Granuloma - what is it? Granuloma: treatment, causes. Methods for the diagnosis and treatment of tooth granuloma Dental granulomas resolve

From this article you will learn

• why does a granuloma form on the root of a tooth,
• how it looks in the photo and x-ray,
• treatment methods.

Tooth granuloma - an inflammatory formation at the top of the tooth root, which is formed during the development of chronic. It is tightly attached to the apex of the root, and in fact is the initial stage in the development of cystogranuloma and radicular cyst, from which it differs only in size.

The fact is that it is customary to call a granuloma a formation only up to 0.5 cm in size, a cystogranuloma is a formation from 0.5 to 1 cm, and a cyst is a formation from 1 cm in diameter. That's all the difference between them. If left untreated, the granuloma will certainly grow and will eventually turn into.

Tooth granuloma: symptoms

The final diagnosis can only be made on an X-ray image, in which a slight darkening of a rounded shape will be visible in the region of the tooth root (Fig. 1, 4-6). Darkening on the x-ray always indicates the presence of a cavity formation. However, the formation of a granuloma indicates the development of chronic periodontitis, which still has its symptoms.

Most of the time, the tooth may not bother you in any way, i.e. symptoms may be completely absent. Periodically, pain may appear when biting on a tooth or aching pain from hot. This is the symptomatology of chronic periodontitis.

However, periodically (against the background of a decrease in immunity) - an exacerbation of chronic periodontitis may occur, which may be accompanied by acute pain, especially when biting on a tooth. The gum in the projection of the root apex may swell at such moments, be painful when touched.

What does a granuloma look like on a tooth root: video

Granuloma on the root of the tooth: causes

There are only 2 main causes of granulomas on the tops of the roots of the teeth. These causes occur in 98% of cases and we have detailed them below. Much less often, granulomas are formed as a result of poor-quality orthodontic treatment, or mechanical trauma to the tooth (after an impact).

• As a result of untreated pulpitis(Fig. 4) -
  when the carious cavity of the tooth becomes deep enough, cariogenic microorganisms penetrate the dental pulp, causing inflammation in it (it is called). This is accompanied by sharp or aching pain. If the tooth is not treated at this stage, then the nerve in the tooth dies, and the pain temporarily stops.

  After the death of the nerve, pathogenic microorganisms penetrate through the root canals and holes on the tops of the horses - beyond the limits of the tooth. This leads to the formation of foci of inflammation at the tops of the roots. Such a disease is called. There are several types of this disease, in one of which granulomas are formed on the tops of the roots.

  Keep in mind that in this case, the tooth does not have to have a carious cavity, because. inflammation of the nerve in the tooth can also occur in a tooth previously treated for caries. This happens if the doctor did not completely remove the tissues affected by caries, leaving a small fragment of them under the filling (Fig. 5). In this case, caries develops under the filling and leads to the development of pulpitis first, and then periodontitis with granuloma.

• Poor quality root canal filling –
  if a granuloma has formed on the root of a tooth in which earlier (for example, in the treatment of pulpitis), then there is only one reason for its formation! This reason is poor-quality filling of the canals, or rather, the fact that the root canals were not filled up to the root apex (Fig. 6).

  If your doctor says that the canals are sealed well, and he does not know why a granuloma arose after treatment, then such a doctor is lying. “The tooth is sealed well, drink antibiotics” is a standard excuse for doctors who do not want to admit to poor-quality work and, at the same time, treat the tooth for free.

Treatment of tooth granuloma -

Treatment is usually only therapeutic. The treatment strategy depends on several factors…

• If the root canals have not been filled before –
  it is necessary to drill out all carious tissues and old fillings, after which mechanical treatment of the root canals is carried out. After their expansion and antiseptic treatment, the strategy for further treatment may depend on the size of the granuloma.

  If the granuloma of the tooth is small (up to 2-3 mm), then the root canal of such a tooth, in principle, can be sealed immediately. If the size of the granuloma is from 3 to 5 mm, then a special therapeutic material based on calcium hydroxide is left in the root canals, which will allow the granuloma to decrease, or even completely disappear.

  Temporary canal filling is carried out for a short period of time (on average 2-3 weeks). After this period, a control x-ray is taken, and if the granuloma has disappeared or decreased, the root canals are sealed on an ongoing basis, and a permanent filling is placed on the tooth. The algorithm for the therapeutic treatment of granulomas more than 3 mm in diameter, cystogranulomas and cysts (detailed descriptions appear when opening the photo) -

  

A tooth granuloma is a cystic sac of pus that is located in the periodontium. Consists of a specific granulation tissue, which is surrounded by a connective capsule. In turn, the capsule is soldered to the root of the tooth.

