Necrotizing ulcerative stomatitis Vincent - Specific infectious mucosal lesion of the oral cavity caused by association fuzobakterii and spirochetes. Patients indicate the appearance of painful ulcers in the mouth, deterioration of general condition, fever, headache, aching muscles. The diagnosis is based on the collected medical history, physical examination results, data and smear cytology smears with ulcerative surfaces. The basis of the treatment of the local causal treatment. In severe shows the use of antibiotics, antiprotozoal drugs in tablet form.
Necrotizing ulcerative stomatitis Vincent
stomatitis Vincent ( "trench mouth", ulcerative membranous stomatitis) - is inflammatory and destructive lesions of the oral mucosa arising from sensitization fuzospirillyarnoy Association. Clinically evident areas of ulceration, necrosis of the mucosa. In 1895 the infectious nature of the disease confirmed the French epidemiologist and bacteriologist Vincent. The main group of patients are men younger (20 to 30 years). The most common disease diagnosed from October to December. Necrotizing ulcerative stomatitis Vincent is an independent nosological unit. But there are also dentistry and ulcerous-necrotic changes in the mucosa of the secondary, symptomatic nature of blood diseases, immunodeficiency states.
gingivitis. With long-term course of the inflammatory process in the pathological focus, along with colonies of microorganisms detected a high concentration of the factors of immune protection. Plasma cells produce IgG and IgM, which occurs under the influence of the activation of the complement system. The formation of the antigen-antibody complexes initiates the launch immunnokompleksnoy reaction type 3: developing superficial damage vessel walls, decreasing blood flow, which creates favorable conditions for thrombus formation. Blood clot blocking the lumen of blood vessels leading to ischemia, tissue necrosis, followed by development.
insomnia. On mucosa there are painful ulceration topped layers of yellow. Over the next 3-4 days, plaque becomes grayish-green hue.
Necrotic tissue tightly soldered to the surface of the subject, when you try to remove a bleeding wound is exposed. Most often ulcerative stomatitis detected in the area of the lower jaw behind the molars, on the cheeks on the line between the teeth, on the side portions of the language. Patients noted hypersalivation. Mild necrotizing stomatitis Vincent characterized by a limited portion of the lesion. The disease occurs without disturbing the general condition. In moderate decreases efficiency, increases body temperature. Locally ulcerative stomatitis progresses, increases as the area and depth of the lesion. For severe form is characterized by severe clinic. The bottom of the ulceration is in the thickness of the muscular layer.
If untreated, the pathological focus can spread to the bone tissue, triggering the appearance of alveolar bone osteomyelitis. With the localization of necrotizing ulcerative stomatitis Vincent in the retromolar area there lockjaw. Due to the involvement in the inflammatory process masticatory muscles patients can not open their mouths. In the transition zone of necrosis develops on the tonsils tonsillitis Simanovskogo- Plaut-Vincent. Chronic necrotizing ulcerative stomatitis Vincent stale. Ulcers covered with a slight touch of gray. The affected area is observed bone destruction. In place of the ulcer formed scars.
dentist brings to the oral mucosa single or multiple ulcerative necrotic lesions. The edges of ulcers are uneven, ragged. Bottom bloodshot, swollen, covered with a thick layer of gray-green plaque. When palpation examination reveals enlarged, painful lymph nodes compacted, which preserved mobility.
Changes in blood test characteristic of inflammation: increased white blood cell count, erythrocyte sedimentation rate increases, WBC shifts to the left. Using microscopy studies can be revealed in the surface layer of mucous, along with resident microorganisms, an increased amount of Borrelia Vincent, fuzobakterii. Deep layer contains only pure culture fuzospirillyarnogo symbiosis. During the authorization number of anaerobic microorganisms falls disease. Cytological analysis confirmed the presence of non-specific pattern of inflammation. In the initial period of necrotizing ulcerative stomatitis Vincent in the material revealed an increase in the number of neutrophils in the decay phase. Later dominated by histiocytes, phagocytic neutrophils.
Necrotizing ulcerative stomatitis Vincent differentiate with drug stomatitis, decaying cancer, stomatitis allergic nature, as well as secondary manifestations of oral syphilis, blood diseases, AIDS, poisoning with salts of heavy metals (bismuth, lead, mercury), violation of the digestive tract functioning . To exclude symptomatic stomatitis in the differential diagnosis may be necessary to consult specialists: gastroenterologist, hematologist, an infectious disease specialist, dermatologist.
Treatment of necrotizing ulcerative stomatitis Vincent
The basis of the treatment of necrotizing ulcerative stomatitis Vincent is local therapy. During hydration phase shows the use of local anesthetics (lidocaine, benzocaine). The prolonged analgesic effect is achieved through the use of applications of gel containing choline salicylate and tsetalkoniya chloride. For antiseptic treatment with necrotizing stomatitis Vincent prescribe drugs possessing antiprotozoal (metronidazole dioxidine), antimicrobial (gentamicin) and proteolytic (terrilitina) actions.
Cleansing of ulcer sites is performed using surgical instruments under constant irrigation mucosal antiseptic and necrolytic means. Also with necrotizing stomatitis Vincent widely used sorbents. In the phase of resolution shown keratoplasty, the effect of which is aimed at accelerating the recovery processes (eg, sea buckthorn). At the stage of epithelialization conduct rehabilitation of the oral cavity.
Total etiotropic treatment of necrotizing ulcerative stomatitis Vincent include antibiotics (semi-synthetic penicillins, cephalosporins), antiprotozoal drugs. As pathogenetic therapy using non-steroidal anti-inflammatory drugs (ibuprofen), antihistamines. For symptomatic treatment prescribed analgesics, antipyretics and rehydration medications.
With early detection and complex treatment of necrotizing ulcerative stomatitis Vincent manages to completely arrest the inflammatory process. Lack of skilled therapy leads to severe consequences: the destruction of bone, gum retraction, the development of osteomyelitis.