Advanced dental cyst. Pathological formation - dental cyst: what is it, how to treat the disease and when surgical intervention is necessary

The article was written by a dentist with more than 19 years of experience.

A dental cyst is a formation at the apex of the tooth root, which is formed due to the presence of infection in the root canals. The cyst is firmly attached to the apex of the tooth root, and is a round-shaped cavity in the bone tissue, which is lined from the inside fibrous membrane, and inside is filled with pus (Fig. 1).

Tooth root cyst also has names - Radicular cyst or Periodontal abscess. Cysts tend to continually increase in size. Cysts grow especially quickly in the area upper jaw, where the bone is more porous.

Tooth cyst: photo

In Fig. 2 you can see what a dental cyst looks like on x-ray: like intense darkening at the top of the horse. In Fig. 3,4 there is a photo of a tooth cyst taken immediately after tooth extraction (the cyst looks like a sac attached to the apex of the root, filled with pus).

Tooth cyst: symptoms

The cyst is very long time can develop either completely asymptomatically or with minimal symptoms - there may be periodic minor pain when biting on the causative tooth or slight pain when pressing on the gum in the projection of the cyst. In this case, it is detected, as a rule, by chance - on survey radiographs regarding the treatment of other teeth.

In case of decreased immunity (for example, due to a cold), the infection in the cyst cavity usually worsens, which is accompanied by intense pus formation. In this case, there may be sharp pains, especially when biting on the causative tooth, swelling and swelling of the gums and cheeks may occur, the temperature may rise and weakness may appear.

What does a dental cyst look like: video

Cyst on a tooth: causes

A tooth root cyst has only one cause: an infection in the root canal. However, infection in the root canals can occur in 2 cases:

1. Untreated caries and pulpitis (Fig.5) –
   tissues affected by caries contain a large number of cariogenic microorganisms. If caries is not treated, then microbes gradually enter the tooth pulp, causing pulp inflammation in it. If pulpitis is not treated, which should consist of removing the infected tooth pulp, then the infection from the pulp penetrates through the root canals outside the tooth (to the area of ​​the root apexes). There, the infection causes the appearance of a periodontal abscess (tooth cyst).
2. Poorly filled root canals –
   Root canals are filled in the treatment of pulpitis and periodontitis. Normally, each root canal of a tooth should be filled to the apex of the root. If the canal is not filled to the root apex, then an infection develops in the unfilled part of the canal, which penetrates beyond the tooth and also causes the formation of a cyst. By official statistics Dentists do not fill root canals in 60-70 percent of cases, which is the reason for the frequency of this disease.

   In Fig. 6, 7 you can see radiographs of teeth whose root canals were poorly filled, which in both cases caused the formation of a cyst on the root of the tooth. In Fig. 6, white arrows mark unfilled areas of the root canals, and black arrows mark the cyst, which looks like an intense darkening in the picture.

   In Fig. 7c root canal only traces of the filling material are visible, i.e. The root canal was sealed loosely and not all the way, which led to the development of infection and the appearance of a tooth cyst measuring about 1 cm in diameter.

Tooth cyst: treatment

Treatment of dental cysts can be conservative (therapeutic) and surgical.

Therapeutic treatment is reasonable to use if...

• Root canals have not been previously filled and do not need to be unfilled.
• If the root canals are poorly sealed along the entire length of the canal (if only at the apex of the root), then it is better to resort to the surgical method.
• If the size of the cyst is more than 1 cm in diameter, and exacerbations often occur with swelling of the gums, pain, etc.

Surgical treatment is reasonable if...

• If there is a pin in the root canal.
• If there is a crown on the tooth.
• A prerequisite (including if there is a pin and a crown) is that the root canals must be well sealed for 2/3 of the length of the canal, and only underfilled at the apex of the tooth root.
• The size of the cyst is more than 1 cm in diameter.
• Frequent swelling of the gums in the area of ​​the cyst, frequent pain...

Therapeutic treatment of cysts using a specific example

Let’s say right away that this method of treatment is very long – over 3 months, requires numerous visits to the dentist, and is the most financially expensive. The sequence of actions is as follows:

1. Working with tooth root canals –
   → if the root canals of the tooth have not been previously filled, then at the first stage the pulp is removed from the tooth and instrumental treatment of the root canals is carried out.
   → if the root canals were previously filled, they are unsealed.

