Cyst on the root of a tooth - treatment or removal? The main remedies used for dental cysts. Surgical treatment of the disease

Therefore, they advise their patients to undergo a preventive examination at least once a year and check “suspicious” teeth. Especially those that were filled more than ten years ago or hidden under a crown.

The easiest way to rid a patient of a cyst is to pull out the damaged tooth and clean out the gums. Just ten years ago, dentists did just that. Patients lost a “healthy” tooth and scolded the doctors, who just shrugged: there were no other ways to get to the cyst. Recently, a revolutionary revolution has occurred in the treatment of cysts and granulomas: now you can get rid of a cyst while saving the tooth.

To treat cysts and granulomas, surgical and therapeutic methods. Each of them has its pros and cons. The doctor decides with the patient individually which treatment method to choose.

Surgery

Among surgical methods most often used cystectomy: an operation during which the cyst and damaged tip of the tooth root are removed. Its main advantage is 100% reliability. Disadvantage: the operation is quite complicated; not every surgeon will dare to perform it on molars.

Another type of operation - hemisection. This is a less gentle removal of the cyst. It is performed when it is not possible to save one of the roots of the tooth. The doctor surgically removes the cyst, completely removes the hopeless root and part of the tooth above it. After hemisection, the resulting defect is corrected with a crown.

Therapeutic treatment

Therapeutic method of treatment allows you to relieve the patient of a cyst without surgery. It is ideal for the treatment of granulomas.

Of course, such treatment is less stressful for the patient. However, it can take quite a long time and does not guarantee 100% removal of the cyst.

The dentist does not cut anything; he gets to the cyst in a roundabout way. At the first stage of treatment, he drills out the diseased tooth and cleans the root canal from bottom to top. Deep in the gum, the root of the tooth passes into the cyst, so its contents can now freely flow out through the resulting passage. The doctor thoroughly rinses the root canal with disinfectant solutions, injects antimicrobials and substances that destroy the cyst membrane. Treatment can be continued only after the cystic cavity is completely cleared of damaged cells and microbes.

At the next stage, the doctor fills it with a special paste that will help it grow healthy. bone tissue at the site of damage. After this, the tooth is filled and waited. If after six months the cyst is not detected on an x-ray, it means that the treatment was successful. Using this method, it is possible to destroy the cyst in approximately 70% of cases.

Dentists consider a more progressive non-surgical method of treating cysts and granulomas depophoresis. It allows you to destroy infection in all root canals of a tooth at once, and not just in one drilled by a doctor. The essence of the method comes down to the following. A special suspension - copper-calcium hydroxide - is injected into the enlarged canal of the diseased tooth. Under the influence of the weak electric current the substance begins to move and penetrates into all corners inaccessible to the drill (including the cyst) and destroys damaged cells and all microbes.

After three sessions of depophoresis, a filling is placed on the cleaned tooth, and the copper-calcium hydroxide remaining inside continues to control the healing process. Advantages of the method: helps get rid of cysts in 95% of cases. Disadvantage: not every dental clinic has the technical equipment for depophoresis.

A dental cyst (from the Greek “kystis” - bubble) is an inflammatory formation in the form of a granule, which occurs as a result of the body’s protective reaction to infection or injury. Externally, the neoplasm is a bubble up to several centimeters in diameter, filled with fluid or pus. The fact is that when the body tries to fight inflammation on its own, the affected cells begin to die, and in order to isolate them from healthy tissues, a membrane forms around them. You can see this cavity in the early stages on an orthopantomogram.

Why does a dental cyst appear?

The main causes of cysts in teeth are:

• Development of infection in the root canal of a tooth
• Injury
• Chronic diseases oral cavity and nasopharynx
• Inflammation of periodontal tissues (periodontitis, periodontitis)
• Reduced immunity
• Caries
• Poorly installed filling or crown
• Difficult eruption of wisdom teeth

Symptoms of a dental cyst

The difficulty in diagnosing a cyst lies in the absence of symptoms. In some cases, a person may pay attention to such signs of a dental cyst as darkening of the enamel, slight displacement of the tooth and discomfort when chewing solid food, but most do not attach importance to this. By the time pain from a dental cyst begins to appear, the granule can already grow up to 1 cm in diameter. From this moment on, the patient begins to feel other quite noticeable signs. Here are the symptoms of a dental cyst that may appear at this stage:

• aching pain in the area of ​​inflammation;
• swelling, which can spread to the face;
• enlarged and painful lymph nodes;
• elevated temperature;
• headaches - with the development of a cyst in the maxillary sinus;
• general malaise.

