Tooth cyst - symptoms and treatment of cystic formation.

A radicular cyst is a cavity formation at the apex of a tooth root. The inside is lined with epithelial tissue and filled with cystic fluid. The most common cause of a radicular cyst is chronic periapical inflammation. The disease is often asymptomatic and is detected only during a dental examination or x-ray of nearby teeth.

What is a dental cyst?

Tooth cyst - what is it? An odontogenic cyst is a pathological neoplasm that occurs in the upper part of the tooth root. The internal cavity of the cyst is filled with liquid or mushy purulent contents; it is enveloped by a dense layer of epithelium.

The size of the cyst starts from a few millimeters, with rapid development reaching several centimeters in circumference. Most often, the pathological process affects the upper jaw, since the roots of its teeth have a more porous structure.

In order to understand what a dental cyst is and how to treat it, you need to know why such a phenomenon occurs. The formation of cysts occurs as a result of inflammation, thus the body restricts healthy tissue from the affected areas, clogging them along with bacteria into bubbles.

What is the prognosis for the disease?

How successfully the situation in a patient with an odontogenic cyst will be resolved depends on at what stage the cyst was discovered, how severe the symptoms were and how it was treated.

As a rule, the use of surgical treatment gives a positive prognosis. Therapeutic treatment provides a positive prognosis only if it is started at the initial stage of the disease.

A negative prognosis may be associated with detection of the disease at a late stage: odontogenic cysts can provoke the development of serious pathologies that cause deformation of the maxillofacial tissues.

Causes

There are several reasons why a dental cyst develops. The main reason is the activity of pathogenic microorganisms in a closed dental space; the following risk factors contribute to this:

• severe pathology, lack of timely treatment and incorrect treatment of dental diseases - caries, periodontitis, pulpitis;
• infectious complications after tooth filling, implantation procedures - in such cases, the doctor removes not only the cyst, but also the crown or implant, this avoids relapse;
• complications during teething, especially when wisdom teeth erupt - dental tissues injure the gums, bacteria get into microcracks,
• microorganisms also enter wounds that form due to mechanical damage to teeth;
• Nasopharyngeal diseases – infections in the nose and throat can spread to the oral cavity.

To provide adequate treatment, it is necessary to accurately determine the cause of the development of a dental cyst; based on it, the dentist will prescribe suitable therapy. So, in cases of injury, treatment consists of removing the cyst and tissue regeneration, but if the cyst is a complication of another disease, then in addition to removing the vesicle, the patient will be prescribed treatment for the underlying disease.

Complications and prevention

Complications after surgery are possible if you do not follow the doctor’s special recommendations. A frequent cause of complications is the lack of self-discipline in the patient. The main complications include:

tissue infection during surgery; generalized sepsis; abscess syndrome around the affected tooth.

Rarely, the cause of postoperative complications is considered to be a lack of professionalism on the part of the dentist. Before treatment, it is important to inquire about the quality of services provided and the rating of the dental clinic. Complications include damage to molars in the maxillary sinuses and sepsis. If not the entire volume of purulent exudate is removed from the cyst, then the emergence of a secondary source of infection occurs almost immediately. Pus quickly spreads throughout the body and leads to dysfunction of many organs and systems. With the high-tech development of dentistry today, cases of complications as a result of cyst treatment are isolated episodes.

Preventive actions

When carrying out high-quality prevention, the patient must follow simple rules:

Carrying out regular hygienic teeth cleaning; sanitation of the oral cavity once a year; dental examination - 2 times a year; timely response to unpleasant symptoms in the oral cavity.

Treatment of cysts today is carried out successfully in a number of cases, so before visiting the dentist it is important to collect as much information as possible about the clinic and the professionalism of the specialist. You should not delay treatment, since in advanced cases, surgery is often the only possible way to eliminate the pathology.

For quick post-operative recovery, it is important for the patient to observe a hygienic regime, carry out preventive rinses of the mouth with herbal decoctions (chamomile, celandine, string, propolis) and medications (Miramistin, Iodinol). The patient’s discipline and attention to their own health are the key to oral health and the ability to treat any problems in the early stages using the most gentle methods.