   In Fig. 8 you can see the initial situation when, as a result of the fact that the doctor did not fill the root canal at the apex of the root, a tooth root cyst formed. Because the canal was sealed - before starting treatment it must be unsealed, which was done (Fig. 9).

2. Medicinal treatment of canals –
   the cyst contains pus, so after unfilling the canals or removing the pulp, numerous rinses of the root canal with antiseptics are required.
3. Removal of medicine from the root apex –
   using special instruments, it is removed from the root apex (directly into the cyst cavity) medicinal substance, which has a powerful antiseptic effect. This is shown in Fig. 10 (1).
4. Temporary filling of canals with medicinal paste –
   After the medication is removed, the root canals are filled with a temporary paste, which also has an antiseptic effect. This is shown in Fig. 10 (2).
5. Repeating points 3 and 4 multiple times –
   The medication needs to be changed periodically. Therefore, you will need to make periodic visits to your dentist over the next few months.
6. X-ray control –
   The effectiveness of treatment is assessed. A decrease in the size of the cyst on x-ray indicates the effectiveness of therapy. In this case, you can proceed to the next stage (permanent filling of the canals).
7. Permanent root canal filling –
   If a decrease in the size of the cyst is noticed over the course of several months during treatment, then the root canals are finally filled, usually with gutta-percha (Fig. 11).
8. Placing a filling on a tooth crown .

After the final filling of the root canals and placement of the filling -

A cyst is one of the most common dental pathologies, which can be of any location: develop in the area of ​​the apex of the tooth root, under the crown, under the filling, near the so-called wisdom tooth. And, of course, a cyst front tooth is also no exception. It can appear in patients of any age, including children during the period of change from the dairy series to a permanent one.

Not so long ago, the diagnosis of a “cyst” meant that the tooth was doomed, it could not be saved, and only removal was required. For this reason, many patients were forced to resort to prosthetic services in the future. Today dental treatment is at high level development, and many ways have appeared effective treatment, especially when early detection pathology. To save the tooth and avoid the serious consequences that this pathological process leads to, you should understand what a cyst on the front tooth is and what to do when its signs appear.

Cyst, development features and causes

A cyst (or kystis, which means “bubble” in Greek) is a round-shaped neoplasm with a dense fibrous membrane and specific inflammatory fluid (pus) accumulated inside. In size it can be from 3-5 mm to several centimeters.

The appearance of a cystic neoplasm is an infectious process that is caused by the action of pathogenic microorganisms placed in limited space. In the case of a cyst of the anterior tooth under ceramic crown most often this happens after poor-quality treatment and an incompletely sealed dental canal. Once in this cavity, bacteria begin to actively multiply, and a protective reaction is triggered in the body and a barrier is formed around the affected area, separating adjacent healthy tissue. The resulting waste products of bacteria lead to the accumulation of pus in the soft tissues, damage to the root and the onset of inflammatory process.

Among other factors that may contribute to the development of a cyst on the upper front tooth, doctors call:

• advanced forms of dental diseases (caries, pulpitis, periodontitis);
• jaw injuries;
• sinusitis ( cystic formations not uncommon in the area of ​​the maxillary sinuses);
• poor hygiene oral cavity.

Signs of the development of a cystic neoplasm

The pathological process at the very beginning of its development is asymptomatic, so it is often discovered on an x-ray completely by accident. Characteristic symptoms cysts in the front tooth are observed with further growth and progression of the process; patients in this case complain of:

• pain when pressing on the affected tooth, especially intensifying when chewing food;
• aching pain that gradually becomes more intense and no longer responds to the influence of anesthetics;
• the appearance of redness and swelling of the gums;
• The temperature may rise, accompanied by general weakness.

If we are talking about the development of a cyst on the root of the upper front tooth located in the area maxillary sinus, a purulent odor may be felt in the nasal passage.

The last stage of growth of the cystic capsule becomes a fistula. It is a canal connecting the front tooth cyst and the gum surface. This passage opens the way for pus to enter the oral cavity after the pus bubble bursts.

