pulpitis
Introduction
Introduction to pulpitis Pulpitis refers to an inflammatory lesion that occurs in the pulp tissue. The pulp is a loose connective tissue mainly containing neurovascular vessels, located in the pulp chamber inside the tooth. The pulp is affected by pathogenic stimuli for various reasons, which can cause inflammation of the pulp, that is, pulpitis. The main symptoms are pain, and even severe unbearable pain. It often makes the patient restless, the diet is difficult to enter, and the pain is unbearable. . basic knowledge Sickness ratio: 0.5% Susceptible people: no special people Mode of infection: non-infectious Complications: pulpitis chronic pulpitis
Cause
Cause of pulpitis
Infection factor (39%):
The most common cause of pulp inflammation is infection. Invasion of the bacteria and its toxins into the medullary cavity by any cause can cause inflammation of the pulp. The pulp tissue enters the pulp cavity in the center of the tooth through the apical foramen, and is surrounded by hard dentin and enamel. Under normal circumstances, it will not be attacked by bacteria, but when the hard tissue of the tooth is damaged due to various reasons. The bacteria can invade the infected pulp. Among them, dental caries is the most common cause of loss of hard tissue of the tooth. When the caries damage the enamel, reach the deep layer of dentin, and even pass through the dentin to reach the pulp cavity, the bacteria in the mouth will infect the pulp and cause inflammation of the pulp. .
Other factors (23%):
Including tooth defects caused by abnormal tooth development, accidental accidental crown fracture of the pulp, also directly damage the pulp. In addition, in severe periodontal disease, the periodontal pocket is deep to the apex, and the bacteria can also enter the medullary cavity by the apical foramen or some small branches of the root to cause pulp inflammation.
Prevention
Pulpitis prevention
The most common cause of pulpitis is rickets. The incidence of rickets in China is high. Most patients can't see a doctor in time. Until the pulp inflammation and pain are unbearable, they often need to receive root canal treatment. The root canal treatment process is complicated and costly, which causes great economic pressure for individuals and society. Therefore, we should pay attention to oral health care, reduce the incidence of rickets, regularly check and timely treat dental caries and other dental diseases, to avoid further development of dental pulp inflammation, causing great pain and unnecessary economic burden.
Complication
Pulpitis complications Complications, pulpitis, chronic pulpitis
Toothache, fever, and empyema.
Symptom
Symptoms of endodontic symptoms Common symptoms Teeth with hot and cold pain, toothache, enamel, corrosion, tooth crack
Pulpitis is a common dental disease. Pain is the main symptom, and even severe unbearable pain often makes the patient restless and the diet difficult to enter. As the saying goes, "Toothache is not a disease, it hurts to be really fatal" refers to this course of disease. Pulpitis is mainly caused by infection from the tooth. If the squat, wedge-shaped defect and other hard tissue diseases of the tooth can not be controlled and treated in time, it can cause pulpitis and become one of the most common and most common diseases in the oral cavity.
Examine
Examination of pulpitis
1. Clinical evaluation indicators: including self-conscious symptoms (function status) and general oral examination results. Conscious symptoms mainly refer to the presence or absence of pain and swelling, including spontaneous persistent pain, occlusal pain, tenderness, good function, presence of swelling of the gums and face, etc.; general oral examination including percussion, percussion, looseness and presence or absence of gums Sinus and so on.
2. X-ray film evaluation index: X-ray film evaluation index is an important and effective index for evaluating the clinical efficacy of endodontic treatment. The assessment method is the comparison of the apical X-ray before and after treatment, including changes in the apical dentin, cementum, periodontal ligament and alveolar bone image.
Diagnosis
Diagnosis and diagnosis of pulpitis
Disease identification
1. squat, reversible pulpitis, chronic pulpitis
(1) Pain symptoms: Both may have hot and cold pain, but there is no spontaneous pain history in squat and reversible pulpitis; chronic pulpitis may have a history of spontaneous pain.
(2) Temperature test: cold measuring the tooth surface with a popsicle, the response of the deep tooth is the same as that of the control tooth, only when the ice water enters the hole to cause pain; the repetitive pulpitis tooth is cold when measuring the tooth surface That is, transient sensitivity. Chronic pulpitis has a severe pain response caused by temperature stimulation, which lasts for a long time, and sometimes mild pain.
2. Acute pulpitis, trigeminal neuralgia
The onset of trigeminal neuralgia generally has a "trigger point" of pain that causes pain every time the patient touches it. When patients complain about their medical history, they often ignore this point and should be specifically asked in detail. In addition, trigeminal neuralgia is less likely to occur at night, and cold and hot temperature stimulation does not cause pain; the typical pain of acute pulpitis can find the cause of pain.
3. Acute pulpitis, papillitis
Spontaneous pain can also occur in papillitis, but the pain is characterized by persistent pain. The response of the affected tooth to the temperature test can also be transiently sensitive. The patient is more likely to be positioned for pain. During the examination, the nipple of the patient indicated that the nipple was congested and edematous, and the bleeding was detected. The tenderness was extremely obvious. There are signs of food jamming or a history of food impaction between the adjacent teeth. Dental hard tissue damage and other diseases that can cause pulpitis are generally not detected.
4. Acute pulpitis, acute maxillary sinusitis
In the case of acute maxillary sinusitis, the pain in the maxillary posterior teeth of the affected side may be similar to that of pulpitis. However, the pain that occurs in acute maxillary sinusitis is persistent pain. The maxillary canine and molars on the affected side can be affected at the same time, causing pain in two or three teeth. The tooth that can cause pulpitis cannot be detected. Tissue disease, the tooth response to the temperature test is the same as the control tooth. The anterior wall of the maxillary sinus can be examined for tenderness. At the same time, the patient may be accompanied by symptoms of upper respiratory tract infection such as headache, nasal congestion and purulent sputum.
5. Chronic pulpitis, dry socket disease
Patients with dry trough have a recent history of tooth extraction. Check that the alveolar fossa is empty, the bone surface is exposed, and an odor is present. Although the adjacent teeth of the extraction socket can also have cold and heat stimulation and pain, but there is no clear indication of pulp disease.
