Acute periostitis: symptoms and treatment
Acute periostitis is an acute inflammatory process that can be triggered by streptococci and staphylococci. Pathology can affect the diaphysis of long tubular bones and ribs, but the most common is acute periostitis of the jaw (upper or lower).
In view of the fact that the periosteum is closely connected with bone and surrounding tissues, this pathological process is often complicated by inflammation of bone tissue.
Clinicians note that acute periostitis of the trunk and extremities in an isolated form is rare. In the case of this form of pathology, orthopedists and surgeons are engaged in treatment.
In most cases, a periostitis of the lower or upper jaw is diagnosed, which with common people is called flux. In such a case, consult a dentist who will conduct the examination and prescribe an effective treatment.
Treatment is prescribed by a physician only after carrying out all the necessary diagnostic measures, which may include laboratory and instrumental methods of investigation. Elimination of pathology can be carried out both conservatively and radically.
According to the international classification of diseases of the tenth revision, acute periostitis has its own separate code, according to the ICD — 10 K10.2.
The etiology of this disease will depend on the localization of the pathological process, so it is rational to single out the factors separately for the damage to the bones of the trunk and jaw.
In the first case, the provoking factors are the following:
- injuries in the area of those places that are «not covered» with soft tissues. This includes the area of the radius, shoulder, elbow and tibia;
- direct injury of the periosteum
- erysipelas, purulent wounds, abscesses — in this case the pathological process will be caused by the transition of infection from neighboring affected tissues
- Complication after a common purulent process.
However, it is noted that this form of the disease is extremely rare.
Most often, periostitis of the upper jaw or acute odontogenic periostitis is diagnosed, which can be caused by the following etiological factors:
- complication of periodontitis, which is the most common cause of pathology
- ingress of infectious microorganisms into the oral cavity wounds
- neglected dental diseases;
- improper teething;
- complications after improperly performed dental operations
- open fractures of the upper or lower jaw;
- complication after tooth extraction, if before that person suffered acute respiratory infection, angina of viral etiology
It is also necessary to identify predisposing factors for the development of acute periostitis:
- weak immunity;
- frequent and prolonged hypothermia
- acute shortage of vitamins and minerals in the body
- frequent stress.
It should be noted that most often the cause of the flux is inflammatory diseases of the teeth, dental diseases in neglected form.
There are following forms of development of this acute inflammatory process:
- acute serous periostitis
- acute purulent periostitis of the jaw;
- ossifying periostitis in acute form
Determine exactly which form of the ailment there is to be, perhaps only a qualified physician after carrying out all the necessary diagnostic measures. Self-medication can lead to serious complications.
The clinical picture will depend on the area in which an acute inflammatory process develops. If the bones of the trunk are affected, the following clinical picture may be present:
- focal elevation of the affected bone
- at the site of the localization of the disease the skin may be inflamed — redness, swelling, local temperature increase
- pain of a spontaneous nature
- With palpation, pain is only increased.
If the inflammatory process has passed into purulent, then the following symptoms will join the general clinical picture:
- sharp toothaches that can bother the patient even in a state of complete rest
- Significant soft tissue swelling in the localization of the pathological process
- increase in body temperature;
- signs of general intoxication of the body, which are expressed in weakness, nausea and vomiting, drowsiness and headache
- the tuberosity will be felt in the lesion area
- Pain increases dramatically when palpation
In addition, regardless of the form in which the disease occurs, there will be limited movement and reduced physical activity.
Acute odontogenic periostitis is characterized by the onset of the inflammatory process from the root of the tooth. If at this stage therapeutic measures are not initiated, then the disease goes into a purulent form.
The clinical picture of acute purulent odontogenic periostitis of the upper or lower jaw is characterized as follows:
- pain of intense, pulsating nature, which can irradiate in the eye, ear, temporal lobe
- When contacting hot food the pain intensifies, has a sharp, piercing character. When you use cold fluid, on the contrary, the pain subsides;
- As the ailment worsens, pain can disturb the patient even in a state of complete rest;
- subfebrile body temperature;
- weakness, general malaise
- Impairment or total lack of appetite
- soft tissue swelling
Puffiness of soft tissues is localized on the basis of the following factors:
- In the inflammatory process in the area of premolars — swelling of the lower part of the cheek
- pathology in molars — puffiness is observed in the upper part of the cheek, with a shift closer to the cheek and ear
- when the upper incisors are damaged — the edema of the upper lip with spreading to the nose
Swelling of soft tissues may indicate that a purulent process has begun. This complication is extremely dangerous, since purulent exudate can spread through wounds or ulcers throughout the body.
In some cases, the capsule with purulent exudate spontaneously opens, which entails an improvement in the patient’s well-being and the elimination of acute symptoms. However, we should not regard this as a complete recovery, as the inflammatory process continues in the tooth itself, which means that at any time a relapse of the disease with a more intensive clinical picture may occur.
The program of diagnostic measures will depend on the localization of the inflammatory process. If there is an acute periostitis of the bones of the trunk, then consultation of such narrowly qualified specialists as:
- infectious disease
If acute periostitis is observed in the oral cavity, then consultation of the dentist and maxillofacial surgeon is required.
Diagnosis of the disease is based on clinical manifestations and collected during the initial examination of the anamnesis. The basis of diagnosis is radiography, however, the expediency of such a survey takes place only two weeks after the onset of the inflammatory process. It is due to the fact that until this time the radiographic examination will not show any pathological changes.
Treatment can be carried out both conservative and radical methods. It should be noted that conservative therapy can be used only if the purulent process has not started. In the latter case, urgent medical intervention is required.
In acute periostitis of the bones of the trunk, drug therapy may include the use of such drugs:
- antibiotics if the infectious nature of the disease is established;
- Non-steroidal anti-inflammatory drugs
In addition to medical treatment, a physician can prescribe the following physiotherapy procedures:
- electrophoresis with calcium chloride
- warming compresses
The question of hospitalization is decided on an individual basis. However, if surgery is not required, treatment can be done at home.
In the inflammatory process of the odontogenic type, drug therapy will include preparations of this spectrum of action:
If the serous form of the inflammatory process is diagnosed, then the medical measures are as follows:
- nerve removal
- Wash the wound with special antiseptic solutions to prevent the development of the infection process
- antibiotic therapy — if necessary.
With a purulent form of the disease, therapeutic measures are identical, however, the physician can additionally prescribe physiotherapy procedures. If progression of the disease is observed, the tooth is removed, and the wound itself is washed and drainage is carried out.
If therapeutic measures are carried out in time, then serious complications can be avoided, the outlook is favorable. In the opposite case, this inflammatory process can lead to serious complications.
As a prevention, it is appropriate to apply the following recommendations in practice:
- timely removal of all dental diseases and infections in the body
- strengthening of immunity;
- prevention of dental diseases of infectious nature
- Exclusion of self-treatment, especially if there is swelling of soft tissues
In addition, you need to systematically undergo a preventive check-up with a narrowly qualified physician.