Vincent Symptom: Diagnosis
In medical practice, along with a description of the pathology of the oral cavity, the concept of Vincent's symptom is often encountered. What is this condition, at what inflammatory process does Vincent's symptom arise and what is the favorable ground for the occurrence of such a pathology? We will deal with these issues in our article today.
What is this symptom?
The symptom of Vincent is a condition in which a person loses sensitivity in the chin area, more precisely - in the area of the lower lip. Symptom is a consequence of various disease states of the body, such as osteomyelitis of the jaw and acute apical periodontitis. This pathology is also mentioned in ulcerative plethora angina, the second name of which is angina of Simanovsky-Vincent( symptoms of pathology are quite diverse).
Let us consider in more detail each of the pathologies that lead to the manifestation of the above-described symptom.
Ulcerative plethora is a disease that leads to inflammation of the palatine tonsils. The cause of the pathology is the activity in the body of the spindle-shaped Plaut - Vincent with spirochete Vincent. With sore throat, ulcers with a characteristic dirty-green bloom are formed. The patient's breathing is accompanied by putrefactive odor. I must say that such bacteria are constantly present in the oral cavity of a healthy person, but under the influence of various factors, for example, in the caries of molars, with the presence of foci of necrosis in the oral cavity, and with a general weakening of immunity, microorganisms are activated, and their activity leads to the development of pathologicalstates.
Angina Vincent. Symptoms and treatment
Ulcerative-film angina is manifested as a whole complex of characteristic symptoms. These include:
- Increased amygdala. Mostly the disease affects one of the parties.
- Increased and moderate soreness of regional lymph nodes.
- Formation on mucous membranes of palatine tonsils of grayish-yellow plaque, which can cause the formation of superficial painless ulcers with a grayish bottom. If the pathology progresses, ulcers occur in other parts of the pharynx, as well as on the mucous cheeks or gums. Sometimes ulcers can heal without creating any defects.
- When eating food( when swallowing), there are painful sensations, while patients noted increased salivation, bad breath.
- The body temperature in pathology rarely rises above normal limits, although sometimes the disease can begin with a high fever and a state of chills.
- Numbness and loss of sensation in the chin area.
Treatment of pathology is aimed at eliminating the inflammation of the mucous membrane of the throat. Often doctors-otolaryngologists prescribe means for rinsing or lubricating the area of the lesion. In the case of a protracted course of the disease resort to antibiotic therapy. Patients with ulcerative-filth angina are always isolated, with severe forms of pathology - they are hospitalized. The main principle of disease prevention is strengthening the body's protective functions and increasing immunity. Symptom Vincent in dentistry. Periodontitis
Periodontitis is a pathology caused by infection from a carious cavity into the bone tissue through the tip of the root. The disease causes inflammation of the dental root. In the absence of treatment, periodontitis manifests itself in various signs, including Vincent's symptom. Reversibility of the disease depends on many factors: the timeliness of seeking medical help, the general condition of the human body, etc. Consider the mechanism of the origin of pathology.
Deep caries leads to pulpitis - inflammation of the pulp, as a result of which microorganisms enter the periodontium through the root canal. There are also other ways of penetration of bacteria into bone tissues, for example due to injuries, with sepsis, however pulpitis is the most common cause of inflammatory processes in the bone. When inflammation occurs sweating fluid, and periodontium - tissue, saturated with receptors, - responds to an increase in pressure. In this case, inflammation causes pain.
A characteristic feature of periodontitis is the increasing pulsating pain, which is strictly localized. Sometimes when the teeth are closed, pain is difficult to endure, patients can not eat. It is painful for a person to simply touch the tooth edge, which also becomes mobile, the gum around the tooth, and also the lip and cheek, swell up, the body temperature rises sharply. A concomitant symptom of periodontitis may be a symptom of Vincent. Signs of it have already been noted earlier: numbness and loss of sensitivity of tissues in the region of the chin.
Forms of periodontitis
Distinguish acute and chronic form of periodontitis. If inflammation forms the fluid through the root canal of the tooth, periodontitis acquires a chronic form. The pain syndrome is not very pronounced, but the pathological processes in the apex of the tooth flow slowly. Bacteria, multiplying in the area of the affected bone, secrete toxins that "poison" the human body and lead to the development of diseases of various organs and systems( joints, heart, kidneys).
In the opposite case, development gets an acute form of periodontitis, which with time, in the absence of proper treatment can go into a purulent stage.
