Dental cyst - basic information
periapical cyst caused pulp infection
What is odontogenic cyst?
A dental cyst is a pathological change that occurs most frequently in the bone tissue of the maxilla or mandible, and can also occur in soft tissues or in the area of the maxillary sinuses. It is usually formed as a result of chronic inflammation of the periapical tissues of the tooth, which may occur in the course of tooth decay. Some cysts have a developmental character. These include, for example, dentigerous cysts (also known as follicular) or odontogenic keratocysts. A cyst develops slowly and is initially symptom-free, but as it develops it destroys the surrounding tissues.
types of cysts
The most common cysts around the oral cavity include:
- periapical cyst, also known as radicular – this is the most common type of cyst, located around the apex of the tooth root. It may be caused by a diseased tooth pulp
- dentigerous cyst – is associated with changes appearing around developing bone or an impacted tooth
- odontogenic keratocyst – occurs in the maxilla or mandible bone, and can reach considerable size
- periodontal cyst – this is caused by an inflammatory process within the periodontal pocket near the upper part of the tooth root
- gingival cyst – appears in the soft tissues of the mouth near the alveolar processes, occurs in patients of all ages, most often diagnosed in infants, reveals itself as a small, yellow and white nodule that spontaneously disappears with time
- mucus extravasation cyst – known as an oral mucocele – usually formed at the site of damage to the mucous membrane – damage to the small salivary gland and the accumulation of mucus in the soft tissues, e.g. lips or cheek
- retention cyst – this develops due to obstruction of the salivary gland duct, leading to mucus accumulation within cysts in soft tissues
Normally, cysts do not have any initial symptoms and are detected accidentally during radiological diagnostics, e.g. in a pantomographic picture. Larger cysts may show up through distension or bulging of the bones or gums around the lesion. When inflammation occurs, the cyst may cause severe pain.
One symptom of a periapical cyst associated with a tooth apex with infected pulp may be the appearance of a purulent fistula on the gum near the root, from which purulent content may flow periodically. Alternatively, it may take the form of a pink-red bump. If these are particularly large, you may experience:
- face asymmetry
- tooth dislocation
- loosening of teeth
- pathological fractures
The course of treatment
Depending on the cause and location of the cyst, different types of solutions can be applied:
- For periapical cysts, the most common solution is endodontic (root canal) treatment of causative and cystic teeth, along with surgical enucleation of the cyst and root apex resection.
REMOVAL OF PERIAPICAL CYST THROUGH CANAL TREATMENT AND ENUCLEATION OF INFECTED TISSUES
REMOVAL OF PERIAPICAL CYST THROUGH ROOT APEX RESECTION
- Causative tooth extraction is sometimes required when the size or location of a cyst prevents the implementation of a tooth-saving root apex resection
TOOTH EXTRACTION AND enucleation of PERIAPICAL cyst
- The treatment of cysts usually involves the removal of an impacted causative tooth and enucleation of the cyst.
- In the case of soft tissue cysts, e.g. cysts caused by mucus extravasation or congestive cysts, the treatment involves cyst excision.
After enucleation of the cystic tumor lesion, histopathological examination is always performed to determine the nature of the cyst and the final diagnosis. In cases of larger cysts, a procedure is sometimes performed to extract a fragment from its wall in order to perform a histopathological examination, because only through such evaluation is it possible to make a diagnosis. In addition, a larger cyst, the removal of which would risk of weakening bones or pathological fracture, undergoes a two-stage treatment – first decompression of the cyst and, only after a certain time, enucleation of the whole lesion.
In some cases, after the enucleation of the cyst of the maxilla or mandible, reconstruction of the bone defect using bone substitute materials is performed.
After the procedure it is recommended to observe:
- increased oral hygiene – thorough brushing after each meal (in the operated area using a very soft brush), rinsing the mouth with antiseptic fluid e.g. Eludril 2-3 times a day for 14 days
- a soft diet for about 7-14 days
- cold compresses applied on the day of surgery
- removal of seams after 7-14 days of surgery