We are accustomed to believe that dental diseases manifest themselves, if not pain, then severe discomfort. Therefore, a visit to the dentist is most often planned, guided by the principle “when it hurts”. But there are pathological processes that in the early stages proceed completely unnoticed, and make themselves felt only when the treatment requires considerable effort. One of these pathologies is a tooth cyst.
What is a jaw cyst?
The jaw cyst is a cavity inside the jawbone, surrounded by a two-layer soft tissue membrane. The outer layer consists of connective tissue, and the inner layer consists of stratified squamous epithelium. In the thickness of the epithelial layer there are secretory cells that produce cystic contents, so the cavity is usually filled with a cloudy yellowish liquid.
This is what a cyst looks like on a tooth and in a picture:
The source of cyst growth are epithelial islands in the thickness of the periodontal ligament. Infection, trauma or disruption of the process of normal teething leads to the development of an inflammatory process in the periodontium, which, in turn, stimulates epithelial growth, which forms a pathogenic formation.
Depending on the source and localization, cysts are isolated:
- radicular , which are located around the apex of the tooth root due to a prolonged inflammatory process in the periodontium, trauma or errors in filling root canals;
- follicular , formed around the crown of a tooth that has not yet erupted from the shell of the dental follicle in case of violation of the eruption process;
- paradental , which are most often located behind the crown of the third lower molar and are formed during incomplete eruption of the tooth;
- residual - cysts that were not removed along with the causative tooth and continued to grow inside the jawbone.
Primary or keratocyst is a congenital tumor-like formation and has nothing to do with teeth.
How does a cyst manifest itself and why is it dangerous?
Like other benign formations, the cyst itself does not cause pain. Pain can occur if it puts pressure on the wall of the mandibular canal, grows into the maxillary sinus, or reaches such a size that it leads to deformation of the jawbone.
Nevertheless, it is quite possible to detect it in the early stages. To do this, it is enough to take an x-ray. A cyst detected in time can be removed with the preservation of the causative tooth or even cured without surgery.
If the cyst is not removed in time, one of the following complications may develop:
- Inflammation of the cyst develops when it is infected or accidentally injured. At the same time, its contents are transformed into pus, swelling, pain occurs, lymphadenitis, abscess or phlegmon may develop.
- Pathological fracture of the lower jaw, which occurs not as a result of trauma, but during the performance of a normal functional load. The reason is a sharp decrease in the strength of the bone due to the presence of a cyst in it.
- Loosening, displacement or loss of teeth in the area of cyst growth. The cyst, as it develops, pushes the surrounding tissues, including the roots of the teeth, as a result, their crowns are displaced, and the dentition becomes uneven. In the process of resorption of the bony septa, the teeth become mobile and eventually fall out.
Tooth cyst treatment
Radicular cysts of small volume - up to 8 mm, can be treated without surgery, although success is not always achieved. At the same time, the carious cavity is prepared, the root canals are cleaned and filled with therapeutic filling material for several months. After resorption of the cyst, the canals and crown of the tooth are filled with permanent filling material.
The choice of the method of surgical treatment depends on the size of the cyst, the number of teeth involved in the process, the safety of their crowns, aesthetic value and suitability for further prosthetics.
Ways to remove a cyst can be as follows:
- Cystectomy with resection of the root apex is the complete removal of the cyst while preserving the causative tooth. It is carried out on the teeth of the frontal group, provided that their crowns and interdental septa are preserved.
- Cystectomy with tooth extraction is performed if the amount of bone supporting the root is too small to keep it stable.
- Cystotomy, which is a dissection of the cyst membrane with the formation of a wide fistula with the oral cavity. In this case, the epithelial lining of the cyst acts as an integumentary epithelium, and the cyst cavity is gradually eliminated as a result of bone remodeling. Used for large cysts.