Under no circumstances should these symptoms be ignored, otherwise serious consequences will arise, and removing a tooth with a cyst is not the worst of them. At the first signs of the development of the disease, you should consult a specialist.

What is the difference between a cyst and a granuloma?

A dental cyst is often confused with a granuloma - another dangerous disease, in which a rounded formation is formed in the root area. It is important to distinguish between them, since the diagnosis directly affects the treatment plan and its prognosis. For granuloma, in most cases therapeutic treatment is sufficient. But a cyst requires more radical measures.

Here are the main parameters by which a dental cyst and a dental granuloma differ:

Types of dental cysts

There are several types of molar cysts, which are classified according to location and depending on the reasons for their formation.

Depending on the location, the following types of cysts are divided:

• A cyst on the root of a tooth: it can be interradicular, peri-radicular and basal. Symptoms of a tooth root cyst for a long time do not appear, and only on late stage A purulent capsule forms and pain appears.


• Cyst on the gum: with this type of dental cyst, the fistula can form in any area of ​​the gums; filling with pus occurs a little later. A cyst near a tooth may be accompanied by a tingling sensation. As with other cases of fistula formation, the consequences of a cyst in the gum of a tooth are quite serious.


• A tooth cyst in the maxillary sinus: can only be diagnosed with the help of special equipment, since otherwise it is not even noticeable in the maxillary sinus large cyst tooth is impossible. With an advanced dental cyst, sinusitis can become a sad and very unpleasant consequence.


• Cyst under the crown of a tooth: most often this is a cyst after dental treatment that was unsuccessful. IN in this case a bubble is formed when the crown is installed incorrectly - as a result of the accumulation of food and the proliferation of bacteria. Quite difficult to detect this type cysts on early stage. To treat a tooth cyst with a crown, the latter will need to be removed.


• Wisdom tooth cyst: appears as a result of difficult eruption or chronic inflammation"eights". The only treatment option is to remove the affected tooth.

It should be noted separately the cyst front tooth. In general, the disease does not differ greatly from other types, however, due to the fact that the teeth are anterior section significantly narrower, this affects the volume of surrounding soft tissues. Therefore, the cyst upper tooth(or cysts lower tooth) in the front part of the jaw there is much less room for localization, and it begins to come out only in the gum area. For comparison: a cyst on the back teeth can form fistulous tract even through the cheek or neck.

According to the reasons for their appearance, the following types of cysts are distinguished:

1. Radicular, or odontogenic dental cyst: the most common type. It is formed in the upper third of the dental root from a granuloma - as a result of pulp necrosis and periapical (at the root apex) inflammation. The diameter of a radicular dental cyst varies from 2 mm to 3 cm. If there is no secondary inflammation, the disease is asymptomatic, there is no displacement of teeth or effects on bone tissue.


2. Residual: a cyst after tooth extraction, formed in a situation where the root apex was not completely removed or a granuloma formed in the area of ​​the missing tooth. A cyst after tooth extraction has the same properties as a radicular one.


3. Keratocyst, also called primary and primordial: formed due to a developmental disorder. Not a single tooth is immune from this, but most often it is a cyst due to inflammation in the area of ​​the premolars and third molar lower jaw. With its development, the likelihood of relapse is high.


4. Teething cyst, or retention: formed during the period of replacement of primary dental units with permanent ones. A tooth retention cyst looks like a bluish swelling that contains blood inside. In most cases, the fistula is formed due to slow eruption and can open at any time.


5. Follicular: formed in a situation where a tooth for some reason cannot erupt and grows inside the soft tissue. As a result, a cyst forms on the gum around the tooth. Such a cyst grows quickly, can move to other teeth and is fraught with extensive damage to them. With the development of a follicular dental cyst, complications can be expressed in the tilting of adjacent teeth, displacement of unerupted teeth, and root resorption.


