Septum syndrome
Introduction :
The point of contact between two teeth is of capital importance for the health of the tooth and the periodontium.
An absence or lack of contact leads to very harmful disorders.
1. Definition:
• The interproximal zone is an anatomical and functional unit delimited by two adjacent teeth in contact
• It includes dental and periodontal elements:
1. Marginal dimples and ridges
2. The proximal faces,
3. The interdental contact point or surface
4. The gingival papilla
5. The alveolar septum.
Septum syndrome
2. Anatomy:
• It is important to have a good understanding of the anatomy of the constituent elements of this area in order to be able to subsequently
Restore it in good conditions
2.1 Dental elements:
-The marginal ridges:
Are linear elevations of the occlusal surface of cuspid teeth and the lingual or palatal surface of
Incisors and canines.
They provide the junction between the vestibular and lingual cusp of multicuspid teeth and between the edge
Free and cingulum of monocuspid teeth.
The proximal faces:
It is a convex surface which becomes concave towards the collar and ends with a straight part in the vicinity
From the gum
The contact zone:
An interproximal contact is a clash of adjacent teeth in the continuity of the dental arch.
The point of contact:
The interdental contact point is defined as the contact area between the proximal faces of 2
Adjacent teeth.
It is located at the crossroads of 4 pyramidal volumes or embrasures: vestibular, palatine/lingual, occlusal,
Cervical.
The area thus delimited around the point of contact is called the interproximal space.
In adults; due to interproximal wear resulting from the mobility of the teeth during chewing, we speak of
Of contact surface.
2.2 Periodontal elements:
The interproximal space:
The interproximal contact zone, between two convex surfaces, induces the formation of four spaces
Pyramidal called embrasures
The gingival papilla:
It is the portion of free gum that fills the interdental space of the two adjacent teeth in contact.
In young subjects the interproximal space is filled by the papilla, which is subdivided into papillae: vestibular and lingual separated by a depression which is the interdental neck.
The alveolar septum:
It is a spongy bone limited by two external and internal cortices, it serves as support for the gingival papilla.
3. physiology of the interdental area:
Functional role: stabilization and balancing of teeth by distributing the stresses applied to the teeth.
Food deflection.
Protective role: the contact point protects and maintains the integrity and physiology of the tooth and especially the periodontium.
No food stuffing.
4. Interdental septum syndrome:
4.1. Definition:
– It is an inflammation of the tissues of the interdental space, first the gum, then if nothing is done, the bone
Alveolar, and which ends with the destruction of the bony septum and an infection with a small abscess located between
The two teeth involved.
Septum syndrome is the consequence of a dysfunction of the interdental area which manifests itself by a
More or less deep painful injury.
It is caused by food compaction, often aggravated by iatrogenic elimination maneuvers.
4.2. Etiologies:
Morphological causes:
– Shape anomalies
– Dental malposition
Iatrogenic causes:
Defective restoration (overflowing amalgam, poorly adapted prosthesis, hook or attachment system of an auxiliary prosthesis, roughness of a restoration)
4.3.Symptomatology :
Clinical signs:
Subjective:
1. Food compaction with a feeling of compression.
2. Pain caused especially during and after meals.
3. Pain caused by thermal variations.
4. Spontaneous pains may exist more or less intense, sometimes diffuse or even pulsating. These pains
Can be violent and difficult to localize, often confused with pulpitis pain.
Goals:
The inspection:
Food stuffing.
Hypertrophy of the papilla.
Spontaneous and induced hemorrhage
Sensitivity to pressure and transverse percussion.
Radiology (Retro alveolar):
Can show:
Interdental septum involvement +/- advanced depending on the stage of the lesion (horizontal, vertical, oblique)
A desmodontal enlargement.
The presence or absence of proximal caries, overflowing fillings
Septum syndrome
4.4. Differential diagnosis:
It will be made with:
- Acute pulpitis
- Acute periapical reactions
- Alveolitis
4.5 Evolution and complications:
If no treatment is undertaken, the progression will lead to damage to the epithelial attachment, then
Destruction of the connective tissue attachment, finally lysis of the alveolar bone may appear:
Complex periodontolysis with tooth mobility;
Cementum caries;
Periodontal abscess;
Retro pulpit;
Intraosseous abscess.
4.6 .Processing:
Symptomatic treatment :
Cleaning the interdental space (clearing the proximal space of debris)
Under anesthesia, curettage of the interproximal area.
H2O2 hemostasis
The recommendation to use 0.2% chlorhexidine mouthwashes twice a day
For a week
Oral hygiene tips.
– Etiological Treatment:
Eliminate all causes responsible for the passage of food, depending on the clinical case the practitioner can:
Recreate an ideal contact point (recovery of a faulty restoration)
Perform occlusal adjustments
Modify the existing prosthesis
Prophylactic Treatment:
Periodic consultation with the dentist to detect proximal caries + Regular monitoring of the condition
Periodontal.
Good hygiene.
Septum syndrome
5. Conclusion:
The interdental space, an important anatomical and functional entity of the dental arches, must be known
And respected by practitioners in order to achieve non-iatrogenic and physiological fillings.
Successful treatment allows for careful and regular maintenance of the proximal areas by a patient who is aware of the
Plaque control and rigorous brushing, as well as the passage of the silk thread which must not tear
When passing the contact point.
Septum syndrome
Wisdom teeth can cause infections if not removed.
Dental crowns restore the function and appearance of damaged teeth.
Swollen gums are often a sign of periodontal disease.
Orthodontic treatments can be performed at any age.
Composite fillings are discreet and durable.
Composite fillings are discreet and durable.
Interdental brushes effectively clean tight spaces.
Visiting the dentist every six months prevents dental problems.