damaged tooth.Puffiness often affects the area of ​​the upper lip of the , the wings of the nose and cheeks and at the same time the vestibular or palatal side of the oral cavity swells.

As statistics show, periostitis of the lower jaw is most common and occurs in approximately 65% ​​of cases.There were cases when purulent inflammation affected up to ten teeth at once.Cutting the teeth is often complicated by various diseases.For example, the so-called inflammation of the "hood" which must be cut or the wisdom tooth must be pulled out.

Classification of periostitis of upper and lower jaw

Several criteria can be used to classify periostitis.Depending on the level of involvement of the infection in the pathogenesis of the disease: aseptic and purulent .

Specific features of exudate: proliferative and exudative.By the nature of the severity of the leak: acute and chronic .

Types of periostitis depending on the form of the disease:

• purulent;
• serous;
• ossifying;
• fibrous;
• simple.

Causes of periostitis

The reasons underlying the development of periostitis of the upper jaw are varied.The predominant factor is infection.Streptococci, staphylococci and other gram-positive bacteria are the most common pathogens of infection.

Penetrating the periosteum in different ways, they provoke purulent processes.One of the main sources of bacteria are carious teeth .The late stages of caries, as a rule, are marked by the appearance of cavities inside the tooth.

The presence of pulpitis aggravates the state of things.Passing this cavity, pathogenic microbes freely penetrate into the root, gum and jawbone, which, in turn, gives impetus to the formation of inflammation and periostitis.

In the case of exudate and pus accumulating in the periosteum, it is a question of purulent periostitis.To serve as the cause of the development of periostitis of the jaw can not only caries, but a single human organ that serves as a source of infection.

The disease provokes problems with the upper respiratory tract.Infection causing a flux moves through the circulatory system and reaches the periodontal tissues.In such cases, the diagnosis is lymphogenous periostitis .This is a very dangerous condition.

Immune protection plays an enormous role in the development of this disease.Strong immunity can for a long time resist the multiplying bacteria that provoke the flux.

Sometimes patients of dental surgeries have to repeatedly seek help after they have been treated.Periostitis may occur due to non-compliance with hygiene rules , then there is a risk of infection in the gum.

In general, periostitis is formed against a background of any dental disease, but there may be independent reasons contributing to its appearance.

Types of periostitis

Depending on the etiological features, several types of periostitis are distinguished in medical practice:

1. Inflammatory.As a result of a rapidly developing inflammatory reaction in the oral cavity, which is localized in the periodontal region.Symptoms are gradually increasing.
2. Toxic.Occurs in episodes when soft tissues become infected due to infection in the bloodstream.This pattern is typical for patients suffering from systemic diseases of the body.
3. Traumatic.A person can get an infection during the traumatization of the jaw, gingiva or teeth.
4. Specific.Is a companion of diseases such as tuberculosis or actinomycosis.

The process trigger can be:

• Problematic tooth eruption.
• Inflammation affecting the half-retina and retinas.
• Accumulated in radicular cysts pus.
• Odontomous proliferation.
• Paradontal diseases.
• Distortion of gingival integrity with tooth extraction.

Acute purulent periostitis may occur due to the following common factors:

• excessive physical exertion and overwork;
• hypothermia of the body;
• susceptibility to stressful situations.

Clinical picture of periostitis of the jaw

The main symptom that allows suspected periostitis, is the swelling of the gingiva.A pronounced pain syndrome will be noted with periostitis, which appears on the background of caries or pulpitis.Acute periostitis develops instantly and is accompanied by such symptoms:

1. . Soft tissue sores gums.
2. Severe pain in the affected periosteum.
3. Redness in the inflamed area of ​​the gingiva.
4. Facial swelling, lips, or cheeks on the side of the flux localization.General weakness and malaise
5. .
6. An exacerbation of a headache.
7. Noticeable increase in submandibular and cervical lymph nodes.
8. Decreased appetite.
9. Slightly increased body temperature to 37.5-38.

The nature of pain with periostitis can be a pulling, cutting or pulsating .

Diagnosis of periostitis is necessary, based on clinical data and results of laboratory studies of .A similar clinical picture is present in other diseases that need to be distinguished, otherwise the chosen treatment strategy may not succeed, and even worse, harm.