Types of dental cysts

Tooth cysts have different classifications, each of which is formed according to certain characteristic parameters of the pathology.

According to the nature of the disease, they are distinguished:

• residual cysts – occur after tooth resection (removal) surgery; this is the most common type of cyst;
• retromolar – formed during severe eruption of wisdom teeth;
• radicular - cysts are located on or near the tooth root;
• follicular – at the heart of such cysts is the germ of a permanent tooth; follicular neoplasms arise as a result of poor quality care of baby teeth.

Classification of neoplasms according to their origin:

• odontogenic – arise as a result of the transition of the inflammatory process from other dental diseases;
• non-odontogenic - the causes of the development of such cysts include problems not related to the teeth and oral cavity.

Locations of cystic formation:

• anterior teeth;
• teeth that are adjacent to the nasal sinuses with their roots;
• wisdom teeth.

Types of cystic formations

Based on the time of appearance, all cysts are classified into 2 categories:

1. Congenital, or dysontogenetic, arise due to disruptions in the process of intrauterine development.
2. Acquired ones appear as life progresses.

According to the mechanism of development of cysts, there are:

1. Retention - the most common. They are formed if the excretory duct of the gland is compressed or blocked from the inside. The secretion has no outlet, accumulates and stretches the surrounding tissue.
2. Ramolitic - arise at the site of dead cells, for example, in the brain after a stroke.
3. Parasitic is a capsule within which the parasite is located. In this way, the helminth protects itself from the body’s immune attacks.
4. Traumatic ones form at the site of bruises due to the accumulation of tissue fluid.
5. Tumor - lined with epithelium with signs of metaplasia; inside there are seals and places where fluid accumulates.

Symptoms

The danger of a dental cyst lies in the fact that signs of pathology appear only when the neoplasm reaches a relatively large size. In the early stages, small cysts do not manifest themselves in any way, meanwhile the infectious process covers an increasingly larger area of ​​healthy tissue. In the initial development of pathology, cysts are discovered by chance during routine examinations or treatment of other diseases.

The duration of the formation of a dental cyst takes only 1-2 days; as it develops, the following symptoms may occur:

• unpleasant and even painful sensations in the tooth, which intensify when chewing solid food;
• protrusion of the gum of a tooth, in the area of ​​the root of which a cyst forms, the growth of the gum becomes larger over time, redness is observed;
• the formation of a fistula in the area above the root of the tooth, the release of serous or purulent accumulations from it;
• general weakness and malaise;
• increase in body temperature.

Note! When a dental cyst occurs, the symptoms are not immediately visible; they appear in the later stages of development. The pain when a tumor appears is aching in nature, but it is less pronounced than the pain caused by caries and pulpitis.

If a clinical picture occurs and you suspect a pathological process, be sure to consult a doctor. Under no circumstances should you resort to self-treatment - the dental cyst must be removed. In addition, taking the wrong medications can worsen the patient’s overall well-being.

Sometimes there is no pain in the oral cavity; instead, the basis of the clinical picture is intense headaches. The cause of this phenomenon may be a cystic formation in the maxillary sinus.

Radicular cyst as a disease

Cyst translated from Greek means “cavity”, “bubble”. In medicine, this bladder is often filled with blood, organic fluid or purulent exudate. The outer layer of the cystic component consists of soft connective tissue, and the cavity itself is filled with epithelium. Diagnosis of a radicular cyst is carried out specifically in the upper segments of the jaw bone. Detection of its signs in the lower jaw is quite rare. At the very beginning, the disease occurs in a latent stage and does not manifest itself in any way. If detection occurs, it is usually through an X-ray of a completely different dental area. Based on size, dentists distinguish two groups of cysts:

cystogranuloma (about 0.5 cm); cyst (more than 1 cm).

