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ERRORS AND COMPLICATIONS WHEN TREATING PULPITIS
Ilkhomjonova Sevara Tulkinovna
Abdullaeva Parizoda Rustamovna
Akhmedov Dilshod Khabibulloevich
Zoirov Tulkin Elnazarovich
Samarkand State Medical University
Department of Therapeutic Dentistry
https://doi.org/10.5281/zenodo.14842252
Abstract.
Inflammation of the dental pulp is a common disease
encountered in the practice of a dentist. According to various authors, in the
structure of dental care in terms of visits, patients with pulpitis range from 14 to
30%. This article discusses errors and complications in the treatment of pulpitis.
Key words:
Pulpitis, tooth canals, microorganism, outer layer of tooth
protection, blood poisoning.
Pulpitis is an inflammatory reaction of the bundle of vessels and nerves
located under the enamel and dentin of each tooth. Living tissue feeds the pulp,
but becomes extremely vulnerable as soon as caries overcomes the hard tissue
of the enamel. Also, pulpitis with injuries, blows that occurred with a fracture of
the dental crown. Errors and obligations when pulpitis exits are directed due to
the incorrect rotation of the tooth.
The main reason for the development of pulpitis is the destruction of the
outer protective layer of the tooth. Hard tissues protect the pulp from the
penetration of various bacteria, which provoke inflammation. As soon as the
protective layer disappears, the internal cavity is immediately attacked by
microorganisms. Less often, pulpitis occurs as a result of blood poisoning.
Microorganisms enter the pulp through the blood vessels, causing inflammation
Focal pulpitis is the initial stage of the disease. It is characterized by the
initial processes of the pulp and a small degree of its damage. The main
symptoms are toothache from various irritants, which intensifies at night. At this
stage of the disease, there are high chances to cure it without complications. If
you detect the first signs of pulpitis, you should immediately visit your dentist.
Only timely diagnosis of the disease and its treatment will allow you to save the
tooth and avoid complications. Their development is associated with the
infectious nature of the disease. If you neglect pulpitis and allow it to develop,
complications such as sepsis or brain abscess are possible.
It occurs as a result of the development of inflammatory processes and the
formation of abscesses. It is characterized by complete damage to the inner part
of the tooth. With diffuse pulpitis, pain is felt constantly or infrequent severe
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attacks. In addition to the tooth, the pain spreads to the ear, jaw, temples. The
pain intensifies under the influence of high temperatures. When cooled, it
subsides. The danger of this type of pulpitis is the risk of developing a chronic
form.
The chronic form of pulpitis is divided into four types: fibrous, gangrenous,
retrograde, hypertrophic.
Fibrous pulpitis is the first stage of the development of the chronic form of
the disease. It is characterized by the death of nerve tissue. Because of this, the
intensity of pain decreases. At this stage, the patient may mistakenly believe that
the disease goes away on its own. However, if measures are not taken to treat
the disease, the processes of complications begin, as a result of which the pulp
will have to be removed. In especially advanced cases, complete surgical
removal of the tooth and its replacement with a prosthesis is allowed. The
retrograde form is characterized by the development of periodontal pockets - an
accumulation of bacteria in the root of the tooth. This provokes their
development and spread to other parts of the human div. Depending on the
location of the bacterial sites, various complications may develop. So, from the
upper jaw, complications may go to the brain, mucous membranes of the nose or
prenasal sinus. Destruction of the jaw, inflammation of the gums is possible.
From the lower part, the throat and gastrointestinal tract often become
inflamed. The danger of this form lies in complications on the bone tissue of the
jaw. The development of destructive processes in the bone tissue of the jaw and
other healthy teeth is possible.
The main symptom of the disease is a sharp throbbing pain in the
tooth. It occurs due to temperature changes, exposure to alkalis, acids, or tactile
contact with the inflamed tooth. These are common symptoms. The disease has
several stages: acute and chronic. The acute stage is divided into two types: focal
and diffuse.
Pulpitis is treated in two ways: conservatively and by amputation. The
conservative method is used in cases where the disease is just beginning to
develop. With this method of treatment, the tooth can still be saved by
completely removing the inflammation. It is used in the focal and diffusion
stages of the disease. The conservative method of treating pulpitis consists of
getting rid of caries (if any), cleaning the inner cavity of the tooth from infection
and installing a filling.
Inflammation is removed using medications: pastes, enzymes.
Preparations based on calcium hydroxide.
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Anti-inflammatory pastes and proteolytic enzymes are used to
eliminate inflammation. They are placed on the bottom of the tooth and covered
with a filling. At the same time, the canals are cleaned. Proteolytic enzymes
relieve swelling, inflammation, and prevent the development of tissue necrosis.
Calcium hydroxide enters the dentin tissue, stimulating its growth and
protecting the pulp from bacteria. However, conservative treatment of pulpitis
can cause complications in chronic forms, since their treatment is carried out
only by removing the pulp.
There is a complete and partial method of amputation treatment of
pulpitis. With the vital method, the pulp is completely removed, the canals are
cleaned, and the formed cavity is filled. This method allows you to preserve the
hard layer of the tooth with proper surgery and care. This will preserve the
chewing functions of the tooth and the aesthetic appearance of the oral cavity.
However, such a tooth is demanding in care. The operation itself is carried out in
just one visit to the dentist's office.
Devital or partial pulpitis treatment is prescribed when it is not
possible to completely remove the pulp. This is usually due to the small width of
the canals. In this case, the pulp is removed in places where it is possible, and the
rest is mummified. Affected areas of the tooth that cannot be removed surgically
are treated with a special antibacterial paste to prevent the development of the
disease. The removed areas are covered with a filling. This method can prevent
the development of complications and save part of the tooth.
The basis for preventing any disease is its prevention. In the case of
oral diseases, you should take care of dental hygiene. Note the signs of the
development of any possible diseases. Conduct regular examinations in dental
offices. Use a suitable toothbrush to prevent damage to the gums and the
development of their infection.
If any pain occurs in the teeth, you should check with a dentist. Timely
detection of the disease is the key to its successful treatment. In the case of
pulpitis, this will save the tooth and its functions. Regular check-ups will also
help to avoid the development of complications and chronic forms of oral
diseases.
For teeth with significant changes in periapical tissues, microsurgical
tooth-preserving operations are indicated. It is necessary to know what errors
and complications can occur at each stage of pulpitis treatment.
References:
1. Therapeutic dentistry. Part 1. Dental diseases / edited by E.A. Volkov and O.O.
Yanushevich. – Textbook. – M., “GEOTAR – Media”, 2013 – 236 p.
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2. Therapeutic dentistry / edited by prof. E.V. Borovsky. Textbook. – M.: Medical
information agency, 2011 – 800 p. – ISBN 978–5–8948–1726–2.
3. Maksimovsky Yu.M., Mitronin A.V. Therapeutic dentistry. Guide to practical
classes. Study guide, M.: GEOTAR Media, 2011 – 459 p.
4.https://ls-stom.ru/informatsiya-dlya-patsientov/lechenie-pulpita-i-ego-
oslozhnenij
5.https://drlopaeva.ru/blog/therapy/lecheniye-zubov/oshibki-i-oslozhneniya-
pri-lechenii-pulpita-zuba