6. Lateral periodontal: The exact causes of occurrence are not fully determined. As a rule, these are small cysts associated with the lateral surface of the tooth root.


7. Calcifying odontogenic: formed in the area of ​​the supporting surface mainly of the lower jaw. The reasons for its appearance are also not fully understood.

What to do with a dental cyst?

Since it is difficult to determine a cyst under a tooth, since it forms slowly and without brightness severe symptoms, patients often go to the doctor already at later stages diseases - when pain, malaise and other signs of inflammation are felt.

Previously in this situation the only way out the affected tooth was removed. Today, there are different methods for treating cysts without losing a tooth. Depending on the degree of the disease, you can get rid of it therapeutically or surgically.

Therapeutic treatment includes cleaning out the cyst from the canals, treating them and filling them. Surgery involves removing the damaged part of the tooth root while preserving the tooth itself. In this case, the cyst is eliminated and the missing tissue is replaced with a special material.

The indications for tooth extraction due to a cyst today are: special cases threatening complications, as well as a wisdom tooth cyst.

Is it possible not to treat a dental cyst? Only if it appeared in a child before the change of milk teeth, over time such a tooth cyst will burst on its own, due to the friction of the gums against each other.

Why is a dental cyst dangerous?

The irony is that, forming as a result of the body’s defensive reaction, a cyst under a tooth can ultimately lead to serious complications. The main ones:

• Periodontitis: an advanced case of dental cyst, in which inflammation from the tooth tissue spreads to the bone.
• Flux: purulent inflammation in the subgingival and subnasal jaw area. This complication of a dental cyst is accompanied by swelling of the soft tissues, including the cheeks, and severe pain.
• Tooth loss: occurs if the cyst is not treated. In this case, the damage extends to adjacent teeth(although the cyst itself is not an indication for removal).

In addition to the above, exacerbation of the disease can lead to even more severe consequences: purulent abscess, inflammation of the lymph nodes, osteomyelitis, sepsis and even a jaw fracture. Therefore, if you are diagnosed with a cyst, treatment should follow immediately.

How formerly cyst tooth has been identified, the higher the chances of its successful treatment. Therefore, instead of struggling with the consequences of a dental cyst, visit your dentist regularly and get preventive examinations to maintain oral health.

A dental cyst is an inflammatory formation, often filled serous fluid and having a direct affinity for dental tissues. It can occur in the root region, apex or in the area of ​​the lateral dental surfaces. Refers to benign neoplasms(not to be confused with tumor-like processes in the jaw area such as granulomas).

Characteristics of the neoplasm

1. The cavity is surrounded by a dense fibrous capsule.
2. The contents can be serous, purulent, hemorrhagic.
3. The sizes vary widely (can cover several teeth).
4. Localization for each option is individual.
5. During an external examination or in a photo, the gum tissue may be intact, since external manifestations such as hyperemia and edema appear only during suppuration.
6. In 85% of cases, the process is caused by an infection in the dental tissue (caries).
7. Expressed clinical picture(pain different intensity, symptoms of intoxication, headaches).
8. There is no pronounced dependence on age or gender.

Why does it occur

Exist following reasons dental cysts (in each individual variant of occurrence one of the reasons dominates):

1. Inflammatory diseases of dental tissues (pulpitis, periodontitis). In this case, inflammation engulfs adjacent tissues, and a cavity is formed in which inflammatory exudate accumulates.
2. Inflammatory diseases of adjacent organs (sinusitis, sinusitis, otitis media). In this case, the inflammatory agent enters the dental tissue by contact or hematogenous route.
3. Poor quality dental care (preservation of carious lesions with subsequent filling). It is also possible that cystic formations may appear during tooth extraction (not complete removal, preservation of cyst membranes).
4. Disruption immune system. Opportunistic flora In case of minor injuries, the oral cavity can become a source of inflammation.
5. Traumatic injury. In this case, the cystic cavity is more likely to be post-traumatic than true. Such formations are often hemorrhagic in nature, are not associated with dental tissues, and rarely suppurate.
6. Disruption of the teething process. In adults, this phenomenon often occurs when wisdom teeth appear. It is most often localized in the retromolar region and is associated with the formation of a bone pocket, which is filled with fibrous and epithelial tissue. During inflammation, the cells of these tissues begin to divide, and a cystic cavity gradually forms.
7. Disruption of the processes of development of the tooth germ. In this case, there is chronic periodontitis temporary teeth. Around the crown of an unerupted tooth, a focus of intensively dividing epithelial cells(at any stage of tooth formation, which leads to disruption of its structure). This explains the presence of rudimentary tissue in such a cystic cavity (tooth-containing cysts).

