2 English reference periodontitis [National Guidelines for Clinical Application of Essential Drugs: 20 12 Edition]. Chemicals and biological products]
Arthur Dentistry [Landau Chinese-English Dictionary]
Fouchard's disease [Landau Chinese-English Dictionary]
Periodontitis of gingiva [Landau Chinese-English Dictionary]
Alveolar periostitis [Landau Chinese-English Dictionary]
Landau Chinese-English dictionary
Periodontitis [Landau Chinese-English Dictionary]
Periodontitis [Landau Chinese-English Dictionary]
Periodontitis [Landau Chinese-English Dictionary]
Osteomatous parotitis [Xiangya Medical Dictionary]
Exploratory gingivitis [Xiangya Medical Dictionary]
Periodontology [Xiangya Medical Dictionary]
3 Western medicine periodontitis is a chronic infectious disease caused by microorganisms in dental plaque, which leads to inflammation and destruction of periodontal supporting tissues [1].
3. 1 Clinical manifestations of periodontitis: gingival swelling, edema, bleeding from brushing teeth, bleeding from periodontal probing, and soft gums [1]. The periodontal pocket is formed, the attachment is lost, the probing depth is more than 3mm, the root of enamel cementum has a pocket bottom, and the periodontal pocket may overflow pus [1]. Teeth are loose, displaced and even fall off, which leads to mastication weakness [1]. It may be accompanied by root furcation, periodontal abscess, root surface exposure, sensitivity, root surface caries, food impaction, bad breath, and occlusal discomfort or pain caused by gingival recession [1]. Patients often have obvious dental plaque, tartar and local factors [1].
3.2 Diagnosis of periodontitis 1. Inflammation of the gums? Gingival swelling, edema, bleeding from brushing teeth, bleeding from periodontal probing, and soft gums [1].
2. The periodontal pocket is formed and lost, and the depth of probing is more than 3mm, and the bottom of the pocket is at the root of enamel cementum, and pus may overflow from the periodontal pocket [1].
3. Alveolar bone absorption, X-ray film can show that the height of alveolar bone decreases, showing horizontal or vertical absorption [1].
4. The teeth are loose, displaced or even fall off, resulting in mastication weakness [1].
5. Occlusal discomfort or pain caused by furcation lesion, periodontal abscess, root surface exposure, sensitivity, root surface caries, food impaction, halitosis and gingival recession [1].
6. There are often obvious dental plaque, tartar and local factors [1].
3.3 Treatment of Periodontitis The treatment of periodontitis should be based on local treatment, and local pathogenic factors should be removed by scaling, subgingival scaling, root surface leveling and other methods. After treatment, it can be washed with local drugs [1].
Patients should be instructed to brush their teeth, use dental floss or toothpick or interdental brush correctly, control dental plaque for a long time, and maintain oral hygiene [1].
Patients with systemic diseases such as severe chronic periodontitis, aggressive periodontitis and periodontitis with diabetes need to be supplemented with systemic drugs and local drugs [1].
3.3. 1 local treatment of periodontitis is mainly local treatment, and 3% hydrogen peroxide solution or chlorhexidine solution can be used for local irrigation [1].
3.3. 1. 1 scaling can be used for supragingival scaling (figure 1) or subgingival scaling according to local factors. If necessary, adjust the occlusion, eliminate food impaction and correct bad repair.
Figure 1 tartar scaling
3.3. 1.2 Treatment of periodontal pocket When the periodontal pocket overflows, it can be washed with 1 ~ 3% hydrogen peroxide solution and bagged with 10% iodine mixture or spiramycin and metronidazole. After removing local factors, shallow bags can be cauterized with iodophenol solution. Deep pockets require periodontal surgery to eliminate periodontitis. When the periodontal pocket reaches the root tip and the teeth are loose obviously, it can be considered to be removed.
3.3. 1.3 Loose tooth fixation. If the inflammation has been eliminated after treatment, but the teeth are still loose, temporary or permanent periodontal splint can be used to fix the loose teeth.
