Wisdom tooth pericoronitis

Introduction

Introduction to wisdom tooth crown inflammation Wisdom tooth pericoronitis refers to soft tissue inflammation around the crown of the third molar (also known as wisdom tooth). Often occurring in young people between the ages of 18 and 25, it is one of the common oral diseases. The main symptom is swelling and pain in the soft tissue around the crown. If inflammation affects the masticatory muscles, it may cause varying degrees of mouth opening, such as swallowing pain on the pharyngeal side, causing difficulty in chewing, eating and swallowing. Patients with severe illness may have systemic symptoms such as general discomfort, headache, rising body temperature, and loss of appetite. basic knowledge The proportion of illness: 0.15% Susceptible people: no specific population Mode of infection: non-infectious Complications: periarticular cellulitis osteomyelitis

Cause

The cause of wisdom tooth pericoronitis

Cause:

Due to the increasingly fine human food, the jaws gradually degenerate and shrink, causing the length of the dentition and the jaw to be inconsistent. The wisdom tooth is the last erupted tooth in the dentition. It erupts more than 18 to 25 years old. Due to insufficient eruption position, the wisdom tooth may be incomplete and ectopic or obstructive. The crown part is exposed outside the gum and partially covered by the gum. A narrow and deep blind bag is formed between the gums and the tooth body, which is easy to accumulate food debris and bacteria. Generally, the brushing mouth is difficult to clean; in addition, the crown gum is easily damaged by chewing food to form an ulcer. When the systemic resistance is reduced and the virulence of the bacteria is enhanced, inflammation of the tissue surrounding the crown can be caused.

Prevention

Wisdom tooth pericoronitis prevention

1. Maintain adequate sleep and enhance the body's resistance to disease.

2, brush your teeth, diligent mouth, maintain oral cleanliness, prevent inflammation.

3, remove the impact wisdom teeth as soon as possible to prevent pericoronitis and adjacent gums.

Complication

Wisdom tooth pericoronitis complications Complications, periorbital cellulitis, osteomyelitis

If acute pericoronitis is not completely treated, it can be converted to chronic, and then recurrent, and even left fistula. If the inflammation continues to expand, the following complications can occur, such as spreading to the periosteum to form a subperiosteal abscess; or pus along The mandibular lateral bone faces the anterior flow, which can form an abscess or sputum on the cheek side corresponding to the first or second molar of the lower jaw; it can also expand outward to form a subcutaneous abscess of the cheek, or form a skin sputum through the skin. Patients with buccal skin fistula should be considered, and the possibility of pericoronitis should be considered to prevent misdiagnosis. Patients with severe pericoronitis can still have periorbital cellulitis, mandibular osteomyelitis and even systemic infection.

Symptom

Wisdom tooth periarthritis symptoms common symptoms lymph node enlargement cellulitis inflammation purulent abscess soft tissue swelling lack of wisdom teeth

1. It occurs mostly in young people, especially at 18 to 25 years old, with systemic predisposing factors or recurrent episodes.

2. In the early stage of acute pericoronitis, there is no obvious systemic reaction. The patient feels pain and discomfort in the affected area. Chewing, swallowing, and pain in the mouth opening activity. The swelling of the affected teeth and the posterior region can be seen. Sex secretions.

3. The inflammation develops further, involving the masseter muscle and the pterygoid muscle. The mandibular angle area is swollen, with varying degrees of mouth opening and even opening. The systemic symptoms are obvious. There are often submandibular lymph nodes and tenderness. Can develop into periorbital abscess, maxillofacial cellulitis and even osteomyelitis.

4. Chronic pericoronitis can form a fistula on the buccal side of the first molar of the mandible, or form a skin fistula at the leading edge of the masseter muscle.

The main symptoms of acute wisdom tooth pericoronitis are swelling and pain of soft tissue around the crown. For example, inflammation affects the masticatory muscles, which may cause different degrees of mouth opening. If swallowing, the swallowing pain may occur, causing the patient to chew, eating and swallowing difficulties. In severe cases, there may be general symptoms such as general discomfort, headache, rising body temperature and loss of appetite.

Examine

Wisdom tooth pericoronitis check

1. Check that the third molar of the mandible is incompletely erupted, covered with a sacral flap, and formed by a blind pocket. The soft tissue around the crown is red and swollen, the edge of the flap is smashed, and there is purulent secretion in the blind pocket. Sometimes a periorbital abscess can be formed, with maxillofacial swelling, ipsilateral submandibular lymphadenopathy, tenderness.

2. X-ray examination can detect the presence of impacted wisdom teeth and its shape and location.

3. Laboratory tests for acute suppurative pericoronitis often increase the total number of white blood cells and the proportion of neutrophils.

Diagnosis

Diagnosis and differentiation of wisdom tooth pericoronitis

Diagnosis can be based on symptoms.

Differential diagnosis

1. The mandibular wisdom tooth periarthritis with the mandibular first molars in the buccal vestibular sulcus should be differentiated from the buccal canine caused by the periapical lesions of the mandibular first molar. The former first molar has no exact lesions in the clinical examination. The X-ray teeth also have no periapical lesions, but there is a history of obstructive wisdom teeth and redness. The first molar has rickets, pulp disease and periapical destruction.

2. Malignant tumors in the third molar region Although the malignant tumors in this region are often accompanied by inflammation, it is a hyperplasia-like mass, and it is a substantial infiltration mass. X-ray examination shows local bone tissue dissolution damage.

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