Dentist (in some cases maxillofacial surgeon) conducts diagnostics (X-rays in various projections), and depending on specific factor, which led to the formation of a cystic cavity, establishes a treatment regimen.

Treatment of a cyst on a tooth

The following are used in treatment:

• surgical method (removal);
• conservative method(usually serves as an addition to the operation).

Surgery

IN surgical practice it is customary to share cystic neoplasms into two types:

• odontogenic, which have inflammatory nature(root, tooth-containing, paradental);
• odontogenic, which relate to developmental defects (follicular, eruption).

The following options are available for removing a cyst on a tooth, depending on the type:

There are several features of the treatment of suppurating cystic formations:

• no incisions are made in the area of ​​the future mucoperiosteal flap;
• a puncture is made along the alveolar ridge for adequate outflow and drainage;
• elective surgery is indicated after inflammation has subsided.

Possible the following complications surgical treatment:

• bleeding or suppuration of a postoperative wound;
• traumatic damage to the nerve plexuses;
• sinus perforation;
• separation of wound edges due to repeated suppuration;
• postoperative paresthesia;
• necrotic changes in surrounding tissues.

Conservative therapy

Non-surgical treatments include:

1. Injecting antibiotics directly into the root canal (an option for removing root cystic formations, which has high frequency relapses).
2. Depophoresis is another option in which dental cavity a special gel-like substance is introduced, after which electrophoresis is used. Provides an antibacterial effect.
3. Laser exposure. The essence of the method is associated with the introduction of special laser equipment into the dental canal and “sealing” the wall of the cystic cavity with simultaneous disinfection of the affected area.

No conservative method is 100% effective against odontogenic cysts.

Possible consequences

At untimely treatment or its absence, dental cystic neoplasms can have a number of complications:

1. Purulent melting of bone tissue (especially for cysts on the root of a tooth). The result may be the development of osteomyelitis of the lower jaw due to pus entering deep into the bone. IN in rare cases Pathological fractures or cracks are possible due to thinning of the bone tissue.
2. Transition of inflammation into an abscess or phlegmon. In this case, the purulent focus has a significant spread.
3. Regional lymphadenitis, or inflammation of regional lymph nodes. As a rule, it goes away without a trace once the cause is eliminated.
4. Sinusitis or sinusitis when the cyst is localized in close proximity to the walls of the sinuses.
5. Sepsis. Very dangerous complication, which appears only against the backdrop of a vast purulent lesion, by itself cystic formation doesn't call it.

The cyst rarely gives serious consequences after a course of treatment.

Video

We offer you to watch a video on the topic of the article.

Sometimes patients confuse a dental cyst with a granuloma, for example, or other diseases with similar symptoms. Therefore, today we will tell you in detail: what is a dental cyst and how to treat it?

A cyst is a formation at the root of a tooth with liquid or suppuration; most often it forms deep in the gums as a result of complications of dental diseases and is quite painful, excuse the tautology. It can affect both the main row of teeth and the eights (wisdom teeth).

Why does a cyst form? Main causes

A cyst on a tooth appears as a result of the activity of harmful microorganisms in a closed dental space. Conventionally, the causes of cysts can be divided into several types:

• after severe dental diseases, improper treatment or lack thereof (caries, pulpitis, periodontitis);
• complications after implantation, filling, etc. In this case, the crown or filling can be removed to eliminate not only the cyst itself, but also the cause of its occurrence - the accumulation of harmful organisms under the dental insert;
• complications during teething, especially in the case of wisdom teeth. The fact is that a tooth that is cutting through can injure the periodontal tissue, which leads to disease;
• mechanical damage to the dental body, as a result of which microorganisms enter the wound;
• diseases of the nasopharynx (for example, sinusitis or tonsillitis), which can result in infection in the oral cavity. In this case, it is necessary to treat both the nasopharynx itself and get rid of the resulting cyst.