3.3. 1.4 Treatment of periodontal abscess When the abscess is limited, incision and drainage can be performed. Periodontal bags should also be washed and coated with medicine film or iodine glycerin.
3.3.2 Patients with severe periodontitis or periodontitis with systemic diseases can be treated with systemic drugs [1].
(1) metronidazole: 200 ~ 400 mg, three times a day for 5 ~ 7 days [1].
Adverse reactions: nausea, vomiting, loss of appetite and other digestive tract symptoms, as well as headache and dizziness; Pregnant women, lactating women, active nervous system diseases and hematological diseases are prohibited [1].
(2) Tinidazole: 2g on the first day, then 0.5g, twice a day; Take it continuously for 3 ~ 4 days [1].
Adverse reactions: Less common than metronidazole, mainly including nausea, vomiting, abdominal pain, loss of appetite, headache and dizziness [1].
It is forbidden for people who are allergic to tinidazole or pyrrole drugs, patients with active central nervous system diseases and hematological diseases [1]. /kloc-disabled for patients under 0/2 years old [1].
(3) Amoxicillin: 500mg, 1 time, every 6-8 hours; Take it continuously for 7 days [1].
Adverse reactions: nausea, vomiting, diarrhea and other gastrointestinal symptoms [1].
Penicillin allergy is forbidden, and there is partial cross-allergy between amoxicillin and cephalosporin [1].
(4) Amoxicillin clavulanate potassium [200mg: 28.5mg (7: 1)]: 457 ~ 914mg, every12h1time [1].
Adverse reactions: Common gastrointestinal reactions, such as nausea, vomiting and diarrhea. Infectious mononucleosis, penicillin allergy and pregnant women are prohibited [1].
(5) Erythromycin: 1 ~ 2g daily, 3 ~ 4 times orally [1].
Adverse reactions: Gastrointestinal reactions are the most common, such as diarrhea, nausea and vomiting. People who are allergic to macrolides and pregnant women are prohibited [1].
(6) doxycycline: the first oral dose is 0.2g, and then 0. 1g, twice a day; 10 ~ 14 days is 1 course of treatment [1].
Adverse reactions: It can cause gastrointestinal reactions such as nausea, vomiting, abdominal pain and diarrhea [1]. With hepatotoxicity and allergic reaction, long-term application can lead to fungal infection [1].
It is forbidden for those with a history of tetracycline allergy, pregnant women, lactating women and children under 8 years old [1].
When low dose doxycycline is used to regulate the host response: 20mg twice a day, 3 months is 1 course of treatment [1]. Long-term application should pay attention to control fungal infection, and regular follow-up examination of blood routine and liver function [1].
4 Chinese medicine periodontitis acupuncture has a good analgesic effect on periodontitis [2].
4. 1 Etiology and Pathogenesis of Periodontitis The Yangming Meridian of the hands and feet enters the upper and lower teeth respectively, and the accumulation of heat in the gastrointestinal tract, invasion of pathogenic wind and deficiency of kidney yin can all cause toothache [2].
4. 1. 1 Wind, fire and wind evil invade meridians, suppress fire, commit crimes along meridians, and lead to toothache [2].
4. 1.2 excess fire accumulates heat in large intestines and stomach, which inhibits Yangming and causes toothache along meridians [2].
4. 1.3 Deficiency-fire kidney dominates bone, while teeth are bone, which is not as good as teeth, and it is more complicated with deficiency-fire inflammation, causing toothache [2].
4.2 Dialectical treatment of periodontitis Chinese medicine has long recorded its understanding of periodontal disease, emphasizing dialectical treatment.
4.2. 1 toothache due to wind-fire 4.2. 1. 1 Symptoms and signs: severe toothache, swollen gums, body heat due to cold, thin and white fur, and floating pulse [2].
The gums are red and swollen, and the teeth are painful. The pain is relieved when it is cold, and it is very painful when it is hot. It is often accompanied by slight heat and bad wind, and dry mouth [3].
