Red and swollen pads after grinding
Introduction
Introduction After the molar pad: for the soft tissue covering the triangular surface of the molar, the third molar of the mandibular periarthritis, the pad after the molar is often red and swollen.
Cause
Cause
First, because human beings are gradually shortening in the process of evolution, the third molars lack sufficient space to erupt when they erupt, which means that the crown is only partially erupted or the position of the teeth is skewed, and a few teeth are completely Buried in the bone, that is, the third molar is blocked.
Second, because the third molar crown that is blocked or erupting is covered by the gums or the whole, it forms a deep blind band, and the food residue is not easy to remove after entering the blind band. The temperature and humidity in the crown band are beneficial to the growth and reproduction of bacteria. When the soft tissue around the crown is subjected to the pressure at the time of tooth eruption, or when it is chewed, it is affected by the occlusal teeth, causing local blood supply disorders, and the Western Jin Dynasty can invade. When the body's resistance is strong, the local symptoms are not obvious. When the whole body's resistance is reduced due to work wholesale, lack of sleep, menstrual period, childbirth or some injuries, pericoronitis can be acute. Pericardial inflammation of the mandibular third molar, which is clinically affected by vertical soft tissue, is most common.
Examine
an examination
Related inspection
Oral endoscopic oral X-ray examination
Pericardial third molar molar pericoronitis - symptoms and signs
In the early stage of inflammation, only the posterior region of the molars is uncomfortable, occasionally mild pain, and the patient has no systemic symptoms. When the inflammation is aggravated, there is a local spontaneous jumping pain that radiates to the ear area. Inflammation affects the masticatory muscles with varying degrees of mouth opening, increased pain during chewing and swallowing, poor oral mood and bad breath. At this time, there are general malaise, fever, chills, headache, loss of appetite, constipation and other symptoms. Blood routine examination showed a slight increase in the total number of white blood cells.
Mandibular third molar pericoronitis - diagnostic examination
Oral examination showed that the third molar of the mandible was incomplete or impaired, and the soft tissue around the crown was red, swollen and tender. The probe can be used to reach the crown under the swollen sacral flap, often with purulent discharge, sometimes forming a periorbital abscess. In severe cases, the side wall of the tongue and throat is red and swollen, and the submandibular lymph nodes in the affected side are severe and tender. According to the medical history, clinical manifestations, oral examination and X-ray films, the correct diagnosis can be obtained. Attention should be paid to the identification of the infection of the first molar, the pain in the posterior molar region, and the pain caused by the abscess around the tonsils. If not treated in time, complications may occur: pericoronitis forms a subperiosteal abscess in the posterior molar region, and the infection may spread to the surrounding space of the river. The following diffusion pathways are included: the infection is forward, and the oblique line is in the cheek vestibule of the first molar. Abscess formed in the ditch, pierced and formed sputum, easily misdiagnosed as the first molar apical infection or periodontal disease; infection spreads between the anterior mass of the masseter muscle and the posterior edge of the buccal muscle to form a buccal abscess, after ulceration The fistula can be formed on the cheeks; the posterior mandibular canal can form a psoriasis abscess or marginal osteomyelitis; infection along the mandibular branch can form a submandibular space, parapharyngeal space or peritonsillar abscess The infection spreads inside the mandibular body, which can form an abscess in the lower sulcus and a cellulitis in the mouth.
Diagnosis
Differential diagnosis
Differential diagnosis of redness and swelling after molars:
1, parotid gland enlargement: parotid gland enlargement is often the first sign of the disease, lasting 7-10 days, often on the side of the first swollen 2-3 days, the contralateral parotid gland also appeared swollen, sometimes swelling only unilateral, or parotid gland At the same time, there is a submandibular gland enlargement, or even a submandibular gland enlargement without a parotid gland enlargement. Pain, chewing, especially when eating acidic foods.
2, painless mass of the parotid gland: basal cell adenoma showed a painless mass of the parotid gland. The tumor grows slowly, has a long course of disease, has no symptoms, and often visits with a painless mass. The tumor has clear boundaries and no adhesion to surrounding tissues. Mostly round or oval, the texture is soft.
Pericardial third molar molar pericoronitis - symptoms and signs
In the early stage of inflammation, only the posterior region of the molars is uncomfortable, occasionally mild pain, and the patient has no systemic symptoms. When the inflammation is aggravated, there is a local spontaneous jumping pain that radiates to the ear area. Inflammation affects the masticatory muscles with varying degrees of mouth opening, increased pain during chewing and swallowing, poor oral mood and bad breath. At this time, there are general malaise, fever, chills, headache, loss of appetite, constipation and other symptoms. Blood routine examination showed a slight increase in the total number of white blood cells.
Mandibular third molar pericoronitis - diagnostic examination
Oral examination showed that the third molar of the mandible was incomplete or impaired, and the soft tissue around the crown was red, swollen and tender. The probe can be used to reach the crown under the swollen sacral flap, often with purulent discharge, sometimes forming a periorbital abscess. In severe cases, the side wall of the tongue and throat is red and swollen, and the submandibular lymph nodes in the affected side are severe and tender. According to the medical history, clinical manifestations, oral examination and X-ray films, the correct diagnosis can be obtained. Attention should be paid to the identification of the infection of the first molar, the pain in the posterior molar region, and the pain caused by the abscess around the tonsils. If not treated in time, complications may occur: pericoronitis forms a subperiosteal abscess in the posterior molar region, and the infection may spread to the surrounding space of the river. The following diffusion pathways are included: the infection is forward, and the oblique line is in the cheek vestibule of the first molar. Abscess formed in the ditch, pierced and formed sputum, easily misdiagnosed as the first molar apical infection or periodontal disease; infection spreads between the anterior mass of the masseter muscle and the posterior edge of the buccal muscle to form a buccal abscess, after ulceration The fistula can be formed on the cheeks; the posterior mandibular canal can form a psoriasis abscess or marginal osteomyelitis; infection along the mandibular branch can form a submandibular space, parapharyngeal space or peritonsillar abscess The infection spreads inside the mandibular body, which can form an abscess in the lower sulcus and a cellulitis in the mouth.
