The dental granuloma , also called apical or periapical granuloma , is a medially frequent inflammatory pathology of the deep tissues of the tooth , often a consequence of other infections or necrosis. What are the characteristics of the disorder, what are the consequences and remedies?
Before going into the discussion, it is worth struggle with joints pain emphasizing that the disorder is often asymptomatic, so the patient may not be aware of it. For this reason, it is always essential to perform routine checks at the dentist , so that every possibility and unpleasant consequence is avoided.
Let’s see in detail all the useful information to learn to recognize a dental granuloma in time and find out which are the most suitable dental treatments:
Dental granuloma: the causes
Dental granuloma is often the consequence of an infectious process that involves the apical tissues of the tooth, that is those located at its root. It is normally a foreign mass, round in shape and of an average contained size, which surrounds the root of the tooth . The sac that is formed usually contains bacteria and white blood cells and is, at least in its initial forms, completely asymptomatic.
|It is a chronic disorder, because the infection has an immune system response that limits the proliferation of external agents in place, precisely forming the granuloma. Precisely for this reason, unless particularly large manifestations, the patient may not notice it: it is very frequent, in fact, that the granuloma is discovered during a normal routine check, such as the X-ray examination of the dental panoramic . If left untreated, it can form a true radicular cyst.|
Symptoms of the Apical Granuloma
As already specified, it is difficult for granuloma to manifest itself with specific signs, even if the most severe forms can be characterized by swelling, mild pain and lesions on the gums. In the latter case, it could also be associated with the outward expulsion of whitish, often purulent material.
In common parlance, it is customary to associate the granuloma with a not perfectly successful devitalization . In fact, bacterial infection often occurs precisely due to a non-corrected endodontic treatment performed. However the causes are the most varied: the disorder may also depend on a deep caries, a chipping of the tooth, the death of the nerve apex for reasons not strictly related to dental procedures.
Dental granuloma: the risks
Granuloma, as we have seen, can go unnoticed for a long time. This does not mean, however, that it is harmless: it can in fact pass from the chronic to the acute phase, forming an abscess , therefore endangering the entire health of the patient if the localized infection is able to extend from its location to other areas of ‘body. A fact that should not be underestimated, especially in those subjects with an immune system compromised or suffering from important chronic diseases. Consequently, as soon as the granuloma is detected, it is necessary to provide for its treatment in a timely manner.
How to treat an apical granuloma
The cure of choice for the disorder is the removal of the granuloma itself, since pharmacological treatments rarely have any effect. An antibiotic therapy , for example, may contain infection only in its acute phase, not in its chronic phase. The techniques that the specialist will implement depend on the severity of the infection, therefore on the size of the granuloma and the basic conditions of the tooth. In general, three common methods can be listed:
New root canal treatment : when the radiographic survey reveals a previous not correctly performed devitalization, it is possible to provide a new root canal treatment, removing the fillings, sterilizing the roots and the apices, then providing a new devitalization;
Apicectomy : this is an invasive operation which, by means of a special opening in the bones, serves to remove both the granuloma and the end of the tooth root, followed by a special filling. Although effective, the accessibility of apicectomy depends on both the physiognomy of the palate and the position of the affected tooth;
Extraction : this is the last available option, when the conservation precedents had no effect. The tooth is then removed in its entirety and surgery is started on its seat, definitively solving the problem. When completely cured, and always according to the specialist’s opinion, the missing tooth can be replaced with bridges or implants.
|As easy to guess, since the treatment of choice is devitalization or surgery, there are no natural remedies that can solve the problem. If anything, you can resort to the classic advice useful for the abscess, such as rinses with water and salt, if there was pain and swelling. It goes without saying that these findings are symptomatic and momentary, because on the granuloma it is necessary to intervene as soon as possible.|