Radicular cysts of the jaws (lower or upper) are cavity neoplasms in the periapical dental area with cystic fluid, formed as a result of the inflammatory process of the periapical (root) part of the tooth. There are main forms of the disease:

acute process; chronic form.

Prolonged growth of the cyst can lead to gradual perforation or thinning of the jaw bone, which increases the risk of jaw fracture in the affected segment. A radicular cyst often requires surgical treatment, so if unpleasant symptoms are detected, a visit to the doctor is urgent.

Consequences

Without adequate treatment, the dental cyst continues to grow and develop; in advanced stages, large neoplasms destroy the bone tissue of the skull, as a result it is replaced by connective tissue formations, which leads to the development of the following complications:

• dissolution of the jaw bone, which depends on the growth of the cyst;
• the formation of pus in the cyst, further purulent inflammation can lead to the development of an abscess;
• inflammatory process of lymph nodes located near the source of infection;
• development of osteomyelitis or periostitis;
• development of chronic sinusitis when the cyst grows in the maxillary sinus;
• pathological fracture of the jaw bones when the cyst reaches a large size;
• development of phlegmon due to a long-term purulent inflammatory process in the cyst;
• sepsis – blood poisoning;
• degeneration of a cyst into a malignant tumor without timely treatment.

Many patients are interested in why a dental cyst appears in the maxillary sinus, how dangerous it is and its symptoms. The formation of a cyst of this type occurs as a result of untreated inflammation of the tooth root in the upper jaw. A granuloma forms at the root of the tooth, which increases in size and becomes a peri-radicular cyst, then takes a position in the maxillary sinus. The volume of such a cyst can reach 9-12 cubic centimeters.

The symptomatic picture includes painful sensations, the nature of which is similar to trigeminal neuralgia, pain in the occipital, temporal and parietal regions of the head. Externally, a dental cyst can be identified by the asymmetry of the face. Tooth cyst - photo shows a cyst in the maxillary sinus.

Diagnosis of tooth root cyst

To make a diagnosis and carry out appropriate treatment, the dentist collects and analyzes the medical history. During the initial diagnosis, many patients report the fact of endodontic treatment performed to eliminate periodontitis or pulpitis. Some patients indicate an exacerbation of the disease after intraoral dissection.

Radiography is used as the main diagnostic method. Below is a photo and x-ray of a dental cyst.

To obtain an x-ray, several methods are used, the first method is based on contact intraoral x-ray, the advantages of this technique:

• determining the degree of destruction of the jaw bones;
• assessment of the condition of the tooth root and tooth canal;
• assessment of the quality of canal filling;
• identifying the presence of perforations and fragments of instruments and materials in the tooth canal;
• determination of the relationship between the cyst and the roots located near the teeth.

The second method of performing radiography is an orthopantogram; the procedure is a panoramic photograph of both jaws and the maxillary sinuses of the upper jaw.

Another method of the procedure is a survey X-ray in the nasomental projection; the X-ray covers the bones of the skull from the nose to the chin; using the image, the doctor assesses the condition of the maxillary sinuses and detects cysts that have grown into the nasal cavity.

In addition to radiography, to detect a tumor, the patient may be prescribed an electroodontic diagnostic procedure. This technique helps to assess the degree of such an indicator as the electrical excitability of the teeth that are located next to the cystic tooth. If the value exceeds 60 microamps, the dentist prescribes endodontic treatment to the patient.

For diagnostic purposes, histological and cytological studies are used to determine whether the neoplasm is benign or malignant.

Diagnosing a dental cyst is not difficult, but only qualified dentists can carry it out in a hospital setting; under no circumstances try to independently determine the presence of a cyst and do not take therapeutic measures; strictly follow the doctor’s recommendations.

What are periapical tissues

To clarify the concept of a radicular or periapical cyst, it is necessary to clarify the features of its localization. The root of a tooth is the part of the tooth that is located in the jawbone, and the apex of the root is the end part, the narrowest and farthest from the crown of the tooth. The root has a root canal through which the nerves and vessels supplying the tooth pass.

