traumatic ulcer
Introduction
Introduction to traumatic ulcer Traumatic ulcer refers to ulcers formed by long-term chronic mechanical damage such as sharp roots, sharp edges of teeth, misplaced teeth, and poor prostheses; or long-term bite, bite cheeks, bite lips, etc. Ulcers. The shape of the ulcer fits perfectly with the stimulating factor. The causes are mainly divided into two types: 1. Persistent mechanical stimulation: such as the residual crown formed in the oral cavity due to the destruction of rickets, residual roots, sharp edges, sharp cusps, and poor prostheses. 2, non-persistent mechanical stimuli: such as hard and brittle food stimulation, chewing inadvertent bites, brushing damage, improper use of instruments when the dentist is diagnosed and treated, even can cause trauma to the mucosa and ulcer damage. basic knowledge Sickness ratio: 0.0001% Susceptible people: no specific people Mode of infection: non-infectious Complications: gingivitis
Cause
Causes of traumatic ulcer
According to the time of mechanical stimulation, it can be divided into persistent and non-persistent stimuli.
1. Persistent mechanical stimulation: such as the residual crown formed by the destruction of rickets in the mouth, residual roots, sharp edges, sharp cusps, poor prostheses, etc.
2. Non-persistent mechanical stimuli: such as hard and brittle food irritations, chewing inadvertent bites, brushing damage, improper use of instruments when the dentist is diagnosed and treated, etc., can cause trauma to the mucosa and cause ulcer damage.
Prevention
Traumatic ulcer prevention
(1) Living and nursed back to life, to ensure adequate sleep, avoid fatigue, nervousness, excessive use of the brain; keep the mouth clean, clean the mouth 2 to 3 times a day, the comb of the toothbrush should not be too hard, so as not to hurt the oral mucosa, insist on using thick Green tea gargle can promote the healing of oral ulcers.
(2) Spiritual nursed back to maintain a happy mood, cheerful personality, relaxed mind and body, and correct daily work and disease.
Complication
Traumatic ulcer complications Complications gingivitis
There may be secondary infections, increased pain, regional lymphadenopathy, tenderness, and dysfunction.
Symptom
Traumatic ulcer symptoms Common symptoms Persistent pain Mucosal congestion Lymph node enlargement Secondary infection Wound healing Itching Congestive tissue necrosis Blood blister laryngeal trauma
There is a history of mechanical stimulation or mechanical stimuli found in the vicinity of the lesion. The shape of the ulcer is consistent with the form of the stimulating factor. If the stimulating factor is removed, the ulcer can heal in a short period of time.
If the ulcer does not heal after removal of the stimulating factor, the diagnosis should be further examined.
(1) Physical damage
This is the most common traumatic ulcer, such as the residual roots caused by smashing, the sharp edges of the crown, the bad restorations, the sharp cusps, etc., which can cause the corresponding mucosa to form ulcers or erosion surfaces. There may be only mild pain or swelling. After a long time, there is an inflammatory reaction around, the base of the ulcer is hard, and even the tissue hyperplasia occurs in the tongue of the elderly. It is often suspected of tongue cancer. The size and location of the ulcer vary. However, in accordance with the irritant, the severity of the condition is related to the time of the stimuli, the physical condition of the patient, and the secondary infection is aggravated by pain, regional lymphadenopathy, tenderness, and dysfunction.
The sharp edge of the prosthesis or the overly long substrate compresses the mucosa of the vestibular sulcus to form an ulcer. The common margin of the denture substrate is not only ulcer but also tissue hyperplasia. This is called decubital ulcer, and the fixed bridge is pressed against the gums. Then, an ulcer forms under the bridge.
In the baby, the bilateral mucosa at the flap of the flap is sometimes artificially fed by a hard pacifier. It is often rubbed here and is prone to ulceration. It is called Bednar ulcer. If the breast is erupted after the eruption of the deciduous teeth, the tongue is ligated and the tongue is tongue. Abdominal and tooth sputum rubbing will also cause ulcers, only local congestion at the beginning, followed by small ulcers, the result of continuous stimulation not only ulceration, pain increased or even tissue hyperplasia.
Acute or accidental mechanical injuries are also common, such as trauma, bites, toothbrushes that are too hard or improperly used, and improper use of sandstone or dental drills, causing acute damage to the mucous membranes, ulcers, and even lacerations.
(2) Chemical damage
Chemical damage of the oral mucosa is caused by improper local administration or strong acid, and strong alkali is in the mouth. In oral therapy, some corrosive drugs are often used to damage the mucous membranes, such as arsenic trioxide inactivating agent, iodine phenol, nitric acid. Silver liquid, etc., arsenic trioxide can be seen in the temporary sealing of the cement is not strict and flow into the interdental space, not only damage the mucosal gray-brown tissue necrosis, but also can cause alveolar bone necrosis, improper use of silver nitrate, trichloroacetic acid, etc. Mucosal necrosis, in addition, patients sometimes have painkillers such as aspirin due to toothache, due to drug exposure to the gums for too long to form chemical damage, local congestion, erosion, there is a layer of white pseudomembrane.
(three) mucosal blood blister
It is common in the clinic to eat overheated or hard foods. When chewing or swallowing, it may cause blood blister to form immediately after soft rubbing, buccal mucosa, or parapharyngeal mucosa. The true cause of the disease is still unclear. Or stinging, Zhangkou can see the mucous membranes of the mucous membrane here, which is purple-red, the wall of the blister is thin, the size is not limited, and the shape is different. After the break, the herpes is covered, and then the herpes is necrotic and shedding is a bright red with a clear edge. Color ulcer surface, there is a little secretion on it, the surrounding mucosa is congested, the patient feels burning pain, talking, and the pain is increased when eating. If the damage is too large, the healing is slow, and the granulation tissue grows gradually on the ulcer surface, fresh epithelial coverage Healed afterwards.
Examine
Examination of traumatic ulcers
1, oral examination.
2, visual inspection.
Diagnosis
Diagnosis and diagnosis of traumatic ulcer
Differential diagnosis
1. Identification with recurrent aphthous ulcers:
The local factors of recurrent aphthous ulcer in traumatic ulcer are not obvious. The size of the ulcer is different. The irritant is round or elliptical in the corresponding part, and the diameter is 2~4mm.
2. Cancer:
The growth of the tongue, especially those with ulcers, should first think of the possibility of cancer, and the traumatic ulcer caused by the residual root and crown stimulation is clinically like a cancer, except for the identification of medical history and examination. The most important thing is to remove the local factors first instead of the biopsy. If the stimuli in the corresponding parts can be found in the local area, they should be removed. The lesions are serious, and the irritants can be quickly improved after removal. If they are not removed after removal, A biopsy should be performed in time to confirm the diagnosis.
3. Glandular aphthous ulcers:
First of all, we must carefully look for the irritants in the corresponding parts of the lesions, and eliminate the local factors, then consider the diagnosis from the medical history, oral examination, etc., the ulceration period of the glandular aphthous ulcer is longer, should be observed.
4. Tuberculous ulcers:
First of all, it is necessary to carefully check whether there is any irritant in the corresponding part of the lesion, and then from the medical history, the characteristics of the ulcer: the bottom is granulated, the edge is not uniform, etc., if necessary, for chest X-ray examination, biopsy can help to confirm the diagnosis.