The above forms of periodontitis require a long and highly qualified treatment. The main goal of therapy is to provide an outflow of pus from the site of inflammation localization. In the process of treatment, the inflammatory process is first stopped, then an antiseptic treatment of the pulp is carried out, then a temporary seal is established. During the therapeutic activities, the bone tissue is monitored by means of radiography.
In the treatment of chronic periodontitis, medicament preparations are used that stimulate the restoration of periodontal disease. Concomitant methods of treatment can be physioprocedures: electrophoresis, UHF-, microwave, laser therapy, magnetotherapy. In some cases, antibacterial treatment is used.
Antibiotics can be used topically in the case of the formation of deep periodontal pockets. Seeding of the root canal is performed by materials that are selected individually in each specific case.
If the inflammation affects extensive tissue sites, or conservative therapy does not result in the proper result, surgical intervention is performed. The aim of manipulation is resection of the tip of the tooth root. A small incision is made in the gums in order to gain access to bone tissue. Further, the affected structure is removed, the tip of the canal is sealed. Regeneration of the bone is a long process. If the treatment does not lead to positive dynamics, the tooth may be removed.
In order to avoid the development of such a disease, you must carefully monitor oral hygiene. This involves an obligatory daily two-time brushing of teeth. In this case, the toothbrush should be periodically changed, scrupulously approach the choice of toothpaste. At least once a year, go to the dentist for a professional procedure for removing tartar.
The dentition of the dentition leads to the fact that the remaining teeth in the mouth are under an increased load. Molars become vulnerable, an inflammatory process can develop in the oral cavity, which in the future will lead to periodontitis.
Periodontitis is a rather insidious disease, because it causes a number of complications, including acute sepsis, inflammatory processes of the facial soft tissues, osteomyelitis of the jaw.
What is osteomyelitis?
Another reason why Vincent's symptom occurs is osteomyelitis. This pathology, regardless of which part of the human skeleton is manifested, belongs to the group of infectious diseases of an inflammatory nature.
In osteomyelitis of the jaw, all tissues are affected: periosteum, bone substance, bone marrow. Pathology occurs primarily in people no older than forty. However, there are cases of the development of the disease in children, as well as in elderly people. Everything depends on how badly the teeth of a person are affected by caries. Equally, osteomyelitis worries both men and women. Vincent's symptom in osteomyelitis affects the area of the chin, and this is due primarily to the fact that the pathology often affects the lower jaw, rather than the upper one.
Earlier, when oral hygiene was not given proper attention, osteomyelitis of the jaw occupied about 40% among the pathologies of other bones. Not so long ago the situation changed for the better.
Today, due to the widespread planned sanation of the oral cavity in both children and the adult population, the percentage of patients with osteomyelitis of the jaw dropped, and the use of antibiotics allowed making the course of the disease less severe.
Classification of osteomyelitis
In most cases, the osteomyelitis of the jaw is a consequence of tooth decay, as well as a complication after periodontal disease. This group of osteomyelitis is called odontogenic( dental).The infection enters the bone structures through caries affected by caries. In the foci of inflammation there is a diverse microflora. This is streptococcus, and staphylococcus aureus( white and golden), pneumococcus and other bacteria.
Contact osteomyelitis is a pathology that occurs due to infection of the skin or mucous membranes( for example, in the face boil).There are specific osteomyelitis:
Sometimes the damage to the bone marrow of the jaw occurs by getting bacteria with a blood flow. This condition is classified as hematogenous osteomyelitis, which occurs after infections such as influenza, typhoid fever, scarlet fever, measles.
A separate group consists of osteomyelitis, which resulted from a trauma( fracture, severe bruise).Vincent's symptom in fractures, when sensitivity is broken in the region of the chin nerve, and patients notice the numbness of the lower lip, arises from the compression of the lower lunar nerve, formed during inflammation with exudate.
The course of the disease
The course of the disease can be different, and most often it depends on the state of the body as a whole, on the magnitude of circulatory disorders in the area of the lesion. In some cases, the scale of bone necrosis is small, due only to the primary focus. In such cases, we are talking about limited osteomyelitis. If the disease progresses, the inflammatory process is transferred to the surrounding jaw soft tissue. This condition can manifest as a periostitis or phlegmon. Phlegmon is an acute purulent inflammation of the spaces( often soft tissues), which is diffuse and has no clear boundaries, such as an abscess. By the way, often a symptom of Vincent can be observed with phlegmon, patients note a loss of sensitivity in the affected area.