Other factors, or several of the above, can contribute to the appearance of a cyst. Establishing the cause will help both in the treatment of an existing disease and in the process of preventing the appearance of new similar formations.

Kinds

A dental cyst can be classified according to several, the most characteristic parameters, which can be divided into the following groups or types:

1. According to the nature of the disease:

• Inflammatory:
  a) Residual - after tooth extraction surgery, are the most common.
  b) Retromolar – for difficult eruption of wisdom teeth.
  c) Radicular - cysts located on or near the tooth root.
• Non-inflammatory:
  a) With difficult teething - unlike retromolar cysts, these most often appear in childhood.
  b) Follicular cysts - contain a germ permanent tooth, they most often arise during insufficient or poor quality medical care behind baby teeth.

1. By origin:

• odontogenic – cysts caused by dental diseases;
• non-odontogenic - the cause of the appearance lies in problems not related to the teeth or oral cavity.

1. By location:

• anterior teeth;
• wisdom teeth, etc.;
• teeth adjacent to the maxillary sinuses with their roots.

Tooth cyst: symptoms and consequences

Experts note that diagnosing a cyst, especially on early stages its development is a rather complex process. The fact is that at first, it actually does not manifest itself in any way, and the first sensations of discomfort come when it reaches an impressive size.

At the same time, it is worth noting that the formation of a cyst is a long process. This carries with it both dangers and positive points, which consist in the fact that the patient has the opportunity to identify symptoms that foreshadow the onset of this disease and contact the dentist in time, which will greatly facilitate the treatment process.

The most common symptoms are:

• gradually increasing swelling on the gum near the tooth root. The enlargement process is usually not very rapid, however, it is quite noticeable;
• if a cyst forms in the area maxillary sinus, then the patient will feel headaches, which often do not go away even after taking medications;
• occurrence, which is some kind of tunnel that indicates the epicenter of inflammation with outer surface gums;
• during an inflammatory process it is possible general increase temperature of the whole body, or in the area of ​​cyst formation.

The symptoms are quite general character, as you noticed, therefore we strongly recommend visiting a dentist more often, who will be able to diagnose a cyst in the early stages using an x-ray, most exact way definitions of disease.

What is dangerous about a cyst is that the patient may not realize for a long time existing problem, because of which it can cause great complications, which will make the process of its treatment more difficult.

What does a cyst on a tooth look like? Photo and X-ray

It is difficult for an inexperienced person to detect a cyst with the naked eye. When it becomes visually noticeable, this means that it is already at the final stage of its development, has a very large size, and the pain from it becomes intolerable, sharp and noticeable.

The gums in this place may become noticeably red, stand out in color from healthy areas, and swell significantly. The inflammatory cyst may appear pale yellow or gray, with a red rim around the edges.

For dentists, the main diagnostic method remains X-ray, On him dental cyst has the shape of a round dark spot different sizes, depending on the stage and course of the disease. This spot is located at the tooth root, at its highest point, and has fairly clear contours.

Treatment of dental cyst

As a rule, patients who have had a cyst , they learn about its presence when it has already become inflamed or caused complications in the maxillary sinuses . In this case, pain and severe discomfort in the oral cavity occur, which prompts a person to consult a doctor.

Dentists, however, often cannot say with complete certainty whether a person has a cyst on a tooth and send them to take an x-ray, which confirms the diagnosis or refutes it. If the dentist doubts the origin of the cyst, he sends the patient for a puncture and appropriate tests, which should determine whether the disease has an oncological origin.

After all of the above procedures, the doctor can begin treatment; it can be either surgical or therapeutic.

Surgical intervention

Many patients believe that to get rid of a cyst it is necessary to remove the tooth on which it appeared, but this is not entirely true. Indeed, several years ago it was necessary measure, but now such a turn of events can be avoided thanks to resection (removal) of the tooth root on which the cyst is located. At the same time, the remaining root is sealed, and the surgical canal through which the cyst was removed is processed and sutured.