Diagnosis of the disease

Differential diagnosis is performed with such diseases:

• Acute periodontitis.A distinctive feature is the location of the foci of infection: a swelling in this disease does not go beyond the boundaries of the affected tooth, and with the flux can cover several adjacent teeth.
• Acute sialadenitis.It is characterized by inflammation of the salivary glands.With sialodentites from the ducts of the salivary glands, purulent contents are excreted, without affecting the dental structures.
• Acute osteomyelitis.With this disease, a general intoxication of the body with the products of the vital activity of bacteria is expressed.There are typical symptoms: fever, fever, headache, chills and weakness.In this case, the alveolar process can be seen on both sides, and not with one, as with periostitis.
• Abscesses, lymphadenitis, phlegmon.With these pathologies, palpation is probed for dense formations in the depth of tissues in the neck and face.Of the other symptoms, hyperemia and tightness of the skin are noted.

Periostitis, in turn, is palpated as tissue softening.Fluctuation in the mucous membrane does not cause redness of individual parts of the face, the skin does not stretch or gloss over.

Treatment of periostitis

In the case of an acute form of purulent periostitis, the main treatment will be surgical intervention.Its purpose is to open and drain the abscess.In parallel, conservative methods are used and medication is prescribed to relieve the patient's condition.

In the early stages of the disease, when the serous form has not become purulent, the incision can be avoided if the cavity of the tooth is cleared, cleans the channel and creates conditions for exudative fluid outflow.Some patients need to get rid of the affected tooth in order to ensure complete recovery.

In order to avoid any pain, the patient is offered conductor or infiltration anesthesia .Transition of the periostitis into a purulent form forces the doctor to perform a periostomy - dissection of the periosteum in the inflamed area.Local anesthesia is used to perform this operation.

Injection with a drug is injected with a thin needle into the intended line of the incision, and it is unacceptable for the anesthetic to enter the purulent cavity.This oversight can significantly increase the swelling of the gums, and anesthesia will not work.

After successful opening of the abscess, the patient is given a weak solution of manganese or sodium hydrogencarbonate so that he can rinse his mouth thoroughly.Further, the doctor rinses the site of the incision with chlorhexidine or another bactericidal solution.

The tooth, due to which the periostitis of the jaw developed, should be removed if it is not of functional importance for a person, has a carious lesion and breaks the aesthetic appearance.The removed tooth improves the outflow of purulent exudate, and the inflammation in the jaw gradually decreases.

If the preservation of the tooth element is shown, should be thoroughly performed with the endodontic treatment of followed by sealing, while observing all antiseptic norms.

Medical and physiotherapeutic treatment

Drugs prescribed for a patient with periostitis of the jaw:

• antihistamines;
• nitrofurans;
• sulfonamides;
• antibiotics;
• Calcium preparations;
• multivitamin complexes.

Recently, doctors are increasingly distrusting sulfanilamides, as the bacterial flora does not show high sensitivity to them.Instead, prescribes broad-spectrum antibacterial drugs and nitazole derivatives.

The next day after a surgical procedure, carefully examine the patient's oral cavity and determine the degree of reduction of inflammatory processes.

If the patient consulted for acute purulent periostitis of the jaw, he is given the referral to the physiotherapeutic treatment of , which he can attend on the second day after the operation.The following procedures are recommended:

1. UHF.
2. Microwave.
3. Laser therapy with neon-helium and infrared lasers.
4. Fluctuorization.
5. Antiseptic and deodorizing solutions as warm baths for the oral cavity.
6. Tampons with sea buckthorn or camphor oil.

Predicting the outcome of the disease is quite difficult.In many respects this will depend on when the treatment procedures were started and how effective they are.

If all the measures for treatment of purulent periostitis at the very first stages are observed, you can be sure of complete recovery.Literally in five days the patient becomes able-bodied.

With a palatine abscess, the abscess can break out on its own, which will cause necrosis of the parts in the jawbone.Unprofessional and unscrupulous treatment leads to a chronic form of periostitis, allowing him to move to osteomyelitis.

Preventive measures are made by in the urgent treatment of foci of odontogenic origin: pulpitis, caries, periodontitis.Do not forget about the daily oral hygiene.