Granulomatous periodontitis
Last reviewed: 23.04.2024
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Granuloma is one of the forms of apical periodontitis, which develops as a consequence of the granulation process. Granulomatous periodontitis clinically manifests less active than its predecessor - granulation periodontitis.
Pathogenetic mechanism of development:
- Granulation tissue begins to expand into zones near the apex of the root.
- Peripheral granulation boundaries are transformed into a granuloma - a fibrous capsule.
- In the apex (top) of the root are parts of the root cement, dentin.
- Those zones of the root that come in contact with the capsule are covered with small tumors, accumulations of excess cement.
Granulomatous periodontitis differs in structure of granulomas:
- Simple granuloma of connective tissue.
- Epithelial capsule, in which the granulation tissue alternates with epithelial cords.
- Granuloma in the form of a cyst, which has an epithelial cavity.
[Symptoms of granulomatous periodontitis
Clinical symptoms of granulomatous periodontitis:
- A long asymptomatic development of granulomas.
- The location of the capsules is most often observed from the sides of the apex of the root.
- The presence of painless swelling in the area of the alveolar process in the projection of the apex of the root.
- Gradual and steady increase in granuloma.
- The aggravation of the process is accompanied by the destruction of the dental alveoli.
- There is a slight pain when pressing on the affected tooth.
How to recognize granulomatous periodinitis?
Diagnosis of the granulomatous process is most often accidental, when the patient visits the dentist's office for another reason - tooth restoration, filling and so on. Granulomatous inflammation is differentiated with a circumcranial cyst, although its radiological imaging is quite specific for setting the right diagnosis.
Treatment of granulomatous periodontitis
Granuloma is essentially a cyst, so the treatment of granulomatous periodontitis is to neutralize the contents of the cysts, to stop the process of inflammation and possible excision of granuloma tissue.
Effective treatment of granulomatous periodontitis involves at least three visits to the dentist, the stages of therapy are as follows:
- First visit to the doctor. Inspection and diagnosis of the condition of the oral cavity, periodontal, conducting examinations (X-ray). Instrumental treatment and cleaning of the canal, irrigation and sanitation of the canal with the help of antimicrobial agents. Introduction to the tooth cavity of the medicinal material and the setting of a temporary filling.
- The second visit to the doctor. Apex root is opened to provide an outflow of purulent contents or accumulated exudate. In the treatment of granulomas, enzymes, antiseptics, and hyposensitizing agents are used.
- Third visit to the dentist. If the exudate successfully expires, and there is no infectious obturation of the canal, a permanent filling can be established. Before that, the channel is re-sanitized, and its condition is monitored by X-ray. It should be noted that the peculiarity of the therapy of granulomatous periodontitis is that if the cyst is quite large, it is excised during the first visit.
The prognosis of treatment of the granulomatous form of periodontitis is very favorable, rarely treatment ends with extraction of the tooth or a gum incision. Of course, a favorable outcome of therapy is possible only with timely assistance, and this primarily depends on the patient himself.