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Granulomatous periodontitis
Last reviewed: 07.07.2025
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Periodontitis, in which tissue granulation occurs, most often occurs in a chronic form. Chronic granulating periodontitis is an inflammation in which the pulp is already necrotic. Granulation can be a consequence of an exacerbation, but also an independent form. Granulation tissue grows in the apex zone - the top of the root, causing resorption (destruction, destruction) of the bone. The granulating focus can grow into the periosteum, soft tissues (subcutaneous and submucous tissue), as a result, granulomas are formed. When conducting an X-ray examination, the image clearly visualizes a focus of loose bone tissue with a characteristic pattern - "flame appearance".
[ Symptoms of granulating periodontitis
Manifestation of pain:
- Periodic pain sensations.
- A feeling of distension, as if the tooth is in the way.
- Pain when taking hot food or drinks.
- Tooth sensitivity when eating solid foods.
Appearance of the affected tooth:
- The tooth is clearly destroyed.
- The color of the tooth changes.
- Signs of caries are visible; there are particles of softened dentin in the cavity.
- The carious cavity is connected to the tooth cavity.
- The pulp is often necrotic.
Mucous membrane of the gum:
- The mucous membrane in the area of the affected tooth is hyperemic.
- When pressing on the mucous membrane, a small depression is visible (vasoparesis).
The presence of a fistula indicates the duration of the inflammatory process. A fistula can develop, subside and reappear. Often, purulent exudate flows from the fistula.
The lymph nodes are painful to the touch and may become enlarged during the acute stage of the process.
If a person notices at least one of the above symptoms, contacting a doctor will help avoid complications caused by purulent exacerbation.
Treatment of granulating periodontitis
Treatment of granulating periodontitis consists of neutralizing the infectious focus in the periapical tissue, as well as eliminating the activity of the identified pathogen (streptococcus) in the root canal. As a rule, after sanitation, filling and reconstruction of the normal shape of the diseased tooth is carried out.
The prognosis of granulating inflammatory process depends on the timeliness of diagnostics and quality of therapeutic measures. As a rule, the treatment outcome is favorable in 90%, despite the fact that periodontal tissue is not completely restored due to the specificity of the lesion. Nevertheless, the restored tooth can perform all functions, provided that caries is treated comprehensively and effectively. If the affected tooth is not treated, the prognosis, of course, will not be so rosy. Exacerbations in the form of pain are not the main danger that accompanies granulating periodontitis. Much more serious in terms of symptoms and outcomes are fistulas on the face, neck, sinusitis, periostitis or osteomyelitis, often requiring surgical treatment, up to hospitalization.