4.2. 1.2 syndrome analysis: exogenous wind-cold can cause stagnation of fire; Or oral cavity is unclean, teeth are unclean, and wind-heat induces latent evil, which leads to toothache caused by wind-fire and exterior heat syndrome [2].
4.2. 1.3 Acupuncture Treatment [2]
Treatment: expelling wind, clearing away heat and relieving pain. Mainly the acupoints of the large intestine meridian of hand Yangming.
Prescription: Hegu, Bike, Xiaguan, Waiguan and Fengchi.
Acupoint selection according to syndrome: for patients with sore throat, add less and increase yang.
Acupuncture method: purging needle method.
Fang 1: Yangming pulse of hand enters the lower teeth, Yangming pulse of foot enters the upper teeth, and hand communicates with Yangming pulse of foot. Therefore, choose Yangming meridian points such as Hegu, Buccal Vehicle and Xiaguan to dredge the meridians and relieve pain. Table of solutions for air distribution pool and external clearance ventilation.
4.2. 1.4 Moxibustion Therapy [3]
Acupoints: Hegu, Dazhui, Waiguan and Bike.
Moxibustion: Moxibustion with moxa sticks is like the sparrow's head moving up and down when eating. The moxibustion stick is closest to the skin by 0.5 ~ 1 cm, which produces a burst of burning sensation. Each acupoint lasts 10 ~ 15 minutes, and the acupoint is warmed 1 time every day, with 7 times as 1.
4.2.2 toothache due to excessive fire 4.2.2. 1 Symptoms and signs Severe toothache, swollen gums, bad breath, thirst, constipation, or swollen teeth, even bleeding and pus on cheeks, yellow fur and red pulse [2].
Severe tooth pain, swollen gums or oozing pus and blood, swelling can spread to the whole cheek, accompanied by headache, thirst, bad breath, constipation and sweating [3].
4.2.2.2's syndrome analysis shows that the stomach fire is blazing and the gums are steaming along the meridians, so the toothache is severe and the gums are red and swollen [2].
Fire burns blood vessels and then bleeds [2].
When the muscle membrane is injured by heat, it will turn into pus [2].
Fierce gathering leads to tooth swelling and cheek pain [2].
Heat hurts body fluids, so thirst, bad breath and constipation [2].
Both yellow fur and red pulse are signs of Yangming's fu-organ heat [2].
4.2.2.3's prescription is suitable for clearing stomach and purging fire, and it is modified by Wei Qing decoction.
4.2.2.4 acupuncture therapy [2]
Treatment: clearing stomach, purging heat and relieving pain. Mainly at the stomach meridian point of Foot Yangming.
Prescription: buccal car, Xiaguan, Hegu, inner court and two rooms.
Acupoint matching and syndrome matching: for those with headache, add sun exposure. Nightmares, more.
Acupuncture method: purging needle method.
Fang Yi: Buccal vehicle, Xiaguan and Hegu all belong to Yangming meridian and are used for relieving pain. The auricular apex and the inner chamber are the acupuncture points of the hand, foot and stomach meridians respectively, which have the effects of clearing away heat, purging fire and relieving pain.
4.2.2.5 moxibustion therapy [3]
Acupoints: Neiting, Daying, Shu Wei and Hegu.
Moxibustion: Moxibustion with moxa sticks is like the sparrow's head moving up and down when eating. The moxibustion stick is closest to the skin by 0.5 ~ 1 cm, which produces a burst of burning sensation. Each point lasts for 10 ~ 15 minutes, and the point is red and hot, once a day 1 time, and 7 times is 1.
4.2.3 toothache due to asthenic fire 4.2.3. 1 Symptoms and signs toothache is weak, intermittent, often aggravated at night, or chronic slight pain, with slightly swollen and reddish gums, loose roots, weakness in chewing, bad mouth, dizziness, tinnitus, backache and other symptoms, red tongue and thin or thin pulse [2].
The teeth are dull, the gums are slightly red and swollen, they contract after a long time, the teeth are loose, and the pain is aggravated in the afternoon, which may be accompanied by dizziness, dizziness, tinnitus, weakness of the waist and knees, thirst but no desire to drink water [3].