The danger lies in the fact that, without showing itself outwardly, it can have a detrimental effect on the patient's health. Under the influence of the disease, the patient may develop diseases of the heart, kidneys and other internal organs. There are cases when a dental granuloma was the cause of female infertility.

Symptoms

Symptoms of the disease may not appear for a long time. And then suddenly, overnight, the gum swells and there is a sharp unbearable pain. Only an experienced dentist can determine the presence of a granuloma at an early stage of the development of the disease on the basis of an x-ray examination.

Main symptoms:

• pain during chewing food (can be both very strong and insignificant);
• swelling of the gums (both significant and imperceptible);
• darkening of tooth enamel;
• an increase in the patient's body temperature (rarely, usually during an exacerbation of the granuloma).

Given the fact that the symptoms appear rather late, when the disease is already progressing with might and main, most often the doctor detects a granuloma quite by accident, during an X-ray examination of the patient.

Diagnostics

Often, a granuloma of the tooth root is diagnosed quite by accident during treatment at the dentist. It happens that the doctor prescribes an X-ray examination for a completely different reason, and as a result, a disease is detected in the picture.

When making a diagnosis, the doctor may note such signs as bulging of the bone opposite the top of the roots, the presence of a painful bulging on the gum opposite the granuloma.

X-ray examination is the determining factor in the diagnosis. The x-ray shows a zone of rarefaction of bone tissue, which is very clearly defined and usually has a rounded shape.

Prevention

There is no unique prophylaxis for granuloma. Basically, the dentist recommends the same measures as for the prevention of other dental diseases. You should follow the rules of oral hygiene, brush your teeth in the morning and in the evening. It is imperative to timely treat diseases of the teeth and gums - such as caries, pulpitis, periostitis and others. It is necessary to systematically visit the dentist, preferably twice a year. All this will help prevent the appearance of a lesion, and in case of its occurrence, diagnose the disease in a timely manner.

The reasons

The granuloma of the tooth root does not appear without a reason:

• untreated caries or pulpitis;
• poor-quality treatment of pulpitis.

As you can see, both causes of the appearance of granulomas are directly related to other diseases, that is, it is a complication of caries or pulpitis.

With advanced caries, microbes penetrate into the dental pulp, causing inflammation, or pulpitis. Without proper treatment, the dental pulp dies, and microbes continue to multiply. Over time, they go beyond the pulp, into the bone tissue, causing an inflammatory process. As a result, the bone tissue seems to recede, and in its place a connective tissue is formed, saturated with capillaries, which effectively fights bacteria, isolates them inside itself and, in fact, is called a tooth granuloma.

If the doctor carelessly sealed the tooth after caries or pulpitis, a granuloma may also form. This happens if the canal has not been cleaned of bacteria or has not been completely sealed. It happens that an inexperienced doctor breaks the instrument when cleaning the canal, and part of it remains inside the tooth, causing constant inflammation and granuloma formation.

Treatment or removal?

If a granuloma has been found in a patient, treatment should be started as early as possible, in which case it will be possible to save the tooth. The doctor makes a decision on the method of treatment in each case, after a thorough examination of the diseased tooth and a mandatory x-ray examination. Remember: without an X-ray, it is impossible to diagnose a granuloma.

In modern dentistry, there are two main methods of treating granulomas - therapeutic and surgical. With therapeutic treatment, it is possible to save a healthy part of the tooth. During surgical treatment, the doctor cuts the gum and releases pus, most often this method also allows you to save the tooth. Let's take a look at both methods.

Therapeutic Method

In therapeutic treatment, sulfa drugs and antibiotics are used to prevent the further development of the inflammatory process. This method of treatment is indicated if it was possible to diagnose a granuloma at an early stage of formation. Therapeutic treatment allows you to save a healthy part of the tooth and later completely reconstruct the tooth.

Surgical method

Unfortunately, it is far from always possible to cure a granuloma with a therapeutic method. And then the surgical method of treatment comes to the aid of the dentist. If the inflammation provoked a complication, the doctor opens the gum to release the pus, and installs a special drainage in the wound. In parallel, drug treatment is prescribed - antibiotics, antiseptics, anti-inflammatory and analgesic drugs.

In particularly difficult cases, it is necessary to completely remove the diseased tooth. The granuloma after tooth extraction usually disappears, as pus flows out through the wound.

Consequences and complications

If the treatment of the granuloma is not started in a timely manner, a tooth cyst may form in its place, which is much more difficult to treat. Also, the presence of a granuloma can become a constant source of infection in the patient's body, causing a general deterioration in well-being and provoking the occurrence of various diseases, ranging from flux to serious diseases of the internal organs of a person.