Diagnosis and treatment of pathological phenomena

It is not difficult to diagnose a cystic formation on the front tooth; it can be seen on a regular x-ray. This study is the main one, allowing you to establish the exact size and location of the tumor, as well as distinguish pathology from other dental disorders. In the resulting image you can see dark spot in the form of a circle or oval, and prerequisite is the presence of clear boundaries. Mostly cysts form in the root region, in particular in the upper part of the roots, so the doctor pays the closest attention to this area. IN in rare cases Based on the resulting image, it is not possible to make an accurate diagnosis - this happens if the device does not capture the affected area or only partially captures it. For such patients, the study is re-assigned, changing the location of the X-ray examination in order to exclude other diseases and identify a cyst of a particular front tooth.

To obtain a more accurate picture of the development of the cyst, its size, shape and degree of tissue damage, electroodontodiagnosis or CT can be prescribed. Based on a dental examination, medical history and analysis of hardware diagnostic images, a method of treating anterior tooth cyst is selected.

In modern dental clinics main goal is not just therapy dental disease, namely tooth preservation. Today, for the treatment of such pathology, the following can be chosen:

• therapeutic (conservative) treatment;
• surgical intervention.

In most cases this pathology is treated surgically, the neoplasm needs to be removed, because it will not resolve on its own and the pus needs a way out. If we talk about conservative therapy, it is only possible when the tumor is at initial stage(in the form of a granuloma) and is small in size (5-7 mm). In this case, the doctor opens the canals, cleans them, treats the affected area with antiseptics, administers special medications for bone tissue regeneration, and then seals it. An advanced method of treating cysts is dopophoresis, which involves the use of a special suspension of copper and calcium hydroxide, which is injected into the root canal and subjected to electrical action. This treatment option differs most high performance effectiveness, however, is not available to everyone due to the lack of specialized equipment in some clinics.

If conservative treatment did not help, then apical surgery is indicated. It is possible in the case of a cyst on the front tooth, because the bone in the frontal area is not as thick as that of the posterior (chewing) row. During the operation, the doctor removes the contents of the cystic cavity and removes along with it part of the tooth root to which the tumor was attached, then fills the canal from the inside and sutures the gum.

Attention! In modern clinics equipped with appropriate equipment, laser surgery is practiced. The method is highly effective, low-traumatic, painless, different fast healing treated area.

Prevention of the development of cystic formations

The best prevention of development cystic neoplasms is a regular, at least once a year, visit to the dentist for examination and timely treatment diseases such as caries. Of course, visiting the dentist is not the most pleasant pastime, but your health depends on it, so it is necessary to undergo an examination every six months or at least a year. Moreover, when early diagnosis it will be possible to cure a cyst fundamentally faster and cheaper, and also without resorting to radical methods therapy. In addition, keep in mind that sometimes the development of a neoplasm occurs without obvious symptoms; therefore, only a visual examination can detect it.

Considering that the pathology at the beginning of its development is asymptomatic, a dental examination is the only opportunity to early stage suspect an inflammatory process and prevent serious consequences.

Why is it necessary to treat a cyst?

A characteristic feature of this pathology is constant growth; in particular, there is a risk that the neoplasm will grow onto adjacent molars and penetrate into the area of ​​the maxillary sinuses. If events develop according to the first scenario, two or three teeth will simultaneously lose their stable position, and in the second case, chronic stage sinusitis. So apply for dental care makes sense even if the development of the cyst is not accompanied by painful sensations.

Advanced stages of development of this pathology can lead to dangerous consequences. In addition to the fact that a person is tormented by severe toothaches, the body is poisoned by toxic substances accumulated in the cystic cavity. Patients observe a constant deterioration in their health, increased body temperature, and weakness. Subsequently, the periosteum begins to rot, which leads to thinning of the jaw bone, and there is a threat of infection entering the blood.

Attention! The appearance of any of the symptoms pathological process is a reason immediate appeal V dental clinic.

The natural result of an untimely visit to the doctor may be the loss of one or more teeth and the formation of connective tissue in place of the destroyed bone structures. The most serious complications include:

• active inflammatory processes in the lymph nodes;
• the formation of abscesses with rotting products inside;
• development of diseases caused by chronic course infectious processes (osteomyelitis, periostitis);
• the appearance of an abscess in the gum or cheek area (this can occur both with the growth of a cyst and with the presence of a granuloma);
• purulent inflammatory process in the cervical region;
• general infection of the body by pathogenic microorganisms through the blood;
• spontaneous fractures of the jaw bones.

