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  • Dental granuloma: causes, symptoms and treatment, photo

    What is it - a tight knot diameter of 5-8 mm with the presence of a productive inflammatory process( inflammation of the periodontal) on the root of the tooth is called granuloma.

    In the cystic cavity are dead cells, including bacterial. Specific granulation tissue of the granuloma is surrounded by a connecting capsule most often with the tip of the tooth. This leads to the spread of infection and destroys healthy tooth tissue.

    Causes of dental granuloma


    Granuloma is a complication of pulpitis or caries, which is why it arises because of:

    • of untreated pulpitis, which occurred during the infectious process of a sore nerve in the root of the tooth.
    • of untreated caries and inflammation in the tissues surrounding the tooth - periodontitis.
    • fracture of the tooth with an infection in it.
    • infection due to poor antiseptics and asepsis during removal of the tooth pulp or treatment of the canals.

    Mechanism of formation


    The granuloma capsule breaks through any malfunction of the immune system. This leads to denudation of the roots of the teeth, loss of fixation of the tooth and inflammation of the gums.


    1. In the first stage, neglected dental diseases led to the appearance of a huge number of microbes in the tooth pulp. It starts with inflammation, which leads to death.
    2. In the second stage, due to the multiplication of microbes, infection of the bone tissue occurs.
    3. In the third stage, the connective tissue is formed when the bone recedes from the focus of infection. A capsule is formed from the connective tissue, inside which there is fighting with microbes. This is the granuloma.
    The provoking factors for the development of acute dental granuloma and its manifestations are associated with stressful situations, hypothermia and colds, a sharp change of climate and physical overstrain.

    Symptoms of granuloma on the root of the tooth and photos


    For a long time, the granuloma of the tooth is secretive without certain symptoms, which is dangerous for the human body and makes diagnosis difficult. A small granuloma in neglected form often becomes a source of extremely serious complications.

    Granulation tissue intensively expands and replaces dead cells as a result of inflammation. Therefore, the granuloma constantly increases in size.

    Large granuloma on the root of the tooth becomes noticeable to the patient and dentist. More often it is noticed only on the roentgenogram and rtopantomogram when the patient turns to the doctor because:

    • appearance of swelling of the gum;
    • strong toothache;
    • tooth darkening;
    • appearance of flux or phlegmon( one-to-genital periostitis);
    • secretions with pus from the space between the gum and the tooth, accompanied by high fever, malaise and headache;
    • spread from phlegmon pus into the muscles of the face and neck. In advanced cases, it spreads to the heart area, which leads to death;
    • the formation of the jaw cyst and its delimitation from the tissues that surround it. Formed a dense capsule with necrotic masses and dead bacteria.

    What happens if I do not heal?


    Complications of granulomas on the root of the tooth include:

    • destruction of the apex of the root of the tooth;
    • tooth loss;
    • phlegmon and limited abscess - maxillary abscess;
    • osteomyelitis of the jaw in a purulent process of bone tissue;
    • in the spread of infection - sinusitis, pyelonephritis, infectious myocarditis and sepsis;
    • at the transition of infection in the maxillary sinus and further into the anterior fossa of the skull - meningitis, encephalitis, inflammation of the peripheral nerves, etc.

    Treatment of the granuloma of the tooth


    Suspicion of the granuloma occurs only with the appearance of pains, fluxes and swelling of the gums and purulent discharge. Clarify the diagnosis with radiography and radiovisiography.

    To save a tooth it is possible only at an early treatment of a granuloma, which happens very rarely. Granuloma on the root of the tooth is treated with therapeutic and surgical methods in conjunction with the use of medicinal herbs, which are firmly established in official dentistry.

    The method of treatment depends on the size of the dental granuloma, the state of the tooth tissue, and the complications present. The existing plan for implantation or prosthetics in the oral cavity of the patient is taken into account.

    Surgical treatment of granulomas


    For surgical treatment:

    • remove tooth;
    • perform a resection of the apex of the root;
    • perform hemisection of the tooth;
    • with one-toothed periostitis or maxillary abscess - perform an autopsy and drainage.
    In difficult cases, the doctor must open the gum and let out pus through the drainage for 1-2 days. Antibiotics, antiseptics, drugs for anesthetizing and rinsing the oral cavity with medicinal herbs are used, for example, pharmacies Romazulan diluted in water( 0.5 tsp per 1 tbsp.).

    Chemist tincture celandine( 30%) in a mixture with vegetable oil or glycerin( 1: 1) moisten the cotton swabs and apply to the problem area twice a day.

    In cystectomy or resection of the apex of the tooth root - the tooth is opened, the channel is cleaned and filled with a special solution. The granuloma and infected root apex are removed, replacing the removed tissue with an artificial one, then the tooth is sealed.

    As a result of hemisection: remove the root of the tooth and the adjacent crown part, which is performed on multi-rooted teeth. Assign a hemisection if there is no way to preserve the whole root or one of the root of the tooth. The granuloma is completely removed from the affected root and part of the tooth above it. Then put a crown on the tooth. Follow the condition of the tooth after hemisection with the help of X-ray control.

    The tooth is removed in the late stage of granuloma development, periodontitis with gingival pocket formation, in case of vertical root crack, root canal obstruction, multiple root perforations, severe tooth fracture;

    Conservative treatment of granuloma


    In conservative treatment:

    • is filled with the filling of the granuloma by filling material through the root canal;
    • eliminate the infection with antibiotic therapy, sulfonamide drugs and herbs.
    In the process of filling, the tooth is opened, the channels are cleaned and the outflow of pus from the granuloma is carried out. With the help of special solutions, channels are washed and medicinal preparation is put in them.

    The tooth is closed with a temporary filling in order to conduct several days of re-treatment of the channels with other antibacterial drugs. Following this, the tooth is sealed and restored. As antibiotic agents, treatment is carried out with Amoxicillin, Azithromycin, Amoxiclav, Ciprofloxacin, Doxycycline. Antiseptic and antibacterial infusions of chamomile flowers, sage leaf or eucalyptus leaf - 1 st.l.in a glass of boiling water rinse the mouth in the morning and evening after eating.

    Tinctures: root aira( 30 g) and separately propolis 930 g) pour vodka( 0.5 liters).Give to brew in a dark place for 2 weeks, filter and rinse the mouth, diluting in 1 tbsp.water tincture root aira - 1 tsp, tincture of propolis - 2 tsp.

    Prevention of


    To prevent the development of granuloma on the root of the tooth, it is recommended that the following rules be observed:

    1. 1) Regular preventive examinations should be performed.
    2. 2) Promptly consult a doctor for any pathologies in the oral cavity and dentoalveolar system, including bleeding gums.
    3. 3) Maintain oral hygiene, replace toothbrushes.
    4. 4) Use therapeutic toothpastes.
    5. 5) When bleeding gums use decoctions of medicinal herbs( chamomile, calendula, celandine, oak cortex, St. John's Wort, etc.) for rinsing the mouth.
    6. 6) Include in the menu dishes with calcium and lots of vitamins.


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