Today, medicine distinguishes several types of neoplasms of the tissues of the human body. One of them is a granuloma. What it is? What are the causes of pathology? How to treat granuloma? These and other questions will be discussed in the article.

A granuloma is a focal proliferation of connective tissue cells, which looks like dense nodules. The formations are benign in nature and are localized both on the surface of the skin and inside various organs and tissues.

Granuloma: causes

An ailment develops as a result of an inflammatory process, which can be infectious and non-infectious in nature, as well as an unknown etiology. The cause of infectious growths are such diseases as typhus and typhoid fever, tuberculosis, brucellosis, syphilis, tularemia, rheumatism, encephalitis, rabies. Nodules of a non-infectious nature develop in people who come into contact with compounds of beryllium, asbestos, silicates, talc. Also, formations can develop around a foreign body that has entered the body.

Mechanism of Education

The appearance of an inflammatory vesicle and its further transformation includes several stages:

Immature monocytes accumulate at the site of skin injury.

Young monocytes mature into macrophages.

Macrophages mature and epileptoid cells form.

Macrophages and epileptoid cells merge.

Giant cells are formed.

tissue sclerosis.

The diameter of typical granulomas is within 2 millimeters, but nodules of larger sizes are also found. Neoplasms can have a fast and slow metabolism. In some cases, the growths go away on their own, in others, treatment is required. Depending on this, granulomas are classified into subspecies.

Eosinophilic granuloma

This disease develops in children, in rare cases - in adolescents. Eosinophilic granuloma can affect the skin, internal organs, bones. What it is, has not yet been precisely established, since the true causes of this pathology are still not known. Let's talk about the external manifestations of the disease.

Eosinophilic granuloma is manifested by single or multiple limited foci in the tubular and flat bones of the cranial vault, in the femur and pelvic bones, in the ribs, in the vertebrae. Soreness and swelling of the affected areas are noted.

X-ray at the initial stage of the pathology allows you to see rounded bone defects. In the later stages, foci of inflammation merge into cells. Education is not malignant, chronic, as a rule, does not progress. With large foci of inflammation, bone fractures and formation are possible. When the pathological process is localized in the bones of the legs, the bone thickens, the soft tissues swell, and the patient may develop. The patient feels unwell, limps, refuses to eat, his temperature may rise. These symptoms are not permanent. At the same time, a blood test does not show any deviations from the norm. The vagueness of clinical symptoms makes it difficult to establish an accurate diagnosis. Treatment usually requires radiotherapy or surgery.

Botryomycoma

Pyogenic granuloma, or botryomycoma, is a pedunculated fungus. Education may occur after a few months at the site of an injection, cut, burn or other skin injury. In appearance, the tumor resembles a pea of ​​dark red color with a dense consistency. The formation bleeds slightly. In the initial stages, the papule has a smooth surface, then a partial manifestation of the granuloma occurs and, in addition to blood, pus is released. Most often, pyogenic granuloma is localized on the face and limbs, in rare cases - on the tongue, lips, genitals. The diameter of the botryomycom can be 3-4 centimeters, but more often the formations are much smaller. This ailment is similar in features to diseases such as keratoacanthoma, angioma, and malignant tumors. But cases of degeneration of botryomycoma into cancer have not been recorded.

If a pyogenic granuloma is diagnosed, treatment is carried out using cryodestruction, laser cauterization, electrocoagulation, cauterization with a solution of silver nitrate. If the pyogenic granuloma has a wide pedicle, its removal may not be complete, in which case it is recommended to use the method of surgical excision.

Granuloma annulare

Such a formation is a fairly common type of benign dermatosis. Granuloma annulare (photo below) is located in the form of a ring, the central part of which remains healthy. The diameter of the foci of inflammation is most often 2-3 centimeters, although there are arcs or rings of gigantic size. This type of granuloma usually develops in children and young women.

The exact causes of the pathology have not yet been established. Granuloma annulare may result from:

diabetes;

disorders of carbohydrate metabolism;

mechanical injuries;

healed scars and tattoos;

warts, papillomas, herpetic eruptions;

insect and tick bites;

There are four forms of granuloma annulare depending on the localization.

Localized form

In 90% of cases, children are diagnosed with a localized form. The disease affects the feet and hands, large joints, and in rare cases other parts of the body. As a rule, a single focus with a diameter of up to 5 centimeters develops, having rounded, oval or irregular (rarely) outlines. The center of the focus remains unaffected. With a pathology such as localized granuloma, treatment is not required, since the rashes mostly disappear on their own over time.

Subcutaneous annular shape

This pathology occurs exclusively in children under 6 years of age. Education is localized on the fingers, elbows, knees, shins, scalp.

Disseminated form

It is diagnosed in people over 50 years of age. This kind of dermatosis captures large areas of the body, most often localized on the limbs, the rash looks like merging bubbles.