In contact with

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;
• enlargement and pain 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 at a late stage does a purulent capsule form and pain appear.


• 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 dental cyst in the maxillary sinus: can only be diagnosed with the help of special equipment, since otherwise it is impossible to notice even a large dental cyst in the maxillary sinus. 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 at an 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 of the “eights”. The only treatment option is to remove the affected tooth.

The cyst of the front tooth should be specially noted. 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 a 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. Similar cyst quickly increases, can move to other teeth and is fraught with extensive damage to them. During development follicular cyst Tooth 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 zone supporting surface predominantly 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. Surgical treatment 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 lesion spreads 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.

The earlier a dental cyst was detected, the higher the chances of its successful treatment. So, instead of struggling with the consequences of a dental cyst, visit your dentist regularly and undergo preventive examinations to maintain oral health.

A dental cyst is a neoplasm in the area next to the periosteum of the tooth that occurs due to various circumstances and does not always immediately manifest symptoms. However, under favorable circumstances, the cyst may begin to grow, and then the patient will definitely learn about its existence.

It is impossible to delay treatment of a cyst, as the formation may increase and lead to adverse consequences.

Important! The cyst, as a rule, occurs at the apex of the tooth root and is hollow formation, surrounded by a layer of epithelium and filled with liquid contents. Inside a kind of sac there is pus and dead cells.

A dental cyst is a formation at the apex of the tooth root; it appears due to an infection in the root canals. It is a cavity in the bone tissue, which is filled with pus inside.

Why does a cyst form?

Important! The main reason The appearance of a cyst is an infectious process that occurs in the area of ​​the tooth root. Often the circumstances that provoke a cyst are poor hygiene oral cavity or traumatic causes.

• various forms of caries;
• pulpitis;
• periodontitis;
• gingivitis;
• periostitis.

Traumatic circumstances of cyst formation include:

• head and jaw injuries;
• incorrect installation of prosthetic structures;
• process of teething;
• excessive stress on the teeth that occurs when gnawing nuts or biting off other hard foods, as well as when teeth hit each other.

These reasons can lead to the development of inflammation in the area of ​​the tooth root, which over time will turn into a cystic formation.

Poor hygiene, accumulation of bacteria, infection in the area of ​​the tooth root - all these are reasons that provoke the occurrence of oral cysts.

Types of cysts

Emerging bubble formations are divided into several types of cysts:

1. Retromolar. Such a cyst develops in the presence of a chronic inflammatory process, associated in most cases with eruption. A retromolar cyst often occurs when wisdom teeth are dented, as it is often accompanied by pathology of their formation, inflammation of the gums, etc.
2. Eruption cyst. The pathology is very similar to the previous type, but differs more mild form leakage. Such a cyst is considered benign and sometimes occurs even in young children during the dental process permanent teeth. The formation is mild and is caused by the proliferation of bacteria against the background of reduced immunity.
3. Radicular. This type of cyst is the most common and occurs against the background of an inflammatory process in a chronic form. The cause may be injury to surrounding tissues. It is difficult to make a diagnosis at an early stage, since the process is slow.
4. Follicular. This cyst arises from the follicles, that is, from the rudiments of the future tooth during its eruption.
5. Residual. Such a formation may appear after tooth extraction surgery. If during the procedure a fragment of the tooth root remains in the tissues, it becomes the cause of the inflammatory process. Around this area, suppuration occurs, which surrounds a piece of the tooth. The process is acute and requires immediate intervention.
6. Cyst of the maxillary sinus. The formation in this case is caused by an infectious process in the sinuses that has spread to the roots of the eye teeth.
7. Keratocyst. This form of cyst is a consequence of impaired development of periodontal tissue. At its core, the formation resembles the follicular type, but their nature still differs. The cyst arises from the epithelial tissues located around the tooth and interferes with its further development.

Retention cysts develop around the crown of unerupted teeth embedded in the bone. Eruption cysts occur when the tooth has already begun to erupt through soft fabrics, covering the bone.

