Stages of treatment of pulpitis with drugs. Endodontic treatment

Every person in the world faces a toothache, various factors can provoke it. If you do not seek qualified help in time, the consequences of inaction can lead to serious problems, which often end with the removal of the tooth. Very often dentists, when examining another patient, find out that he has a pulpitis. But what is pulpitis? What are the main methods and stages of treatment of pulpitis in children and adults?

Pulpit - what is this pathology?

Pulpitis is an inflammation that affects the vascular-neural bundle (pulp). One of the most common causes of inflammation is caries, which contributes to the destruction of hard tooth tissues. Pathogenic bacteria filling the carious cavity, provoke the inflammatory process of the pulp (in the people it is called the nerve).

Also pulpitis can develop due to poorly performed procedure of filling or traumatizing the tooth. There are several types of pulpitis, each of them requires an ambulance from a specialist. Methods and stages of treatment of pulpitis for each species are selected individually.

Types of pulpitis

In the initial pulpitis form, the pulp reaction to irritation is hyperemia, during which the blood flow in the pulp arteries is significantly increased. The amount of blood inside the cavity increases and thereby creates pressure on the fine fibers of the nerve, which leads to aching pain. After the irritation is removed, the pain immediately passes.

The acute form of pulpitis is accompanied by a strong pain syndrome. If the pulp is not yet very inflamed, then the process can be stopped, in this case the pain immediately goes away. The pulp is cured independently, it is only necessary to remove the causes of irritation.

In the event that the pulp itself is not restored, the pain continues to disturb and becomes even more acute, especially worse at night, then there is no way to do without the help of a dentist. When examined, a tooth is identified with a deep carious cavity and a painful bottom during probing. The stages of pulpitis treatment in this case are selected depending on how much the tooth is affected and if the inflammation has gone further.

The purulent form is one of the heavy ones and is characterized by a sharp pain that intensifies at night and weaken it with anesthetics.

The chronic form of pulpitis is characterized by attacks if an irritant appears, and if it is eliminated, the pain goes away. Dull pain can take a long time. During the examination, a deep cavity with caries and hemorrhage is detected.

Chronic hyperplastic pulpitis is an irreversible form, requiring that serious stages of pulpitis treatment be performed. In children and young people this form is much more common. It is represented by a hyperplastic tissue of the pulp, called the polyp of the pulp.

Necrosis refers to irreversible forms of pathology, it is characterized by the death of pulp, appears after a prolonged bacterial invasion or is the result of an acute purulent pulpitis.

Symptoms of pulpitis

Pulpitis is a very serious disease requiring rapid response and seeking qualified help. If the initial stage of the disease is accompanied by aching pain, which can be eased by taking an anesthetic, then acute and chronic cause the strongest pain syndrome, which increases at night and does not weaken even after taking medication.

During exposure to the tooth irritants - thermal, mechanical or chemical - the pain intensifies. If you do not start therapy in the acute phase of the pathology, you end up with a chronic form that is characterized by pain when you touch the tooth, it becomes stronger when exposed to hot foods, and weakens from the cold. If you do not take any measures and do not begin to conduct the stages of treatment of pulpitis, the inflammation can affect the bone structure of the jaw.

Why is it necessary to treat pulpitis?

If you imagine a person who is constantly busy with problems at work or in the family, then he does not always immediately pay attention to a small pain in the tooth. The first thing he does is take an anesthetic: "Ketanov", "Nurofen", "Ketorolak", "Baralgin", "Naize" - and forgets about the problem. But over time, bacteria that remain in the pulp chamber of the tooth continue to destroy it and eventually lead to the appearance of pus in the root canal.

After the pus leaves the root canal, a flux appears, and it can manifest not only in the form of a small swelling of the gum, but also in the form of a strong swelling with a strong symmetry breaking. Severe forms of pathology require serious steps to treat pulpitis, otherwise it can threaten not only tooth loss, but also pathologies such as phlegmon, blood infection and bone tissue damage.

The main stages of endodontic treatment

The initial form of pulpitis can be cured very quickly, just one reception at the dentist, but in serious forms requires a long treatment for pulpitis of the tooth. The stages of therapy will require the patient to take several appointments from the doctor, and each of them is designed to relieve pain, to disinfect the tooth cavity and others, but everything in order. When treating the root canal, it is important to follow the steps:

1. Stages of treatment of pulpitis, the photo confirms this, begin with anesthesia, the doctor isolates the tooth from saliva, using a thin sheet of rubber - a cofferdam, which puts a tooth around the diseased.
2. Further, the canal is cleaned of bacteria. Access to the channel is provided by dissection of the carious cavity, removal of the roof of the pulp chamber, creation of free access to the channels for the instrument.
3. Cleaning the channel implies mechanical and chemical disinfection.
4. Further processing of files along the entire length of the root canal, but not beyond it, is therefore very important to determine the length of the channel, for this, first insert the files, and then do X-rays.
5. Chemical disinfection doctor carries out special needles of one-time use.
6. After the channel has been completely cleared, the doctor begins filling.