Perforating shape

In rare cases, a perforating form, a traumatic variety of granulomatosis annulare, may develop. The hands, fingers are affected, the formation looks like a papule, which eventually turns into a plaque. Basically, the granuloma resolves on its own, but if it causes inconvenience to a person, complex treatment with corticosteroids may be required. Also carry out UV therapy, biopsy, surgical excision.

Tooth granuloma

Dental granuloma - what is it? This is a pathology of dental tissue and gums, in which a small formation develops on the root. For a long time, the disease may not manifest itself. Over time, painful sensations appear, the gum area becomes reddened and swollen. A granuloma can cause destruction and loss of a tooth. Such a pathology develops as a result of periodontitis, fracture or trauma of the tooth, infection during treatment.

X-ray will help to identify the granuloma of the tooth. Quite often, such an ailment is detected in the later stages, which is why it is necessary to carefully monitor oral hygiene, visit the dentist regularly, and treat caries in a timely manner. The consequences of dental granuloma are quite unpleasant and dangerous. It can lead to:

Root growths can pose a threat. To prevent the occurrence of an inflammatory nodule on the root of the tooth, it is necessary to immediately consult a doctor at the slightest pain or swelling of the gums. If the diagnosis is confirmed, treatment is carried out by conservative and surgical methods. In the initial stages of the pathological process, the tooth itself can be saved.

Preventive measures

After reading this article, you have learned more about such a formation as a granuloma. What is it and what methods are used for treatment, we have already told. I also want to remind you about prevention. To prevent the development of this pathology, it is necessary to lead a healthy lifestyle and regularly undergo a medical examination. This will allow timely detection of the first signs of the disease and successfully cure it.

Tooth root granuloma is a dangerous, complex and rather serious disease. Most often it occurs as a result of complications. Granuloma has its own peculiarity. First, an inflammatory process begins, which does not cause unpleasant symptoms. Then the disease makes itself felt with a sharp pain. What is this sudden disease, we will understand below.

From a physical point of view, a granuloma is a small dense nodule located at the very base of the tooth, in the periodontium. It can have sizes from 5 to 8 mm. Sometimes a granuloma is compared to a cyst, inside of which there are dead bacteria.

The formed granuloma is the epicenter of the disease. From it, the inflammatory process goes further, and destroys healthy tooth tissue. Such a focus of infection should not be left untreated. In the process of its further development, it will necessarily lead to a disruption in the functioning of the organs of the body. In most cases, inflammation passes to the facial, cervical muscles, as well as to the heart area.

How is a root granuloma formed?

The granuloma has the following mechanism of development:

• The first stage: the appearance of a dental disease and bringing it to a neglected state. The presence of a long inflammatory process leads to the formation of a large number of microorganisms in the pulp. The inflammatory process occurring in the pulp gradually leads to its death.
• The second stage: the microbes go into further action. Gradually, the infection enters the zone of bone tissue. As a result, a new formation appears, which gradually passes into the granuloma in question.
• The third stage: the bone begins to recede from the focus of infection, a capsule of connective tissue is formed in this place, which is quite dense in structure. A serious inflammatory process continues inside the capsule, as a result of which bacteria multiply rapidly. The stage is characterized by the rapid growth of tissue. Over time, the bacteria turn into a form of pus. If you consult a doctor at the last stage, he will diagnose "acute granuloma".

The disease greatly exacerbates a weakened immune system. Against this background, the tooth becomes abnormally mobile. Eventually the roots will be exposed.

Infections reach the root of the tooth in another way: through periodontal pockets. These pockets appear during the formation of hard tartar. The stone contains a huge variety of bacteria. They provoke the appearance of a gap between the hole and the gum. It is through it that the infection goes to the root. At the very base of the root, tissue grows, which is completely filled with pus. This granuloma.

Causes of granuloma

Granuloma occurs after the following factors:

1. Untreated caries.
2. Untreated, which appeared against the background of an inflamed pulp.
3. Inflammatory process in the periodontium (tissue that surrounds the tooth).
4. A fracture of the tooth, as a result of which an infection appears in the internal region.
5. Poor antiseptic of the tooth, which eventually led to its infection.
6. Poor antiseptic treatment after pulp removal.
7. Poor quality antiseptic treatment after root canal treatment.

Secondary causes of granuloma:

• Stress.
• Strong physical stress.
• Abrupt climate change.
• Severe hypothermia.
• Serious cold infection.

The inflammatory process of periodontitis can begin as a result of improper treatment. For example, even due to unprofessional dental fillings.

