Dentitio difficilis

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Classification according to ICD-10
K00.6 Disorders of tooth eruption
K00.7 Teeth disease
ICD-10 online (WHO version 2019)

The pericoronitis (from Latin : dentitio , tooth eruption 'and difficilis , cumbersome, difficult') is a more difficult tooth eruption.

Lower milk incisors, about to erupt

Dentitio difficilis in the primary dentition

The eruption of the milk teeth (first (lacteal) dentition , colloquially also teething ) is often associated with painful inflammation of the mucous membrane and increased salivation, in some cases with general disorders such as fever, cramps, bronchitis or gastrointestinal disorders.

Dentitio difficilis in the permanent dentition

Orthopantomogram of a fully edentulous permanent dentition.
Tooth 28 : Distal gingival pocket.
Tooth 38 : Displaced wisdom tooth with "dirt corner" between the teeth.
Tooth 48 : also distal gingival pocket.


Possible consequences:
A = retained wisdom tooth 48 with mesial caries;
B = distal caries on tooth 47, gingivitis in between;
C = inflamed, artificial gingival pocket;
D = elongated tooth 18
Erupting wisdom tooth 48 in a 22 year old woman.
Wound of a freshly extracted wisdom tooth 48 . Secondary finding: tongue piercing

Synonym : pericoronitis (from ancient Greek : περί (peri) , around, around 'and Latin : corona , crown')

root cause

The poor dentition occurs as Dentitionsstörung in the permanent dentition almost exclusively at breakthrough of wisdom teeth on, mainly in the lower jaw . The cause lies in the lack of space for these (last erupting) teeth. The lack of space arose in human evolution through a shortening of the lower jaw body that occurred in numerous people. In the lower jaw, the ascending branch of the lower jaw ( Ramus mandibulae ) often creates a gum pocket on the distal surface of the tooth crown , which is not sufficiently accessible for teeth cleaning. In this artificial gum pocket, bacteria and food particles can accumulate, which lead to a purulent inflammation . This danger exists especially with a displaced or partially retained tooth, whereby other tooth surfaces can also be used as "dirt spots". (See adjacent figure)

Symptoms

therapy

Depending on the severity of the disease, the therapy consists of cleaning the gum pocket and inserting a gauze strip to ensure that the purulent secretion drains off or the gum hood is excised . In the case of an abscess , this must be opened so that the purulent secretion can drain away. At this stage, the indication for the administration of an antibiotic may be given if a jaw clamp , a parulis ( big cheek) or a fever is already present . If there is a risk of recurrence , the method of choice is to surgically remove the tooth after the acute stage has subsided ( tooth osteotomy ).

Individual evidence

  1. ^ A b Joseph Maria Stowasser : Der Kleine Stowasser , Latin-German school dictionary , G. Freytag Verlag, Munich.
  2. ↑ Wilhelm Gemoll : GEMOLL, Greek-German school and hand dictionary , G. Freytag Verlag, Munich.

swell

  • Walter Hoffmann-Axthelm : Lexicon of Dentistry , Quintessenz-Verlag, Berlin
  • D. Haunfelder, L. Hupfauf, W. Ketterl, G. Schmuth et al .: Praxis der Zahnheilkunde, Chapter B-8, pages 11 f. Urban and Schwarzenberg publishing house, Munich - Vienna - Baltimore

See also