Periapical cyst

It is most frequently located in the anterior region of the mandible and, in most cases, is completely asymptomatic. Its size varies from 5 mm to a few centimeters: on average, it is less than 1.5 cm.

Periapical cysts are caused by necrosis of the dental pulp. It means that the soft tissue underneath the hardest and most resistant layer of the tooth loses its vitality, reducing the supply of blood, oxygen and nutrients. This condition can lead to a cyst at the apex of the root, the end of the tooth inside the gum.

What is a periapical cyst?

Also called root cyst is undoubtedly the most common cyst in teeth. Periapical cysts usually develop as a result of a number of infectious diseases affecting the internal tissues of the tooth. When not treated in time, it can grow significantly to the point of causing even very serious damage to the bone.

If the root cyst is not yet extensive, the tooth can be treated with a root canal. In some cases, the dentist will have to surgically remove the root cyst or, in the most severe cases, extract the tooth.

Very often, the root cyst is almost completely asymptomatic and only a radiographic examination can diagnose it correctly. However, the maxillary root cyst can be safely treated, so it is best to book regular check-ups at dental practices.

Causes

There are several circumstances that can lead to a periapical cyst:

• If there is a cavity that has not been properly treated (or has not been treated at all). The decay first attacks the tooth enamel, then the dentin, and gradually spreads inside the tooth, all the way to the root. This is when the cyst forms. In this case, the patient usually experiences severe pain.
• After a root canal. If a cyst occurs after a root canal, it usually means that the associated root canal treatment has not been performed perfectly. This situation may be due to the dentist having removed the dental nerve, but not having properly filled the canals with the right material, leaving small empty spaces, which are an open door for bacteria.
• Dental trauma. As a result of an impact on the tooth, the root may gradually become necrotic without the patient noticing it, as the process is usually painless and without any other symptoms. An x-ray can easily reveal the presence of a cyst.

The apical lesion may take a chronic form, when, after an acute lesion, the infectious agent that caused it has not been completely eradicated, or when it is not strong enough to cause an acute reaction.

Symptoms of periapical cyst

The diagnosis of a periapical cyst is initially difficult because there are no symptoms. To detect it, in fact, the doctor will need a panoramic and/or periapical X-ray. The cyst may grow over time and show pain, gum inflammation, lip swelling and halitosis.

When the radicular cyst is in the acute phase it presents symptoms such as:

• Toothache.
• Injury to the soft tissues of the oral cavity.
• Blood loss from the gums.
• General and localized discomfort throughout the oral cavity.
• Inflammation of the gums.

If left untreated, it can create fistulas in the dental arch, causing more pain.

In the most extreme cases, the symptoms of a cyst on the tooth begin to affect other parts of the face as well, with:

• Eye pain.
• Headaches.
• Swollen lymph nodes in the neck.

Treatment

The main treatments to remove a periapical cyst are:

• Surgery.
• Endodontic treatment.
• Antibiotic treatment.

Surgery to remove root cysts is fairly quick (about 30 minutes) and is performed under local anesthesia. The procedure is not painful and first a drainage is performed to remove the serous fluid from the cyst and then the epithelium is removed to prevent the cyst from re-forming. Only in the most severe cases is it necessary to extract the tooth.

After surgery, it is important to start treatment with antibiotics and follow a soft diet for a few days.

Subsequently, periodic check-ups are necessary to avoid recurrences.

We have mentioned that one of the symptoms of a periapical cyst is inflammation of the gums. In this case, one of the most effective remedies is chlorhexidine gel or rinse, which is known for its antiseptic properties and can be applied directly to the gum.

Your KIN must-haves:

PerioKIN

Mouthwash, gel and spray for intensive care of gums.

KIN Gingival Complex

Toothpaste and mouthwash with chlorhexidine especially indicated for gum care.

Prevention of periapical cyst

The best remedy to avoid the formation of periapical cysts is, as always, prevention. A careful daily cleaning of the oral cavity, in fact, is fundamental to combat the appearance of cysts and many other pathologies.

To avoid the development of a periapical cyst, it is best to have regular visits to the dentist, who will be able to address any problems in time.

On a daily basis, it is important to maintain proper oral hygiene by brushing teeth three times a day with toothpastes and mouthwashes appropriate for each situation.

It is also important to perform an adequate hygiene of the space between the teeth using dental floss or an interdental brush, since in this area many microorganisms accumulate and can cause the aforementioned diseases.