Often the disease occurs after tooth extraction. Why? The disease appears against the background of inflammatory processes and the complete absence of the necessary preventive measures. The site of the extracted tooth eventually begins to tighten with tissue. Microbes quickly get inside it, which lead to further inflammation of the periodontium. If you do not do prevention, then the granuloma will quickly grow and fill with pus. If treatment is neglected, the granuloma will begin to move along the entire length of the gum. This course of the disease leads to infective endocarditis, a rather dangerous disease that often ends in death.

Often a granuloma occurs after the removal of children's milk teeth. Childhood age does not mean that a patient cannot have a granuloma.

Symptoms of a granuloma

The granuloma begins to proceed asymptomatically. Then comes a certain stage at which the body signals the disease with sharp pain (the first symptom).

Another symptom of the disease is the presence of a foreign body in the oral cavity. This tissue, which, as a result of inflammation, has grown greatly. It is easily palpable with the tongue.

When the granuloma becomes visible visually, the disease begins to be accompanied by the following symptoms:

• Redness of the gums.
• Swelling of the gums.
• Inflammation of the oral cavity, which is accompanied by fever.
• Darkening of the enamel.
• The appearance of pus between the tooth and gum.
• Headache with great malaise.
• Flux.

Swelling and redness can be on different sides of the tooth. For example, from the inner surface of the gums, from the side of the sky or behind the lips.

When pressing on the inflamed area, the pain increases greatly. It has a bursting character and over time it only grows.

Let's summarize. The first symptom of a granuloma is a sharp pain. It is accompanied by slight swelling. The next stage is accompanied by sudden changes in body temperature.

Diagnostics

The correct diagnosis can only be made by a dentist based on an x-ray. In the picture you can see a small darkened area near the root of the tooth.

In the hospital, radiovisiography can also be done. This type of X-ray examination with less exposure. The results are not evaluated on the picture, on the monitor screen. For this reason, such surveys are often referred to as digital surveys.

Granuloma is best recognized in the first stage. Often it is detected in the treatment of other dental diseases. In addition, doctors pay attention to the abnormal swelling of the gums, which is very painful. Also, the bulging of the bone near the top of the tooth falls into the area of ​​\u200b\u200battention of doctors.

Granuloma treatment

From the foregoing, it is clear that treatment should begin already at the first stage. The first action of the patient is the appearance in the clinic. The second is the implementation of all the recommendations of the doctor and the passage of an x-ray examination. The third is to remain calm during the treatment.

Treatment can be of three types:

1. conservative or therapeutic.
2. Surgical.
3. Folk.

The most effective are the first two types. They are performed in a hospital setting. Alternative treatment is more supportive.

Conservative treatment

Such therapy includes taking antibacterial, sulfa drugs and filling the tooth. Such treatment stops the progress of the granuloma and saves the teeth from the decay process.

Antibiotics help to immediately stop the disease, remove the painful microflora and save the tooth from infection. While taking the medication, the doctor also prescribes additional rinses for mouth antiseptics. Anesthetic drugs help relieve pain.

In the case of deep caries, the pulp is inflamed, the dentist cleans the canals and removes the source of infection. Further deep into the tooth, the doctor applies the medicine and installs a temporary filling. After a while, a permanent filling is placed on this place.

In severe cases, therapeutic treatment is meaningless. Then the tooth affected by the granuloma is treated surgically.

Surgery

The essence of such an intervention is to open the gums, from which pus is subsequently removed using drainage. As a result, the tissue becomes non-inflamed. In parallel with surgery, antibiotics, painkillers and antiseptics are prescribed.

The prognosis after surgical treatment is always favorable.

Surgical treatment is reduced to one of the following procedures:

1. Opening followed by drainage.
2. Resection of the apex of the tooth root.
3. Removal of a tooth.

If there is a pocket on the gum, a gap on the tooth, then the cyst is dissected, from which the substance located there is removed.

Root resection

Root resection consists of the following steps:

• Shell opening.
• Channel cleaning.
• Filling with medicinal solution.
• Removal of the granuloma itself and the affected tooth apex.
• Replacement of inflamed tissue that has been cleaned out with new artificial tissue.
• Carrying out tooth filling.

Hemisection of the tooth

The operation is performed if the tooth has many roots and the disease has reached such a stage that it is not possible to save the root. Hemisection of the tooth consists of the following steps:

• Complete removal of the root and the coronal part that is adjacent to it.
• Filling an empty cavity with special dental material.
• Setting up the crown.
• Checking the tooth after surgery with x-ray.

Removal of a tooth

When a tooth cannot be cured, it is removed. Removal is carried out in case of:

• If the patient has delayed the disease.
• If a gum pocket has begun to form.
• If there is a vertical crack on the tooth.
• If the tooth is completely destroyed or the crown is destroyed.
• Root perforation is visible.
• Root canals are impassable.

