A dental( odontogenic) cyst is a cavity formation near the root of the tooth, which has a connective tissue epithelial membrane filled with serous or purulent contents. The medium contained in the cyst exudate has a pathogenic microflora.
Localizes most often at the apex of one or more of the roots of the teeth. Its size can reach from 1 to 3 centimeters in diameter, and when located in the maxillary sinus and up to 12 cm. Large volumes cause a pronounced lysis( dissolution of cells) of the jaw bone. If the shell is damaged and the fluid exits, for example through a fistulous course, the surrounding tissues become infected.
The maxillofacial region is a complex anatomical formation. This is the connection of several bone systems, tendons, muscle tissue, permeated with nerve trunks and blood vessels. It is not uncommon that an asymptomatic inflammatory process begins to develop in one part or another. The most common pathological formation, which does not give a distinct symptomatology and is a cyst on the root of the tooth.
- 1 Contents Types of dental cysts
- 2 symptomatology of the disease
- 3 Properties treating cystic formations
- 3.1 Surgical methods
- 3.1.1 cystotomy
- 3.1.2 Cystectomy
- 3.1.3 Hemisection
- 3.2 Conservative methods for treating
- 3.3 Laser therapy in dentistry
- 3.1 Surgical methods
- 4 Cyst in the maxillary sinus
Types of dental cysts
Neoplasm is similar to a specific capsule filled with serous or purulent exudate. Their diameter is from 1 to several centimeters. Cysts are classified according to certain parameters:
- Localization or location in the oral cavity:
- deep in the gum;
- in a group of teeth;
- approximal area;
- incisive canal;
- of the maxillary sinus;
- root apex or region of their bifurcation;
- is the molar region.
- Reason for occurrence.
- Keratokist. Formed in violation of tooth development from epithelial remains, during the formation stage.
- Follicular or tooth-containing cyst. It develops due to a violation of the eruption of the tooth. For example, when the bite does not change for a long time.
- With severe or complicated tooth extraction, there is residual formation.
- If the wisdom tooth erupts hard and the parodental cyst is formed for a long time.
- The most common are radicular or odontogenic formations. This is when the cyst is located under the tooth in the apex area. The reason for their appearance is the usual granulomas that occur during periodontitis.
Symptoms of the disease
Neoplasm often does not give any symptoms. But this is still small. In the future, with the growth of the dental cyst, signs become more pronounced. In addition, a vivid manifestation of the disease can provoke a weakened immunity or a severe infectious disease.
All symptoms appear on the jaw from the localization of the cyst. With an exacerbation, purulent processes may occur in the bones of the alveolar process and the jaw.
The main signs of the disease are:
- Painful sensations.
They are quite specific. Patients often complain of raspiraniya, aching and drawing pain. Virtually nothing is possible to remove pain. Unpleasant sensations slowly but constantly intensify.
- Swelling of tissues.
At first, edema is observed only in the area of cyst localization. In the future, with the progression of the process, inflammation can pass to neighboring soft tissues and cause abscesses and phlegmon. During the transition to bone tissue, periostitis and osteomyelitis are formed.
- Increased body temperature.
This is like a specific reaction of the body to the pathological process. This manifestation can be observed both during the exacerbation of the disease, and after the operative treatment. In this case, antibiotics must be prescribed. But if the pain and temperature do not subside, then you need to see a doctor quickly.
- Increased regional lymph nodes.
They are not just enlarged, but also painful. Lymph nodes remain mobile and not soldered with surrounding tissues. Their increase is due to the spread of the infection by blood to the neighboring departments of the maxillofacial area.
Features of treatment of cystic formations
The most reliable way to get rid of the problem is to remove the causative tooth. For a long time that's exactly what all dentists did. Modern methods of surgical intervention allow you to keep the tooth in the alveolus.
Any method of treatment is performed only after careful examination and agreement with the patient. The most commonly used methods are:
This is a partial cyst removal. Carry out at its large size or a high risk of damage to neighboring tissues, as well as with a sluggish course of the disease. Its peculiarity is low traumatic, but all procedures are done under local anesthesia.
The capsule itself is not removed. Usually only purulent contents are eliminated, which prevents the healing of the wound. The tooth is not subjected to surgical intervention. After eliminating the exudate, antibiotics and antimicrobials are prescribed.
The operation is a complete removal of the cyst with part of the root of the tooth. Cystectomy has a 100% guarantee of reliability. After its carrying out there are no relapses and very rare complications.
The procedure is rather complicated, not every clinic can offer it. The essence of the operation is to create a perforation in the alveolar bone under local anesthesia, in the area of cyst formation. With the help of curettage tools, it is removed together with the sheath.
The damaged root tip is cut with a cutter. The canal is sealed both through the perforation hole from the top to the bottom and from the side of the crown part of the tooth.