4.2.3.2 syndrome analysis of kidney yin deficiency, excessive fire, gingival aggregation, so dull pain, gingival swelling [2].
Fire hurts the gums, leading to loss of nutrition, gum relaxation and loose bones, so the roots are loose [2].
If the gums are not firm, the chewing power is weak [2].
Because of the deficiency of kidney yin, dizziness, tinnitus, backache and fatigue appear [2].
4.2.3.3 Fang should nourish yin and tonify kidney, and add and subtract Liuwei Dihuang Decoction.
4.2.3.4 acupuncture therapy [2]
Treatment: nourishing yin and tonifying kidney, reducing fire and relieving pain. The kidney meridian of foot shaoyin and stomach meridian of foot Yangming are the main acupoints.
Prescription: Taixi, Hegu, Chache, Shimonoseki and Interrow.
Acupoint selection with syndrome: Shenshu is added to patients with low back pain. Headache and dizziness, plus Yongquan.
Acupuncture method: acupuncture reinforcing and reducing method. Taixi acupuncture therapy. The rest acupoints were treated by the lower method.
Prescription 1: Hegu, Buccal Vein and Xiaguan all belong to Yangming Meridian, which are effective acupoints for treating toothache. Taixi is the starting point of foot-shaoyin meridian, nourishing yin and tonifying kidney to treat its origin. Between the row and the row is the meridian point of Zujueyin, which is used to clear heat and reduce fire.
4.2.3.5 moxibustion therapy [3]
Point selection: Yihai, Taixi, Pai, and Buche.
Moxibustion method: Moxibustion with moxa sticks is mild, each point is 15 minutes, and the point is flushed and warm, 1 time a day, 7 times for 1 course of treatment, and the pain stops.
4.2.4 Kidney-yang deficiency type: Fu Gui Dihuang Pill should be modified by warming and tonifying kidney-yang.
4.3 Other therapies for periodontitis 4.3. 1 Ear acupuncture therapy for teeth, jaws, screen tips and Shenmen. Medium intensity * * *, leave the needle for 20 ~ 30 min, or press the needle for 2 ~ 3 days [2].
4.3.2 electroacupuncture treatment of buccal side, Xiaguan and Hegu. First, acupuncture with a filiform needle, then electrify with pulse current and dense wave for 20-30 minutes. 1 ~ 2 times a day until remission [2].
4.3.3 The symptomatic treatment of moxibustion is often accompanied by symptoms such as thirst and loose teeth, and the following methods can be added according to the accompanying symptoms [3]:
4.3.3. 1 Point selection for thirst: Sanyinjiao.
Moxibustion method: Moxibustion with moxa sticks 15 minutes, and the points are flushed and warm, once a day 1 time.
4.3.3.2 Songya Acupoint: Yinling Spring.
Moxibustion method: Moxibustion with moxa sticks 15 minutes, and the points are flushed and warm, once a day 1 time.
4.4 Medical record Huang XX, female, 68 years old. Outpatient number: 79388. First visit:1979 65438+1October 26th. I have been aware of gum pain for more than half a month, and it gets worse every afternoon and after fatigue. Examination: No dental caries, swollen gums, red tongue tip, no moss, and rapid pulse. Diagnosis: toothache due to yin deficiency. Acupuncture at Taixi point (double point), the pain disappeared after 3 times. (Collection of Ancient and Modern Acupuncture Medical Records)
Sun Moumou, female, 34 years old, worker. Toothache for 4 days, aggravated when chewing, slow in the morning, aggravated in the afternoon, thirst, constipation, red tongue, yellow fur and rapid pulse. He was diagnosed with stomach fire and toothache. The method of clearing heat, purging fire and relieving pain was put forward. Select the left inner chamber, the right upper camp, and the right lower pass, and each cave bird pecks for 10 minute, and the pain stops after moxibustion. Follow-up for 2 months showed no recurrence. [3]
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