Alternative treatment

The people use several recipes to alleviate the condition with granuloma:

• Preparation of tincture on propolis and calamus. It will take 30 gr. dry propolis and 30 gr. calamus roots. The ingredients are poured with vodka and infused for 2 weeks. Used for rinsing.
• Decoctions of herbs: eucalyptus, chamomile, sage. Used for rinsing.

Complications

An untreated granuloma leads to:

1. To the complete loss of a tooth. This happens due to the complete destruction of the root. As a result, soft tissues are drawn into the inflammation process, in which pus accumulates.
2. formation of a tooth cyst.
3. Cancer tumors.
4. Infection of other organs and the development of sinusitis, pyelonephritis and infectious myocarditis.
5. If pus gets into the cranium, then meningitis, encephalitis and inflammation of the peripheral nerves can begin.
6. The appearance of a migratory granuloma. Manifested as a protrusion of the skin of the face. Also, the disease comes out in the form of abscesses and in different places.

Prevention

Preventive measures should be carried out in a complex. They should be aimed at preventing the occurrence of the disease. Preventive actions are reduced to the following actions:

1. Constant maintenance of cleanliness of the oral cavity. That is, it is a daily, high-quality cleaning and rinsing.
2. Treat bleeding gums.
3. Scheduled visits (2 times a year) to the dentist.
4. Change your toothbrushes regularly to avoid spreading infections in your mouth.
5. The slightest pain in the tooth should prompt the patient to immediately go to the hospital. You can't delay the process.
6. Pay special attention to diseases such as caries, pulpitis and periodontitis, which are common causes of granulomas.
7. Use only medicated toothpaste as a preventive measure.
8. Rinse your mouth regularly with decoctions of herbs.
9. Eat food with the maximum content of calcium, trace elements and vitamins.

What is the forecast

The prognosis of treatment always depends on the severity of the disease. Everything affects: the stage of development, the complexity and the methods used in the treatment. Treatment in the early stages of the disease always gives only a positive prognosis. Antibiotics and therapies always help. It also responds well to the treatment of granuloma in childhood.

If the granuloma is at the stage of the appearance of pus, success depends on where the focus of inflammation has appeared. If this is a tooth root, then most likely the prognosis will be unfavorable and the tooth will have to be pulled out. If, then the contents are cleaned with drainage. The patient is also prescribed a course of antibiotics.

Untreated granuloma may well lead to death. Like this? The formed pus penetrates through the muscles and enters the region of the heart. The result is sepsis, which leads to death.

Yes, granuloma is quite an unpleasant and dangerous disease. If this is the initial stage, then do not worry about building. You should, without a moment's delay, go to the hospital. The patient must definitely try to avoid extreme stages.

Reviews

Michael

Oh, this granuloma. I suffered from it. Launched, of course, the disease. In my case, it was not possible without a surgeon. But I want to reassure everyone. Surgical treatment always gives good recovery. I believe in it more than in therapeutic intervention. The surgeon removes the focus of the disease itself. No hearth, no disease. In my case, the tooth was saved. But it's not worth the hassle like me. Run to the clinic! Save your teeth!

Svetlana

My six-year-old daughter suffered from granuloma. How it appeared (in the sense of the disease), I do not know. I regularly brushed my teeth with Masha. Even though they didn't go for checkups. The disease overtook us immediately with unbearable pain. Here's the annoyance. The doctor at my daughter cleaned everything inside and put a seal. But now she has become terribly afraid of hospitals, especially the dentist. We have cured the disease. This is the main thing!

Hello readers, subscribers and guests of our information resource. In today's article, we will talk about a disease that, like a time bomb, is waiting in the wings, and this is tooth granuloma. It's safe to say that a person without a medical background has no idea what it is until they are blindsided by this diagnosis. A good doctor will try to explain to the patient what a tooth granuloma is, reassure, and offer treatment options.

Otherwise, information will have to be sought in other sources. Today, our best assistant and adviser is the Internet. Everyone will find a lot of conflicting information, articles oversaturated with medical terms. In the worst case, you can run into a text that is written by someone who is not clear, and the information is not presented correctly, solely for advertising purposes.

We cannot afford to disappoint our readers with low-quality and harmful information, therefore we keep feedback through comments. The subject of the articles, their content is the fruit of our cooperation with you.

Granuloma of the tooth - what is it?

If anyone is interested in the exact scientific definition, then it can always be found on Wikipedia. We try to present any information in an accessible and understandable language for everyone. So, a granuloma is an inflammatory process, during which tissue changes occur, the so-called nodules are formed. In dentistry, a tooth granuloma is formed in the region of the root, most often at its apex. This is an inflammation of the periodontal tissues, which is a capsule with pus. The size of such a capsule averages 5-7 millimeters. But the growth doesn't stop. It gradually becomes larger, "eating" healthy tissue, affecting an increasing area of ​​bone tissue.

