Granuloma formation begins due to an inflammatory process that is triggered in response to an infection that has entered the root system of the tooth due to caries or after dental procedures. At the initial stage of development, granuloma often proceeds asymptomatically and can be accidentally detected by X-ray examination conducted for another reason.
What is the danger of granuloma?
As the granuloma grows, it begins to put pressure on the surrounding tissues, which can lead to resorption (decrease) of the bone tissue of the jaw. Pressure can also cause pain, affect the position of teeth, and even lead to tooth loss.
Another danger is the possibility of infection with granuloma, which can lead to the formation of an abscess and the spread of infection to other areas of the face and neck. In some cases, granuloma can develop into a cystic tumor, which requires more complex and serious treatment.
Types of granulomas and their causes
Radicular cysts are the most common type that occurs due to chronic periapical periodontitis (inflammation in the area of the tip of the tooth root). Usually, such inflammation begins with caries, which progresses to inflammation of the tooth pulp (pulpitis), and eventually leads to damage to the periapical tissues.
Follicular cysts are formed from the dental follicle, the tissue surrounding the developing tooth. They most often appear in non-erupted or incorrectly positioned teeth, and can cause a displacement of the dentition.
Residual cysts form in the place where the tooth was previously removed if the cystic tissue was not completely removed during the operation. Also, a residual cyst can develop due to injury or chronic diseases of the gums and sinuses.
Keratocysts are a rare type that is characterized by more aggressive growth and a tendency to relapse. They have a more rigid structure, quickly increase in size and can reappear even after removal.
Symptoms of granuloma of the tooth
The presence of swelling on the gum: this may be the first and only noticeable sign.
Pressure soreness: Although the granuloma is not always painful, discomfort and pain may occur when it increases.
Discoloration of the tooth: the tooth under which granuloma develops may darken. The gum can also change color.
Tooth mobility: if the granuloma has reached a large size, it can cause tooth weakening.
If you first suspect granuloma, make an appointment with a dentist.
Diagnosis and treatment of granuloma of the tooth in Olympus Clinics
Examination: the dentist of Olympus Clinics will examine the oral cavity, palpate the area of the alleged granuloma and assess the indirect signs of pathology.
Diagnosis: the doctor will prescribe the necessary examinations: X-ray or computed tomography (CT), which will help to see the size and location of the granuloma, as well as assess the degree of damage to the surrounding tissues.
Treatment: after receiving the results of the study, the doctor will refer you to an endodontist for further treatment, which will help preserve the beauty and health of your smile.
How is tooth granuloma treated?
Treatment can be either conservative or surgical, depending on the size of the granuloma, its type and the degree of exposure to surrounding tissues. It is important to understand that early detection and well-chosen treatment can significantly improve the prognosis and minimize possible complications.
What treatment methods do dentists of Olympus Clinics resort to?
Conservative treatment is performed by an endodontist dentist under a microscope. The main purpose of such treatment is to eliminate infection and inflammation, as well as stop the growth of granuloma.
First of all, the doctor cleanses the root canals of the tooth from infected tissues and microbes. The channels are then filled with a special sealing material, which prevents re-infection. The dentist may also prescribe antibiotics and anti-inflammatory drugs to reduce inflammation and fight infection. This may be enough for the granuloma to gradually decrease in size.
Conservative treatment can be effective, but its success largely depends on the stage of granuloma development and the timeliness of initiation of therapy. If the formation has reached a large size or conservative treatment does not lead to improvement, dentists resort to surgical methods.
One of the most effective methods is cystectomy — surgical removal of granuloma along with a small amount of surrounding bone tissue. Cystectomy is the most radical method of treating granulomas and is used to prevent relapses.
A cystotomy is used to partially remove the granuloma while leaving part of the cystic membrane. The doctor creates a hole in the granuloma through which the outflow of fluid occurs. The granuloma decreases in size, the pressure on the surrounding tissues decreases and the risk of tooth destruction decreases. Doctors usually resort to cystotomy for large granulomas, when complete removal can damage significant areas of the jaw or adjacent teeth.
When the granuloma is localized in the area of the root tips, the method of apical resection or apicoectomy is used. The procedure consists in removing the tip of the tooth root and cystic tissue through a small incision in the gum.
Prevention of granuloma of the tooth
For prevention, it is important to maintain oral hygiene, visit the dentist every 6-12 months for early detection and treatment of caries and its complications, as well as timely removal of teeth that cannot be treated.
Another way of prevention is professional oral hygiene. In Olympus Clinics, plaque and tartar can be removed in one procedure, which cannot be eliminated with a conventional brush. If you clean once or twice a year, the risk of infections decreases. As well as regular professional oral hygiene prolongs the service life of implants, crowns, fillings.