This operation is performed only on multi-rooted teeth. The cyst is removed together with the root to which it is attached, as well as part of the tooth in this area. Restoring the anatomical shape of the crown is possible with the help of composite materials and orthopedic structures. Sometimes a cyst is associated with several roots. In this case, the tooth is removed.
Conservative treatments for
Such therapy takes longer and does not give a 100% guarantee of complete elimination of the problem. Usually, thus, they treat granulomas or cystogranulomas, but with systematic and correct treatment, you can achieve good results and get rid of the cyst.
The main stages of the classical conservative mode of action are the following:
- X-ray examination;
- local injection anesthesia;
- dissection of the tooth cavity;
- removal of decay of the crown and root pulp;
- mechanical extension of the end channel;
- treatment with antiseptics and antibiotics;
- mechanical extension of apical root aperture;
- rinsing with antimicrobial agents and enzymes. At this stage, the tooth is usually left open. The patient is recommended frequent and thorough rinsing with alkaline solutions, antibacterial preparations are given either orally or intramuscularly;
- filling the canal and the site of the cyst localization with a combined therapeutic paste. It consists of antiseptics, enzymes, calcium and fluoride compounds, dry blood plasma, vitamins and minerals. The unique composition of the paste allows maintaining sterility in the canal and accelerating the formation of bone tissue.
Then the decision to treat or delete is taken after 6 months. The condition of periodontal tissues is determined by roentgenologic way. A positive result is observed in 70-80% of patients.
With ineffectiveness or for reliability, dentists often use depophoresis. Its phased implementation is as follows:
- local anesthesia;
- development of carious cavity, pulp chamber and root canals;
- setting quilted turunda with a suspension of copper-calcium hydroxide or pumping it into the canal in the form of a paste;
- placing a special electrode in the channel and fixing it with molten wax;
- feed through the electrode of a weak electric current;
- staging a temporary seal.
The procedure is repeated up to 3 times. Suspension under the influence of current penetrates into the most hidden parts of the channel, destroying the entire pathogenic microflora. This technology allows you to get rid of the cyst in more than 90% of cases. However, procedures are not carried out in all clinics due to lack of experience and special equipment.
Laser therapy in dentistry
Conditionally the method can be divided into 2 methods:
- Channel sterilization.
Initially, the channel is treated mechanically, and I inject antiseptic preparations into it. Sterilization is then carried out with a laser. The cyst is injected with funds that destroy its structure and the means that promote the regeneration of the bone tissue of the alveoli. Usually, several sessions are performed, depending on the size of the lesion and the duration of its formation.
- Transscalal dialysis
A laser light guide is placed through the tooth canal into the cavity of the cyst. The light of the laser begins to evaporate it literally from within. Thus, the destruction and complete elimination of the problem occurs, in addition, the laser flow helps to ensure absolute sterility of all the cavities of the tooth.
The main advantages of this method of treatment are:
- painless procedure;
- high efficiency;
- completely bloodless operation;
- minimal recurrence of the problem;
- no complications due to purulent infection;
- rapid tissue regeneration after surgery;
- can be carried out at almost any age.
The cyst in the maxillary sinus
Usually it is found out by chance during examination or when there is an exacerbation of the process and there is a pronounced inflammation. The cyst may occur due to blockage of the ducts of the sinus mucosa.
But more often the cause of development of education is a poorly cured tooth or a neglected form of periodontitis. And we are talking about specific teeth, whose roots are very close to the maxillary sinus. In an adult, these are fangs, the first and second premolar, and also the molar of the upper jaw. In this case, the cyst passes into the sinus as it grows.
Sometimes the roots of the teeth due to the structure of the maxillofacial region penetrate directly into the sinus. Thus, the cyst develops within the airborne formation and, when ruptured, causes inflammation of the mucosa. The course of a long time can be asymptomatic. When its size reaches 10-12 cm, there are pains similar to neuralgia of the trigeminal nerve.
To get rid of the cyst completely, it is necessary to remove the causative tooth. The neoplasm usually comes out together with the tooth. If this does not happen, the doctor conducts the curettage through the hole in the alveolar bone. All procedures are best performed under the influence of a visionographer. Thus, we can observe the quality of work. In addition, a course of antibacterial drugs and drugs that contribute to tissue repair is prescribed.
If the cause is not in the tooth, then the surgery is carried out permanently. To remove the cyst make a small incision. With the help of an endoscope and instruments, the bladder is opened, cleansing and anti-inflammatory therapy are performed.
In order not to omit the beginning of the growth of cysts or their appearance, it is necessary to follow simple rules. First of all, visit a specialist at least once every 6 months, during the treatment of tooth decay and its complications, do not give up additional methods of examination and follow the doctor's recommendations.