Dental granuloma is a frequently seen pathology in the dental practice and it presents itself as a pathological complication of the dental pulp. As a result, granuloma is a result of a non-treated dental decay, which evolves within the dental pulp where the nerves and blood vessels are located, subsequently being diffused beyond the apex of the root, within the bone.
Once entering the dental pulp, the bacteria will firstly create an inflammation, named pulpitis, and then an infection, named gangrene, which, if not treated, will advance towards the inside of the dental root, until it goes past its apex.
Many times, a dental granuloma can turn into a periapical cyst, which can become acute and externalize as an abscess.
These complications can lead to losing the tooth and can affect the nearby teeth.
Many times, dental granuloma is without symptoms, developing in silence, being discovered accidentally. A tooth with granuloma can turn black or yellow, can become more mobile than the other teeth and, sometimes, it is outside of the normal dental line.
If abscess develops, there will be tooth pain, the gum will swell and becomes sensitive to touch. Usually, at this stage, the patient goes to the dental office.
The diagnosis after performing a dental radiology will be of granuloma, its sizes being also assessed. Based on the individual condition, there are several therapeutic approaches in case of granuloma.
The main treatment methods are:
- root canal treatment (conservative root canal treatment)
- dental extraction
Through root canal treatment, after disinfecting and sterilizing the root canal through irrigation with medication substances, the root canal is filled with calcium hydroxide, attempting the stimulation of bone tissue regeneration.
Apicoectomy is performed under local anesthesia and it consists of surgical separation of the gum and soft tissues, until reaching the root of the tooth, where the granuloma will be removed together with a part of the tooth's root.
Through extractions, granuloma is removed through curettage from the alveolus, after removing the root of the tooth.