Symptoms of pathology

Cyst formation can occur in different ways. When a granuloma develops on the root of a tooth, there are practically no symptoms. The bubble has higher density And small size. In this form, the formation does not cause discomfort to the patient. Occasionally, pain may occur when biting into dense food, but usually they do not pay attention to it, explaining this phenomenon by some other factors.
A highly qualified doctor can diagnose granuloma, but this happens quite rarely. It happens that the process of cyst formation is detected on an x-ray by chance, during the treatment of neighboring teeth.

Attention! When suitable conditions arise, the cyst begins to increase in size. Then the symptoms become much more pronounced. Strong pain is localized in the gum and affected tooth, and can also radiate to another jaw.

Body temperature often rises and swelling of the surrounding tissues occurs, which is noticeable even from the side of the patient’s face.

Symptoms of dental cyst formation are very diverse, the patient feels: headache, weakness, enlarged lymph nodes, odor, aching pain in the nose, possible fever, toothache, swelling of the gums, discomfort when chewing...

What is the danger?

The cyst itself is not dangerous, since it is only the body’s reaction to an infectious process. However, if this condition is ignored, the formation progresses, increasing in size, which can lead to the development of diseases:

• Flux. Purulent complication, accompanied by noticeable swelling of the face and intense pain. The condition requires immediate intervention.
• Periodontitis. Periodontal inflammation can both provoke the formation of a cyst and become its consequence. In an advanced form, the disease can result in tooth loss.
• Phlegmon (purulent inflammation of fatty tissue). It is dangerous due to the rapid spread of the purulent process into the surrounding tissues up to the development of general infection of the body. The condition is especially dangerous for pregnant women, as treatment requires the use of potent drugs.
• Jaw fractures.
• Loss of the affected tooth.
• Osteomyelitis of the jaw bones.
• Tumor diseases.
• Sepsis.

Flux is a disease of people who have advanced diseases of teeth and gums. The main cause of this disease is untreated caries, which develops into a more serious form.

Therapeutic treatment of cysts

Treatment conservative methods possible at the initial stage of cyst formation, when it is no more than 10 mm in diameter with good patency of the dental canals. A doctor usually decides on such treatment if the patient is still young.

Attention! The dentist's job is to stop infectious process, which caused the formation of a vesicle, as well as in taking measures against recurrence of the cyst.

Therapeutic treatment is carried out only at the early stage of cyst development with the help of antibiotics and sanitation of the tooth canals. The tooth is unsealed, disinfected and a drug is injected that stimulates the growth of dental tissues and a temporary filling is installed for about half a year.

Surgical method of treatment

This method is used when the tooth does not require refilling, and the cystic formation has a diameter of more than 10 mm. Indication for surgical treatment is also the presence of a crown on the tooth, a core tab or root pins.
The operation can be performed different ways, which depend on the extent of tissue damage and differ in the degree of intervention:

• cystotomy;
• cystectomy;
• root resection;
• hemisection.

The most gentle way is to remove only fragments of the cyst and treat surrounding tissues antiseptic drugs. This operation is called cystotomy. An incision is made on the gum, through which the cystic formation is removed. After antimicrobial treatment, a suture is placed on the gum. Medicines, embedded inside the tissues, exert their postoperative effect and require constant monitoring by a doctor, similar to the process of therapeutic treatment.
Cystostomy is indicated in cases where:

• the cyst is removed from the baby teeth and it is important to preserve the rudiments of permanent teeth;
• cystic formation affects adjacent teeth or jaw bones;
• there are restrictions on the use of other therapeutic techniques in this patient.

Cystectomy is a more extensive procedure. The gum in the area of ​​the cyst is dissected and the edges of the wound are spread apart. Next, the dentist removes the cystic formation and cleans the surrounding tissue. The outer part of the bone plate is cut out and part of the root in the area of ​​the cyst is removed. The dentist places drugs inside that promote bone tissue growth and then places a suture on the gum. At large sizes cyst and the resulting wound, no suture is applied, and the surface is covered with an iodoform swab.

Important! The most serious of surgical methods is the resection of the tips of the dental roots. The indication for such an operation is the spread of infection to bone tissue. In this case, it is not possible to save them.