Periapical tissues are all tissues surrounding the root of the tooth, located within the bone, that is, periodontium, root cementum and alveolar bone of the jaw.

Treatment

Treatment of dental cysts is carried out through surgery, laser treatment and conservative therapy. The latter has a positive effect only in the initial stages of the disease; overgrown cysts must be removed.

Surgery

To eliminate the pathology, it is not necessary to remove the entire tooth; only the tooth root on which the cyst is located is subject to resection. After removing the affected area, the dentist seals the remaining root, treats the surgical canal through which he removed the bladder with its contents, and stitches it up.

After a few days, the doctor removes the stitches and monitors the wound healing process. It is important to make sure that there are no cyst particles left in the dental canal; to achieve this goal, repeat radiography is performed.

Note! Sometimes it is impossible to remove the root along with the cyst; in these cases, the doctor completely removes the tooth. Indications for complete tooth resection are a difficult-to-reach location of the cyst and a severe course of the disease.

After surgical removal of a cyst, the patient must regularly visit the dentist and follow the recommendations prescribed by the doctor.

Conservative therapy

Tooth cyst - treatment of the disease with conservative methods is possible only in the early stages of its development. In order to eliminate the tumor, the patient is prescribed injections and rinses.

During therapeutic treatment, the dentist opens the dental canal, which leads to a cystic neoplasm, and pumps out exudate from it. The doctor does not fill the canal for ten days; during this period, the patient uses antiseptic solutions and tinctures to rinse the mouth.

Upon completion of the treatment course, the dentist treats the dental canal with medications and then fills the tooth.

Laser removal

Laser treatment is a modern method of treating dental cysts. When performing the method, the doctor opens the dental canal and uses laser irradiation to treat the area where the cystic tumor is located. The laser destroys not only the epithelium of the cyst, but also hundreds of thousands of bacteria that are inside the bladder.

The advantages of laser removal are rapid tissue healing and no risk of secondary infection in the oral cavity and dental canal.

Treatment with antibiotics

In some cases, dental cysts are treated with antibiotics. Taking antibacterial drugs is an auxiliary measure to destroy an expanded infection or the main method of treatment if a dental cyst develops against the background of a primary infectious disease.

Antibacterial drugs can only be prescribed by the attending physician; the following drugs are most often used:

• amoxicillin – has a high antibacterial effect, greatly facilitates the treatment of cysts with other methods;
• Cifroploxacin is a broad-spectrum antibiotic that actively destroys bacteria and relieves inflammation;
• tetracycline - this drug is prescribed more often than others, it actively relieves the inflammatory process, pain syndrome, and facilitates other methods of treating dental cysts.

Sometimes a doctor can prescribe topical antibacterial agents to a patient, but taking such medications is not always advisable - local drugs - antibiotics are quite difficult to distribute evenly over the diseased area.

Note! Antibacterial drugs are potent drugs that also affect beneficial bacteria in the body. You can take such medications only as prescribed by a doctor, without increasing the number of doses or dosage.

Treatment at home

Treatment of dental cysts at home is possible only as an auxiliary therapy. A cyst should not be confused with a granuloma; the latter can resolve on its own, but the cystic formation must be radically removed. Home treatment is not used to remove the cyst, but to eliminate the inflammatory process and destroy harmful bacteria.

The main goal of therapy at home is to provide an antiseptic effect. Propolis tincture, calendula tincture, eucalyptus tincture have an antiseptic effect. Tinctures are used as follows: a small amount of medicine is applied to a cotton swab and applied to the affected area, held for 5-10 minutes.

Medicines with an antiseptic effect can be used before surgery to remove a cyst and after tooth root removal. The antiseptic effect allows these medications to be used in the treatment of caries and other infectious diseases of the oral cavity.

Prevention

It is always easier and faster to prevent any disease than to cure it, so one should not forget about simple preventive rules that will help avoid the development of a dental cyst. The basic rules for preventing dental cysts are based on compliance with the rules of oral care.