However, the treatment process does not end there, since the stitches still need to be removed and the healing of the wound must be monitored. You also need to make sure that there are no remains of the cyst at the site of the operation; for this you need to take a repeat X-ray.

Removing the root along with the cyst is not always possible, and Complete tooth extraction is often necessary, this method is used when the cyst is in a hard-to-reach place and the disease is quite complicated. After its removal, the patient still long time experiences discomfort, pain, should regularly visit a doctor.

Therapy, laser use

The therapeutic method is a process of influencing the source of the disease without surgical intervention, and with the help of injections and rinses, however, this method of treatment is applicable only to small cysts.

1. During the therapy, the dental canal is opened, which leads to the cyst and pus is pumped out from there.
2. The canal is not sealed for up to 10 days; in parallel, the patient must rinse the oral cavity and the affected area with antiseptic tinctures.
3. After this, the dental canals are treated with special medications, and the tooth is filled.

Laser removal

With this method of treatment, the dental canal is opened and the place where the cyst is located is treated with a laser, thus destroying not only the cyst bubble, but also many harmful organisms. The advantages of this method of treatment include the fact that there is no risk of infection in the diseased area, and the healing process is much faster.

Treatment at home without removal

There is an opinion that a cyst can be removed independently using folk remedies without a visit to the dentist, but this can only apply to a granuloma, and not to a cyst, since, unlike the latter, a granuloma does not have a hard capsule and can resolve on its own. A cyst can only be removed in dental office, and it will not be possible to do without surgery.

However, this does not mean that it is impossible to help treat the cyst at home. The fact is that during the inflammatory process that accompanies this disease, the gums need an antiseptic effect. Eucalyptus and calendula have this effect. Of course, these measures are purely auxiliary.

Tinctures and folk remedies with the same antiseptic effect can be effectively used after resection of the dental root and the tooth itself in order to remove the cyst. The fact is that after these operations there is also a significant risk of inflammation and relapse of the disease.

Can a dental cyst be cured with antibiotics?

At therapeutic treatment Antibiotics are often used wide range actions. They are aids and help cope with inflammatory processes V soft tissues, facilitate the course of the disease as a whole.

In the case of a cyst, taking any antibiotics should be prescribed by a doctor and be under his close supervision. The most commonly used drugs are:

• tetracycline – once the most popular antibiotic in the treatment of dental cysts, comes from the group of tetracyclines, has now given way to the dominant place to other drugs;
• Cifroploxacin is the most popular antibiotic after tetracycline;
• amoxicillin - has the best antimicrobial effect, which greatly facilitates the passage of the cyst at any stage of the disease.

Local antibiotics are sometimes used, but the difficulty lies in the impossibility of applying them evenly to the diseased surface. In any case, what kind of antibiotics and how many times to take them should be determined by the doctor, based on the circumstances of each individual disease.

Cyst under the crown: what to do?

The appearance of disease under the crown is most often a consequence of incorrect or incorrect installation of the crown itself. As a result, harmful microorganisms begin to actively multiply in the space between the tooth and gum.

What are they doing to prevent this from happening?

• at small sizes for cysts there is no need to remove the crown, and treatment takes place without direct surgical intervention;
• with sizes of 8 mm or more there is a risk of tooth loss, however modern methods treatment allows you to save the tooth. To do this, you need to open the tooth and treat the canals. special drugs, which should eliminate the cyst, after some time the crown is installed back;
• if this method of treatment does not help, resort to resection;
• in particularly severe cases, the tooth must be removed.

In order not to lose a tooth along with its crown, you must regularly consult a doctor and go to the dentist at the first symptoms.

Video: how to treat a dental cyst and what is it?

Prevention

To prevent cysts from appearing, you must adhere to simple but effective rules of oral care:

1. Do not treat diseases such as caries, pulpitis, periodontitis, treat them systematically until complete recovery.
2. Prevent plaque from appearing and turning into tartar.
3. Monitor the condition of the oral cavity after operations and injuries.
4. Visit the dentist regularly to monitor the condition of filled teeth, implants, etc.

You can also regularly take dental x-rays, especially in cases where there are long-standing fillings and crowns. Over time, harmful microorganisms tend to accumulate underneath them, leading to the formation of a cyst, which even experienced dentists cannot always identify.