In this case, the patient may not feel anything. And the pain will appear already at an advanced stage. Because of this, cases of complications associated with diseases are very common. True, there are cases of completely random diagnosis, for example, with an x-ray, when one tooth is treated, and an education is also found.

Granulomas are usually divided into types depending on localization:

• radical granuloma of the tooth;
• interroot;
• apical.

Origin and Growth Factors

Even modern dentistry today does not undertake to name the exact reasons why granulomas occur. There are certain factors that can trigger its occurrence:

• caries;
• ignoring periodontitis;
• , its untimely or incorrect treatment;
• inflammatory process under the crown;
• trauma (bruise or fracture of the tooth).

Such a disease does not appear in a day or two, it is a very long process. It begins with the fact that the bacteria destroy the enamel, gradually penetrate deeper and deeper through the carious cavities until they hit the pulp. The inflammatory process starts and the pulp gradually dies off. You should consult a doctor not just at this stage, but even much earlier, when only caries began.

Without doing this, the unfortunate patient allows the infection to penetrate deeper and deeper through the root canal and already infect the tissue surrounding the tooth. At this stage, a long-term inflammatory process of bone tissue is launched. The body has its own methods of fighting infection. The affected tissue is reborn into connective tissue. Its main goal is to isolate and prevent further spread of the infection. Therefore, a sac is formed with an infiltrate full of bacteria.

This can be asymptomatic for a long period of time, sometimes stretching for years.

Anything can provoke the growth of a granuloma and make it manifest itself. Most often this happens after we are cold, caught a cold, got into a situation that provoked severe stress. Even moving to another climatic zone and physical activity in excess of the norm can become a provoking factor.

Symptoms and Diagnosis

As mentioned earlier, most often the granuloma of the tooth does not bother us, but sooner or later there comes an acute period when symptoms begin to appear. The presence of a granuloma can be assumed if:

• there was pain in the gums, it became edematous, swelling became visible;
• started to worry. It will rather be sharp in nature, rather than aching;
• you began to notice inflammation in the mouth;
• gums become unnaturally red;
• the temperature suddenly rose. An elevated temperature can indicate a lot, but if there is not even a hint of a cold, and you are overcome by weakness and there are previous symptoms, this is a wake-up call;
• flux popped out;
• you began to notice a change in the color of the enamel. Most often it acquires a dark gray tint;
• between the gum and the tooth, they noticed how pus is released.

Any of these symptoms individually, and even more so together, should not only alert, but also send you to the dentist as soon as possible. It will be difficult to visually confirm the diagnosis, but the doctors have an X-ray machine and radiovisiography at their disposal. With their help, the granuloma of the tooth will be clearly visible. In the pictures, it is visualized as a small dark spot of a regular round shape.

Ignoring such symptoms and confirmed granuloma is unacceptable. Over time, it will not pass by itself and will not resolve. It can only grow, become denser and turn into. Then there is no need for surgery. And you have to say goodbye to the tooth.

Tooth granuloma is dangerous

Why can't granuloma be ignored?

The question is rather rhetorical. There is no such disease that should be ignored. And jokes and delaying treatment in this case can turn into very unpleasant consequences.

These arguments should be enough for you to immediately consult a doctor if you find the slightest suspicion of this disease. Knowing what a tooth granuloma is, you definitely don’t want to joke with it.

Video - Granuloma cyst on the root of the tooth under the crown, signs and treatment

What can modern dentistry offer?

If you have been diagnosed with a granuloma of the tooth, then treatment should begin immediately. After the examination, only the doctor can choose a treatment regimen based on visual and x-ray data. This is a serious disease, which, as you read, can lead to unpleasant consequences, so in no case should you engage in amateur activities.

Rinses with super-healing tinctures from the grandmother's pantry are equated to zero in terms of efficiency. For the simple reason that the rinse solution does not even closely interact with the focus of inflammation. Starting self-treatment, you only delay the process and lose precious time.

In this situation, it is very easy to harm and cause irreversible harm. The use of warm rinse solutions, the use of various warming compresses is unacceptable. High temperature is the enemy in this situation. When heated, the integrity of the granuloma shell is destroyed and all the pus begins to intensively infect the surrounding tissues, spreading through them.

The granuloma of the tooth is treated and quite successfully. It all depends on the patient, at what stage he decided to go to the dentist. It can end with antibiotics or surgery and tooth extraction. When it is seen that the process is running and the flux has jumped out, the patient experiences pain and discomfort when pressing on the gum and biting, it is necessary to install drainage to ensure the outflow of pus, preventing the penetration and spread of pus deep into the tissues.