At the beginning of the pathological process, the bone marrow at the point of inflammation acquires a brown, dark red color. Later, purulent foci are formed, which merge into entire cavities. The pus enters the periosteum, the gum and causes the necrosis of the jaw areas. There are sequestrations. In small blood vessels there are thrombi that undergo melting. In the bone appear areas of bone necrosis, blood supply gradually decreases, which leads to an increase in the scale of necrosis of the bone structure. The magnitude of sequestration is determined by the size of the thrombosed vessels. In particularly difficult cases, necrosis of the entire jaw may occur. Similar conditions are associated with diffuse osteomyelitis.
There are several forms of pathology. In the period of subacute osteomyelitis, there is a so-called shaft between the healthy bone and the dead one. In some cases, resorption of the sequester is observed. There can be regeneration processes - a new bone structure is formed around the lesion zone. In the opposite cases, sequestration is observed. Subacute form is borderline between acute osteomyelitis and chronic.
During the period of acute osteomyelitis, an active development of the inflammatory process takes place. Patients note strong pain in the jaw( drilling, shooting), which develop against a background of high fever, chills, rapid breathing and pulse. In addition to pain in the jaw, the sensitivity of the lower lip may be lost - this is how Vincent's symptom manifests in osteomyelitis. After a few days after the onset of the disease, the teeth adjacent to the diseased tooth acquire mobility.
Palpation of the jaw reveals swelling and is accompanied by painful sensations. There is inflammation and swelling of the gums, cheeks or other areas on the face. During the period of the disease, the lymph nodes increase. In the future, all these symptoms can be accompanied by trism - the reduction of jaw muscles, numbness( Vincent's symptom).Reversibility of the disease depends on the timeliness of diagnosis and further treatment.
The general condition of the patient is classified into conditionally light, medium and severe. Unfortunately, sometimes the illness ends in a lethal outcome in the period of several days from the moment of the onset of the pathological process.
It is well known that at first the patients may seem vigorous, but soon the state of euphoria is replaced by a decline in strength with a sharp drop in blood pressure and an increase in heart rate. The appearance of a person changes dramatically.
In case of diffuse osteomyelitis, progressive inflammation of new bone sites occurs. The patient's condition can be characterized as unstable, with temporary improvements and deteriorating health, during which the body temperature can first recover, and then rise again and be accompanied by repeated chills. The stage of acute diffuse osteomyelitis can last up to four weeks. In this case, a sharp decrease in the lymphocyte content in the blood( up to 15% -18%) is observed, in the urine there is a protein.
The chronic form of the disease in the absence of medical measures can last for months, and sometimes even for years, and lead to the emergence of various complications: lung abscesses, the formation of suppurations in the cerebrospinal sinuses, acute and chronic lesions of the kidneys.
Diagnosis and treatment of
Radiography is one of the methods in diagnosing osteomyelitis and helps to determine the extent of damage to bone structures. However, the initial changes in the bone can be considered only on the 7-10th day after the onset of the disease. The first thing that is determined by a snapshot is the areas of rarefaction in bone structures. Further, if the course of the disease can be suppressed, the radiograph reveals the resulting boundaries between the healthy and dead tissue. By the size of this boundary, one can draw conclusions about the size and location of sequestration. In addition to radiography, a general picture of the condition of the human body and the analysis of accompanying symptoms, including the Vincent symptom, help to identify the disease.
Treatment of osteomyelitis involves the comprehensive use of antibiotics and surgical intervention. Often, as a conservative treatment, penicillin injections, streptomycin or biomycin are prescribed. With antibiotic therapy, however, it is important to remember the ability of bacteria to become addicted to drugs.
Drug treatment is important to continue for 7-10 days even after lowering the temperature to normal values. Otherwise, the disease will be hidden. Often the fate of the tooth, due to the illness of which inflammation has arisen, is decided unequivocally - it must be removed. Although there are exceptions to the rules.
Neighboring teeth are trying to save, restoring their functionality. To do this, use wire bars, which are installed on the entire dentition. In addition, the inflammation of the pulp in the teeth is also, if possible, eliminated. Movable sequestrants are subject to surgical removal, which is carried out no earlier than 4-6 weeks after the onset of the disease. This is primarily due to the fact that only after this period the borders of the sequester are clearly distinguishable. Thus, the Vincent symptom is one of the main signs of development in the human body of serious inflammatory diseases, including osteomyelitis, periodontitis, Simanovsky-Vincent's angina( the symptoms of this particular form of the disease are distinguishable from the general symptomatology of angina due to the manifestation of Vincent's symptom).