Gangrenous pulpitis: how dangerous pathology proceeds and how it can be combated

  • Gangrenous pulpitis: how dangerous pathology proceeds and how it can be combated

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    One of the most dangerous and neglected forms of pulpitis is gangrenous pulpitis. This disease is characterized by a radical damage to the tooth pulp and the spread of putrefactive inflammatory process. The danger of the disease lies in the fact that against a background of exacerbation gangrene of the vascular-nervous complex can develop.

    The main cause of the emergence and progression of this form of pulpitis is the penetration into the pulp of harmful microorganisms, which can occur against the background of chipping or fracture of the tooth. Also, a provoking factor may be purulent pulpitis, which has progressed into a neglected stage.

    How does the disease occur

    Gangrenous pulpitis is characterized by focal, and then diffuse pulp infiltration. Against this background, a purulent exudate is formed.

    A patient who has this type of pulpitis diagnosed suffers from paroxysmal pain. Most often they occur at night.

    What the patient feels

    The disease has specific symptoms. So, the following symptoms of gangrenous pulpitis are distinguished:

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    1. Appearance of aching pain during consumption of hot foods( cold food, on the contrary, has a calming effect).Unpleasant odor from the mouth.
    2. Change the color of the transition fold.
    3. Flow of the transition fold.

    What the dentist sees

    Do not hesitate to visit an experienced dentist. Otherwise, the consequences can be unpredictable. The dentist examining the client's oral cavity sees the following:

    1. Progression of deep caries.
    2. Filling the exposed dental cavity with decomposition products.
    3. Formation of a specific deposit of gray color on top of the pulp.

    Establish a diagnosis of

    In order to prescribe the correct treatment, the dentist must make sure that the client develops gangrenous pulpitis. To this end, the doctor conducts a radiograph. This method shows an overgrown periodontal gap and splitting of bone tissue.

    The degree of pain that occurs during probing depends on how widespread the gangrenous process is. If the pulp does not respond to the study, then it is hopelessly dead.

    Dental intervention strategy

    Treatment of gangrenous pulpitis involves the vital pulp extirpation, which in dentistry is also referred to as pulpectomy. This is a surgical intervention, which is a radical removal of rotted areas. Indications and contraindications

    Indications for this method of treatment of gangrenous pulpitis is the development of:

    • caries process, flowing on the neck of the tooth;
    • diabetes;
    • of periodontitis;
    • of atherosclerosis.

    Pulpectomy is strictly not recommended in the case of progression of such pathologies as:

    • pathologically elevated pressure;
    • hemophilia;
    • active form of tuberculosis;
    • stomatitis( ulcerative-necrotic).

    From the vital extirpation of pulp should be discarded and in the event that the client is in the last week of bearing a fetus, or suffers from mental disorders.

    Carrying out operation

    To avoid injury of periodontal, treatment of gangrenous pulpitis by vital extirpation does not involve touching the apical opening.

    After the dentist removes the pulp, it carefully processes the root canals by coagulation. This method is the operation of special electrodes, with which the doctor cauterizes the dental nerve. Coagulation can be carried out both before extraction from the root canal of the nerve, and after this.

    Operation of this tool helps to prevent excessive bleeding and increase chances of success.

    If, in spite of the dentist's efforts, the blood flows quite strongly, the decision regarding the root canal filling is taken only after the situation has stabilized and an antiseptic dressing is applied. This is necessary in order to prevent infection.

    Less known methods

    To less common ways to combat gangrenous pulpitis include extirpation and devital methods.

    Use of arsenic paste

    The extirpation method of treating this scourge involves the use of arsenic paste. In view of the fact that progress in medicine is now stepping by leaps and bounds, in adult dentistry this method is practically not used.

    Treatment of the disease is carried out by imposing on the problem site arsenic or paraformaldehyde paste.

    The treatment process is as follows:

    • first the dentist exposes the pulp;
    • then a paste is applied to the actual area;
    • after two days the dentist liquidates the pulp, carries out the treatment of the channels and sealing.

    This method is relevant for children and clients who have crossed the forty-year line and suffer from medium or heavy pulpitis.

    The devital method is used in the treatment only in case of obstruction of the root canals.

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