How to prevent the formation of pathology:

• do not trigger the course of dental diseases such as caries, periodontitis, pulpitis; if infections occur, consult a doctor immediately;
• Brush your teeth daily and prevent the appearance of plaque, which can later transform into tartar;
• monitor the condition of the teeth and oral cavity after operations and mechanical injuries;
• visit your dentist regularly;
• monitor the condition of filled teeth and dental implants;

Patients who have had their teeth filled or have dental crowns or implants placed are advised to periodically have dental x-rays taken. This will allow timely detection of pathological changes and increase the chances of successful recovery without serious consequences.

Note! All diseases must be treated in a timely manner; inflammatory processes reduce immunity, as a result of which infections move freely from one organ to another; in addition, secondary infections can be added to already developed pathologies. It is important to monitor your health and strengthen local and general immunity.

To strengthen your immune system, strengthen your body, include fresh fruits and vegetables in your diet, play sports and walk outdoors more often. It is more difficult for any infection to get into a hardened body than into a weakened body.

Treatment process

Treatment of cysts can be therapeutic (conservative) or surgical. The treatment method is determined by the doctor after a visual examination of the oral cavity and the results of diagnostic studies.

Laser treatment

Laser beam treatment is gaining increasing popularity in dentistry. Under the influence of a laser, a tumor can be removed completely painlessly, without the risk of infection. In addition, the laser completely disinfects the affected channels and ensures rapid recovery. The laser treatment algorithm looks like this:

opening and expansion of dental canals; introduction of a laser beam into the canals: disinfection and removal of the cystic component.

The only disadvantages of the method are the relative high cost and the need for special high-precision equipment. Laser treatment also involves following the doctor’s recommendations immediately after the procedure (rinsing with an antiseptic and abstaining from food for up to 5 hours).

Conservative treatment

Therapy for a cystically altered tooth root requires disinfection, tooth cleaning and filling. An alternative treatment method is the introduction of a therapeutic suspension containing copper and calcium, followed by exposure of the tooth to low-power electrical discharges. The main indications for drug therapy are:

absence of fillings on root canals; poor filling in the root canals (not along the entire length); The size of the cyst barely reaches 8 mm.

In treatment, special drugs are used that negatively affect the cyst capsule and its contents. After which, the purulent exudate is completely removed, and instead of it, dental paste is injected into the cyst cavity to restore the bone structure. The manipulations are completed by filling the canal and crown. Cases of relapse of the disease are possible.

Operative method

Surgical treatment is carried out in some cases, since in 80% of cases a radicular cyst is an advanced process. The main indications for surgical intervention are:

presence of a pin in the root canal; early prosthetics of the causative tooth; the size of the cyst exceeds 8–8.5 mm; gum swelling and pain.

Until recently, the cystic component was removed along with the tooth. Alternative methods of surgical treatment are now being used to preserve the natural tooth. A tooth is removed only when the roots of the tooth have become part of a cystic structure or have been destroyed to the very root as a result of disease.

Main methods of surgical treatment:

The postoperative period can take a long time. For the entire recovery period, antiseptic rinses are required, and sometimes antibiotics are required. You should not take aspirin, as it provokes bleeding. Recovery takes about a day, and swelling and slight soreness persist for several more days. If unpleasant symptoms persist or their intensity increases, it is important to immediately consult a doctor.

Traditional methods of treatment

Separately, it is worth mentioning the possibility of treating a tumor of the apical part of the upper jaw tooth with traditional healing recipes. Infusions of herbs, compresses and various poultices are good when the patient is in the postoperative period. Herbal treatment for tooth root cysts helps only as a local disinfectant along with traditional treatment methods. There are main herbs that heal gums faster:

Oak bark; pharmaceutical camomile; swampy cudweed; plantain and others.

If you start treatment only with herbs and compresses, you may not only fail to help your body cope with the cyst, but also lead to complications in the form of rupture of the cystic contents. Purulent exudate quickly spreads through the bloodstream and carries all bacterial microflora to vital organs.