Treatment of an inflamed tooth root. Why is it important to know about the symptoms and dangers of dental granuloma?

Dental diseases are accompanied by acute pain, are fraught with serious complications. Therefore, it is important to know about all the symptoms in order to contact your dentist for help in time. Granuloma on a tooth is a common diagnosis that for a long time remains invisible and is then accompanied by acute pain.

What is granuloma

If swelling appears on the gum, this indicates that a progressive inflammatory process is taking place. At first it is characterized by an asymptomatic course and mild discomfort, then it suddenly appears acute attack pain.Granuloma isa cyst (looks like a sac) formed in the periodontium, which consists of dead cells. Such a neoplasm has clearly defined boundaries and is surrounded by a connective capsule. Another focus of pathology is the apex of the root, as a result of which healthy enamel and dental tissues are gradually destroyed.

Symptoms

If a bulging purulent sac appears on the root of a tooth, for example, this is definitely a cyst. As long as there is no pain attack, you need to consult a specialist. Characteristicsymptoms of dental granulomastart spontaneously, accompanied by severe pain and increased swelling of the gums. This pathology is of an infectious nature, and precedes its occurrence increased activity dangerous bacteria. Other signs of this disease are as follows:

darkening of the enamel;
pain that initially occurs when chewing food, and then when the jaw is at rest;
obvious redness of the inflamed gum;
increased body temperature;
nervousness, irritability;
sleep phase disorder.

Treatment

It is not recommended to treat the disease at home without medical assistance. Otherwise, pus accumulates in the gums, which subsequently spreads to systemic blood flow and causes blood poisoning. Safe and effectivetreatmentbegins with diagnosis, the basis of which is an x-ray of the suspected focus of pathology. Only after receiving the result and examination oral cavity The dentist can select an adequate treatment regimen for the patient. There are two ways to treat dental granuloma – surgical and therapeutic.

Removal

Even if taking antibiotics did not provide sustainable positive dynamics characteristic illness, the patient is about to undergo surgery.Removal of tooth granulomais carried out using one of two methods - hemisection of the affected position and resection of the root apex. Both procedures are performed with preliminary anesthesia and require a short rehabilitation period. So:

If there is no positive effect from endotherapy, and the tooth is a strategically important position, the doctor recommends only resection of the root apex. The operation consists of opening the affected position, cleaning the canal from accumulated pus, applying medicinal solution and excision of part of the root along with progressive pathology.
Hemisection is carried out on multi-rooted teeth, and involves removing the affected position along with its coronal part. The operation is complex and therefore requires x-ray control, subsequent use of antibiotics rehabilitation period. Granuloma no longer appears after tooth extraction, but the crown suffers.

Treatment with antibiotics

If the patient consults a doctor in time with his problem, it is effective conservative treatment with the participation of antibiotics strictly for medical reasons.Antibiotics for dental granulomahelp open the abscess, relieve dangerous infection, as the main provoking factor, and then contribute to the restoration of once-affected gum tissue. It is not painful to be treated in this way, and the desired results are expected soon.

To enhance the overall therapeutic effect, antibiotic drugs are recommended to be taken in combination with sulfonamide drugs, which also suppress inflammation and increase the threshold of pain sensitivity. They are prescribed after surgical filling, especially often in modern dentistry they resort to the following medications - fourth generation antibiotics:

Amoxicillin;
Azithromycin;
Ciprofloxacin;
Amoxiclav;
Doxycillin.

Laser treatment

This procedure belongs to physiotherapeutic methods of treatment, is effective and as gentle as possible. During granulation, antibiotics are not required to be injected into the cavity and interroot space, and a laser light guide enters the expanded channels. Treatment of dental granuloma with a laser provides a direct effect on the affected areas, excision of keratinized cells, destruction of pathogenic flora, and formation of a granulation capsule. Additionally, the affected tissues are sterilized and oral hygiene is ensured.

Treatment with folk remedies

Such alternative methods are more suitable for prevention, and the main treatment with their help can cause the development of a chronic disease. If the dentist prescribes folk recipes, then they only complement the officialtreatment of dental granuloma folk remedies . Self-medication is completely contraindicated, since it ensures the spread of the purulent process. So, if an interradicular granuloma develops, suppress unpleasant symptoms you can do this in the following ways:

Pour 30 g of dried calamus rhizomes into 500 ml of vodka and leave for two weeks. Using the same principle, prepare an alcohol tincture of propolis, and then alternate both medications throughout the day and use them as mouth rinses.
Gum granuloma is successfully treated alcohol tincture calendula or sage. Dilute 30 drops of the chosen medicine in a glass of water and use it to rinse the mouth. Carry out the procedure three times a day.
One more thing effective remedy against the inflammatory process - oak bark. Prepare a decoction by combining 1 tbsp. l. dried raw materials with 1 tbsp. boiling water Infuse, cool, strain, take decoction orally or use for daily rinsing of the pathology site.

A granuloma is a capsule of inflammatory fluid surrounded by granulation tissue located near the apex of the tooth. According to its characteristics, as well as treatment methods, this formation is similar to a cyst. The size of such a neoplasm is not large - it usually has no more than 5-8 millimeters in diameter. Over time, such a capsule can increase in size; when immunity declines, it can also break through, as a result of which pus is released from the granuloma, the tooth root is exposed and the tooth itself loses its fixation.