Modern dentistry, depending on the situation, offers therapeutic and surgical methods of treatment. At an early stage of detection, treatment will consist of taking antibacterial drugs that have an effect on the infectious focus. If everything is done correctly and on time, it will be possible to stop the development of the disease and save the tooth completely.

Even if there is a destruction of the crown part of the tooth, then modern methods of restoration and prosthetics will be able to return the tooth to the system completely.

Stages of tooth granuloma removal:

A photo	Stage	Description
	I stage	From the outside, an incision is made in the mucous membrane in the region of the root apex, then through the bone, access to the root of the tooth is made. This stage is called - resection of the apex of the tooth root.
	II stage	The granuloma is scraped
	Stage III	The hole in which there was a granuloma is carefully processed with a special material based on collagen, and then the mucous membrane is sutured
	IV stage	Subsequently, the bone is restored, and the tooth continues to serve for a long time.

When antibiotics alone are not enough, you have to turn to surgeons. They, if they consider it possible, will put a drain, and if there are associated complications, gingival pockets, then they will have to make a lateral incision on the gum and remove the granuloma with excision of the root apex. Let's take a closer look at each of the methods.

Video - Granuloma treatment

Therapeutic treatment

If the patient is lucky and the tooth granuloma was diagnosed in the early stages of development, an experienced dentist will resort to conservative treatment. In his arsenal, there is a wide selection of anti-inflammatory non-steroidal drugs, antibiotics and painkillers that will cope with the infection with high efficiency. Further treatment will consist in the restoration of the tooth itself and its functions.

The most common drug today is considered. Its popularity is due to its low price and proven effectiveness in dental practice. In parallel with antibiotic treatment, painkillers are often prescribed, which can relieve the inflammatory process. This is Keton tablets and Nimesil powder.

In order not to leave the slightest chance of infection, baths and rinsing of the oral cavity with antiseptic preparations are prescribed in case pus comes out between the tooth and gum. The antiseptic, which has been proving its effectiveness for decades, is inexpensive and available in pharmacies.

The main thing is to remember that self-medication in such cases is very dangerous, and only a doctor can prescribe all these drugs.

Even ten years ago, therapeutic methods would have dried up on this. But today, in the latest dental clinics, treatment of such problems under a microscope has become available. The doctor has the opportunity to have eye contact with the focus of inflammation, which means complete control of the situation. In this case, the granuloma of the tooth is treated by depophoresis, when copper ions are introduced into the focus and electric charges are applied. Laser techniques are also used. All manipulations in these cases are carried out through the canal in the root of the tooth. Specialists manage not only to clean the granuloma, but also to introduce cleansing and healing solutions through the same channel. Then the canal is filled, and the tooth is restored. These techniques have only one drawback - prohibitively high price and limited availability of such equipment.

Surgery

If it came to surgical intervention, it means that the granuloma of the tooth has acquired a menacing size and appearance. The simplest and least time-consuming method is this. The tooth breaks out, the granuloma remains on its root, and the patient gets a gaping hole in the dentition. That was about ten or fifteen years ago. No one was worried about the appearance and safety of the teeth. But today, dentistry is becoming more and more aesthetic, and a qualified specialist will try to keep the tooth in place to the last. And in order to do this successfully, a hemisection or resection of the root apex is performed. Now let's figure out what this means.

Both operations are designed to save the tooth. Hemisection is the removal of the affected root with part of the tooth. The rest is preserved and can continue to carry its functional load. This method is applicable only to multi-rooted teeth, when conventional therapeutic methods are powerless. The second option is more suitable for teeth with one root. And in cases where the granuloma turns into a cyst. Then, through an incision in the gum and a hole in the bone, the surgeon gains access to the focus of infection.

Its main task is to completely clean the resulting cavity from the infiltrate, in a simple way - to scrape, remove the damaged part of the root and fill the cavity with a special material based on collagen. It will help to recover faster the bone tissue that has been damaged and removed. If the surgeon makes the slightest mistake, then after a couple of months, wait for a relapse. Therefore, you need to be very careful and careful in choosing specialists.

Tooth granuloma - summing up

As practice shows, a tooth granuloma is not something terrible and out of the ordinary. Dentists have the necessary techniques to successfully deal with it. Not the least role in this struggle is played by the patient himself. It depends only on him how quickly the treatment will begin.

All those who have suffered this disease, with the doctors, unanimously repeat that instead of treating, it is better not to bring your teeth to such a state. All that is required is to see a specialist a couple of times a year. Select from 365 days twice for 15 minutes. Is it difficult? Of course not. And follow the simple rules of hygiene, not giving bacteria a chance to settle on the teeth and develop.

Video - Granuloma. Cyst