In general, the procedure follows the same procedure as a cystectomy, but it also removes top part root affected by infection.
This method is used when saving the tooth is extremely important, but other methods of treating the cyst have proven ineffective. Before resection, the tooth is prepared for surgery, including orthograde canal filling.
An alternative method is laser therapy. In this case, a tube is placed at the incision site, which directs the laser beam. The laser destroys the tissues affected by the infection, and their remains are removed with a vacuum. High efficiency The method consists in high accuracy, as well as a disinfecting effect on the affected area of ​​​​tissue.
If the pathology has reached a deep stage, then a decision may be made about hemisection. This operation involves removing the cystic vesicle, the root of the tooth, as well as part of its crown to which the infection has spread. Sometimes, along with the cyst, complete tooth extraction may be required. In any case, dentists have at their disposal a wide range of medications and techniques that allow them to try to at least partially save the tooth.

Removal of a dental cyst should be carried out if the cyst was found on late stages or there are extensive inflammatory processes, in which case therapy will no longer help. There are several types of surgery: cystotomy, cystectomy and hemisection.

Prevention of cyst formation

Measures aimed at preventing the development of cystic processes are similar to standard recommendations for maintaining oral health. Main preventive measures are:

• proper and regular dental and oral care;
• carrying out professional hygiene;
• strengthening the immune system and nervous system;
• preventive dental examinations twice a year;
• taking care of your health and avoiding traumatic situations.

Of course, it is better to prevent a cyst from occurring than to treat it. For this reason, you should carefully monitor the health of your teeth and the condition of the body as a whole. However, if pathology does arise, do not despair and give up. A timely visit to the dental clinic allows for the most gentle treatment possible. therapeutic measures and get rid of the cyst, keeping the tooth intact.

A dental cyst is a bubble attached to the root of a fang, molar or incisor, filled with liquid, more often with pus. Cysts on the roots are a consequence of infection and differ in size, location and causes. As a rule, purulent formation is the result of advanced caries, which has developed into pulpitis and inflammation of the gum tissue (periodontitis). How to treat cystic formations: remove the tooth or are other methods of therapy possible?

A dental cyst is formed as a result of infection and the activity of pathogenic microorganisms in a closed, limited cavity. What causes the appearance of purulent cavities on the roots that require treatment or tooth extraction?

• Advanced caries and.
• Periodontitis is an inflammation of the ligamentous tissue connecting the root and gum tissue. May purchase chronic form, characterized by tolerant aching pain. If left untreated, the area of ​​inflammation expands deeper into the gum, approaching the periosteum.
• Sinusitis, tonsillitis or others chronic inflammation nasopharynx. These factors usually do not require tooth extraction; therapy for the underlying ENT disease is necessary.
• Difficult cutting. This factor often provokes a cyst under the wisdom tooth. Difficult eruption is a traumatic factor, causing inflammation. If they get inside pathogenic bacteria, is formed purulent process and a capsule is formed.
• Inflammation of the root under the crown without the possibility of toxic formations leaving the root canals. The result of the accumulation of pus is a cyst.
• Injury with infection reaching the roots.
• Infection due to inaccurate treatment, insufficient sterility of the instrument or the doctor’s hands.

The size of the cyst under the tooth can reach several centimeters. The minimum size is considered to be a bubble of 5 mm. Smaller pus formations usually do not have a clear membrane separating them from the gum tissue and are not considered cysts. They are called granulomas. Granulomas can resolve when the inflammation is treated.

The cyst on the root of the tooth has a membrane and does not resolve. Treatment of a dental cyst requires opening the membrane and removing it.

Medical educational program: types of purulent formations

IN medical terminology There are several types of purulent capsules formed in the jaw area:

• retromolar (wisdom tooth cyst);
• eruption cyst (formation on children’s teeth, in children under 10 years of age);
• follicular (formed on the rudiments of unerupted teeth);
• radicular (formed at the root due to inflammation of the gum tissue - periodontitis);
• residual (formed in the periosteum after the removal of the tooth and its roots due to residual infection).

• Therapy(conservative treatment with medications without surgical intervention: rinsing, injections, unsealing).
• Surgery(removal of the entire tooth or part of its root). The bladder capsule, attached to the root apex, is removed along with the root during surgery. After removal it is necessary therapeutic treatment inflammation of the gums.