Sealing is the last action of the dentist, which completes all stages. But this treatment does not end there, the doctor still recommends carrying out some procedures that will effectively cope with inflammation and help protect against relapse.

Appointments after the first stage of treatment

After the doctor has carried out the treatment of pulpitis, the stages of it are finished, you will need to take drugs and procedures for a few more days at home:

• Physiotherapy is the use of a laser, in this case it is best to carry out the procedure on a helium-neon apparatus. It will be enough only a few procedures to fix the therapeutic effect and prevent a relapse.
• Reception of medicines. Since pulpitis is an inflammation, it is simply necessary to undergo a course of non-steroidal anti-inflammatory drugs, such as "Ibuprofen", to completely eliminate the inflammatory process.

It is very important to monitor the patient, for example a child, after all stages of treatment of pulpitis of infant teeth have been performed, it is very important to monitor his condition, and if there are complaints, then it is urgent to see a doctor. The child can not always determine for himself what is happening to him, so the doctor advises parents to observe him or simply come to a control reception, after a few days.

The method of vital amputation in pulpitis

There are several methods for treating pulpitis, one of which is vital amputation, which involves the preservation of pulp only in the canals of the tooth, but in the area of the crown it is removed. This technique is undertaken in the event that a multi-rooted tooth is affected. This method is not used for single-root tooth therapy, but all because there is no border between the coronal and root zones of the pulp. This technique consists of the following stages:

• Local anesthesia is performed;
• The areas affected by caries are removed;
• The pulp is removed;
• The tooth cavity is treated with medicinal preparations;
• A medicinal pad is applied to the canal;
• Then an insulating overlay is applied;
• temporary filling.

After this procedure, the doctor also recommends taking laser and anti-inflammatory medications.

The method of operative treatment of pulpitis

There are several methods for the therapy of pulpitis, including the operational approach. This method involves removing the nerve, and this occurs both in the crown and root zones. This method is called depulpation. It is used in neglected forms, in which it is required to take all measures to begin treatment of pulpitis, the stages are made up of such manipulations:

• All tissues affected by caries are drilled;
• The nerve is removed in the crown and root parts;
• The channels where the nerve was located are carefully handled;
• After the canals are sealed, and after that the coronal part.

It should be remembered that at one time the doctor will not be able to carry out all the procedures at once, so you need to be prepared for the fact that there will be two visits, maybe three.

And now we will consider in more detail all the stages of treatment.

Stages of pulpitis treatment: first visit to the doctor

So, to accurately understand all the stages of pulpitis treatment, you need to know how everything is going and how the dentist is treating:

1. Most often the patient looks for help at the very moment when he is worried about severe pain that does not stop even after taking pain medications, so immediately the doctor makes anesthesia.
2. After the injection has worked, they begin to remove the tissues affected by caries by using a drill for this, which allows them to drill them.
3. After this, you need to install a cofferdam so that the saliva with the bacteria does not get into the cleaned channel.
4. Then the pulp extractor is removed by the pulp extractor, this tool is very thin and with small notches that help to pull the pulp out of the thin channel.
5. Next, you need to accurately measure the root canal in order to completely fill it and thereby protect against complications. To do this, do X-rays, canals at the tooth may be several, which means that you need to measure each.
6. After processing all channels with antiseptic solutions and establish a temporary seal.

On this first visit will be completed, although very often not always the first time you manage to do it all, the first method can end with anesthesia, reaming channels and packing drugs in them to kill the sensitivity of the nerve.

Subsequent and final visits

But the second visit to the doctor provides such stages of treatment of pulpitis:

• The doctor removes the temporary seal, and then the medicine from the canals.
• Then the channels are washed with antiseptics.
• A seal is fixed, for this purpose gutta-percha pins and a siler are used.
• After an X-ray is carried out to check how well the channels are sealed.
• If the X-ray showed that everything is good, then you can put a seal.

But not only adults suffer from pulpitis, it also often worries children who do not yet have molars, but only dairy teeth. Treatment of pulpitis in children of infant teeth has stages Simple, only partially similar to the treatment of indigenous. But parents should remember that inaction and untimely treatment can lead to complications.

The stages of treatment of pulpitis of infant teeth in children

Often, the child's pulpitis occurs in severe form, so in this case the doctor can recommend the removal of the milk tooth, but still if there is even the slightest possibility to keep it, while the bite will not suffer, then proceed to treatment. Stages of pulpitis therapy of infant teeth:

1. On the first visit, the doctor opens the nerve and applies a paste that has a devitalizing effect, it helps to kill the pulp. If it contains arsenic, then it can be kept for no more than 2 days, and the means without arsenic can be kept for up to 7 days.
2. In the next visit, a special substance is injected into the tooth for the mummification of the infected pulp, most often a resorcinol-formalin mixture.
3. The last visit is a permanent seal.

Treatment of pulpitis is a simple procedure if you seek help from a doctor in time. Moreover, thanks to modern technologies and effective means, a tooth can be cured very quickly today.

Do not sit until the last moment and wait until the pain becomes completely unbearable, it is better to visit the dentist regularly, then you will not have to endure the pain and remove the tooth.