Elektrovozoremontnij teeth with osteomyelitis

When osteomyelitis very often the excitability of missing teeth. This may be due to: 1) involvement in the pathologic process alveolar nerves with the development of a typical picture neuritis; 2) involvement in the process only one dental nerve *; 3) pulp necrosis due to the strangulation neurovascular bundle tooth and malnutrition pulp, or as a result of ascending infection.
To way of distinguishing neuritis alveolar nerve from necrotic pulp easy. When necrosis pulp elektrovozoremontnij absent only in the teeth located in the lesion; the sensitivity of the mucous membrane (and skin) is not violated. However, keep in mind that neuritis may be combined with necrosis of the pulp. That's why when osteomyelitis involving neuritis, you should never rush into trepanation teeth. It is necessary to closely monitor the dynamics of the process. Shifts in the direction of increasing elektrovozoremontnij already allow to exclude pulp necrosis. Lack of improvement while increasing the sensitivity of the mucous membrane (skin) suggests the pulp necrosis. Here is to illustrate a short extract from the case history.

Patient M was aimed on the study of elektrovozoremontnij teeth of the lower jaw on the right. 13 days ago pain and swelling in the region of the lower right wisdom tooth. The tooth was removed, but the pain and swelling grew. The x-ray picture in the body of the mandible respectively 5-3| visible small pockets of depression.
The sensitivity in the area of innervation of the right chin nerve ** not changed. There was a slight lowering of the surface sensitivity of the gums with vestibular surface from 1 to 3| and the sharp drop from 4 to approximately mid-5| and from the middle of 7| 8|. On the gum section from the middle of the second premolar until the middle of the second molar sensitivity within the norm. Research data of elektrovozoremontnij: 1|-dauletova, 2|-29 MCA, 3| -35 MCA, 4567| - anxiety no.
The result osteomyelitis process emerged neuritis right of nizhnelenskoe nerve; mental nerve, however, have not suffered. The presence of excitability (though reduced) 23| may be due to their innervation from the opposite side. As for the remaining teeth, because of their lack of excitability may be as neuritis, and necrosis of the pulp.
The patient was asked to be on a repeat survey in 2-3 weeks. After 16 days after a course of penicillin therapy was re-examined elektrovozoremontnij: 2|-6 MCA, 3|-7 MCA, 4| - 10 m, 5|-mkA, 67|-anxiety no. Thus, in all teeth except 67|, elektrovozoremontnij restored. Sensitivity gums also recovered. Phenomena neuritis, nizhnelenskoe nerve passed, necrosis of the pulp 67| no doubt.

* It's certainly difficult to imagine isolated defeat dental nerve. Undoubtedly, the process involved and the vessels, and the fabric of the pulp. However, in some cases suffering dental nerves is dominant. So when the pathological process dies down, the excitability of the tooth is restored, which, of course, eliminates the need to Traunreut such teeth.
** As you know, the violation of the sensitivity of the skin half of the lower lip and chin to denote "a symptom Vincent". It is usually not even associate with neuritis, nizhnelenskoe nerve or its branches - chin nerve. Specified decreasing sensitivity may be due to the isolated defeat chin nerve. However, there are cases (such as those described), when, despite the defeat of nizhnelenskoe nerve, its branch - mental nerve - little or even no suffering.