Surgery

Ten years ago, cyst surgery clearly required tooth extraction. Modern dentists try to maintain a hard chewing surface. The dental cyst is removed during a minor surgery called apex resection. How it's done?

After anesthesia, the doctor makes a cut on the outside of the gum (inside the mouth). Through a small hole, a special tool is used to cut off the root tip along with the cyst formed on it. Through surgical channel the root is sealed, the surgical cavity is treated with an antiseptic and sutured. As a rule, the wound does not require further treatment, since oral saliva is a disinfecting bactericidal solution. A week after removal, the sutures are removed and the quality of wound healing is monitored (visually) and the possible presence of cyst remnants (x-ray). A visual dental examination shows how much inflammation, swelling, and redness have decreased after the removal operation.

Resection allows you to save the tooth, without unfilling the canals and without changing the crown. It is important to know that if during the previous filling a pin was installed inside the canal, then it is almost impossible to open it without breaking the upper part of the chewing surface. Instead of removing the entire tooth, the doctor will perform a root tip resection.

Resection is preferable to complete tooth extraction. However, the possibility of its implementation is limited. As a rule, it is performed on the upper incisors and canines, less often on the lateral molars.

In the photo - the surgical cavity after removal of the cyst is filled with granules of osteoplastic material

Cyst therapy

Therapeutic treatment of dental cysts is possible for small formations (up to 8 mm). To do this, the carious canal is opened and the cystic capsule is opened. From internal cavity pump out pus. After opening, the canal is left unsealed (5-7 days), the patient is prescribed rinses antiseptic solutions. The resulting pus flows out, and inflammation of the gum tissue is treated with antibiotics. After the pus has flowed out, the inflammation has been stopped, the cystic cavity is filled with a special medicine, which promotes tissue regeneration. Next, the root canals and hard tissues are filled. Monitoring of the condition should be carried out 3-4 months after therapy.

Sometimes, with minor inflammation, therapy is carried out in two visits to the dentist. The tooth canal and cyst are opened, cleaned, filled with gel, the root is filled and a temporary filling is placed. In the absence of pain, swelling and redness, the temporary filling is replaced with a permanent one (7-10 days after opening and cleaning the cystic cavity).

High-quality therapeutic treatment of small formations can be carried out with a laser. To do this, the dental cyst is also opened, after which it is treated with a laser. This not only removes the contents and membrane of the bladder, but also destroys pathogenic microorganisms. Laser treatment has a number of additional benefits:

1. it is not capable of causing any infection;
2. it is painless;
3. the surgical wound heals quickly and does not cause complications, suppuration, or repeated relapses.

Traditional methods of treating cysts

Traditional methods or natural remedies can reduce or relieve inflammation of the gum tissue. As a rule, a dental cyst is accompanied by an inflammatory process (periodontitis). The reason is the effect of infection and the constant flow of toxins through the walls of the purulent capsule. After stopping (limiting and reducing) the inflammation, surgery is necessary to remove the purulent bladder (or therapy with opening the roots). Which natural remedies most effectively treat inflammation?

• Antiseptic herbal infusions eucalyptus, yarrow, sage, calendula. The concentration of the infusion increases the effectiveness of treatment. The required ratio is: 2 tablespoons of raw materials per 100 g of water.
• Alcohol tinctures provide additional disinfection with alcohol: tincture of propolis, calendula, calamus root, aloe.
• Aloe in the form of an application on the gum.
• Garlic paste (also in the form of an application). Saline solutions.
• Sesame oil.

Specified natural remedies can be successfully used to relieve gum inflammation before removal and treat the inflammatory process after surgery.

Cyst prevention: what does it consist of?

Methods for preventing the formation of cysts on the roots of teeth are simple:

1. Monitor your oral health, treat and prevent caries.
2. Clean the oral cavity daily from food debris that forms on plaque enamel.
3. Avoid the formation of tartar.
4. If a jaw injury occurs, take a control x-ray one to two months after the injury.

Healthy teeth are the patient’s responsibility. The doctor does all he can therapeutic assistance, conducts treatment, gives consultations. But only the person himself can ensure a timely visit to the dentist.