The causes of pathology are always incorrect and untimely treatment dental diseases- caries, periodontitis, pulpitis (especially advanced ones). Granuloma is often observed after tooth extraction. With such processes, inflammation of the periodontal tissues is observed, which leads to bone damage and the formation of connective tissue.

With further development, granuloma on the tooth root can lead to bone destruction, spread of infection to neighboring tissues, as well as infection of other body systems by microbes. To prevent this from happening, it is very important for the patient to undergo timely diagnosis and treat the disease in accordance with all the recommendations of his doctor.

Symptoms of granuloma on the roots

Usually dental granuloma long time does not manifest itself in any way, and only in the later stages gives more or less pronounced symptoms, similar to the manifestations of a cyst, including the following characteristic manifestations:

Painful sensations when chewing food, which can have varying degrees of intensity and appear mainly in the morning.
Darkening of the tooth, which may be accompanied by the discharge of pus.
Swelling of the gums in the affected area, bleeding when eating solid food, as well as hygiene measures.
Increased temperature - at the second stage of development of the disease, granuloma can give a temperature of up to 39-40.

It should be noted that the appearance of symptoms of the disease already indicates an advanced state of the disease and the need for immediate treatment. You shouldn't ignore them.

How can granuloma be treated?

There are currently several effective techniques, allowing for short terms rid the patient of a granuloma (as well as a cyst), while preserving the tooth. Their selection depends on diagnostic data, including visual examination and x-ray of the affected area general condition patient, as well as prognosis for the development of the disease. Depending on these factors, the doctor may prescribe conservative or surgical treatment. These methods need to be discussed in more detail.

Therapeutic treatment of dental granuloma

This area includes several different methods of relieving the disease through the use of such means:

antibiotics;
sulfonamide pastes;
drugs aimed at restoring dental tissues;
general strengthening agents.

In some cases, treatment with antibiotics makes it possible to avoid opening the canal in the early stages of granuloma formation. In this case, the specialist treating the patient will be guided only by the data of his x-ray. If at the end of the course it does not show any neoplasm, it means that the technique as a whole was chosen correctly, and the treatment was successful.

One of the most effective methods of dealing with granuloma, especially in the early stages, is also opening and further cleaning the affected canal with instruments and special pastes. This method allows you to save a tooth by reconstructing part of it through filling.

Therapeutic treatment of granuloma gives good results mainly at the beginning of the development of the disease, when it still occurs without symptoms, but also for more late stages can give good results. In general, treatment allows you to stop the spread of infection and get rid of granuloma in 70% of cases. If this direction of work with the patient does not give the expected results, the dentist may decide to surgical removal granulomas.

Surgical treatment

This direction of the fight against granuloma allows you to effectively treat the disease in almost 100% cases according to reviews in dental practice. Currently, it provides several different methods for eliminating tumors from the tooth root:

Laser removal of granuloma. With it, the canal is treated with a special beam without opening, thanks to which it is possible to keep the tooth intact. Treatment with this technology is completely painless, according to reviews, and involves a very short recovery period. Laser removal of granulomas has only one drawback - it is currently carried out by a very small number of clinics.
Cystectomy. Most soft version surgical treatment of root granuloma, in which only the top of the affected tooth is removed and then restored by installing a crown or bridge. A similar method is applicable in the treatment of cysts. According to reviews, it is the least painful of all types surgical intervention.
Hemisection. This treatment involves removing part of the tooth and root affected by the granuloma or cyst. Most often used in modern dental practice. Allows you to effectively eliminate granuloma without the possibility of relapse at the root and restore the tooth by installing a crown. Patient reviews confirm high efficiency this method.
Removing a tooth with roots. It is considered as a measure of last resort and is used in cases where there is an acute purulent process in the periodontal tissues that is dangerous for nearby tissues. In this case, it is practically impossible to restore the tooth.

All of the above options for surgical treatment of granuloma, as well as cyst removal, are carried out in a hospital setting using local anesthesia. Further treatment involves taking antibiotics to prevent the spread of infection, antiseptic rinses and taking general restorative medications. Term complete treatment in this case it will be up to 14 days.

Patient talking to dentist about dental granuloma

Possible complications and prevention

At correct implementation By diagnosing and selecting treatment methods, granuloma can be quickly and effectively eliminated. However, if the patient delays contacting specialists, most likely the disease will continue to develop and can cause serious complications. These include:

cyst formation;
infection of adjacent periodontal tissues with pus;
inflammation peripheral nerves, meningitis or encephalitis, developing as a result of infection entering the cranial fossa through the maxillary cavities.

As for preventive measures To avoid the development of granuloma at the root, they include compliance with hygiene standards, regular visits to the dentist, as well as timely treatment of various diseases of the teeth and gums (since they most often lead to the development of the disease). These measures, of course, do not provide a 100% guarantee that you will not develop granuloma, but they will significantly reduce this risk, and also to detect the development of pathology in time in the early stages, when the disease is quite simply and quickly treated. Also, do not forget about the availability late symptoms and at the first symptoms, immediately consult a dentist; a granuloma (like a cyst) is enough dangerous diseases.

In general, dental granuloma is various stages development is quite treatable and, if the patient receives qualified assistance, can be easily eliminated without consequences for the body. Patients in this process it is important to fully rely on the competence of the dentist, choose with him best option therapy, be it drug treatment, eliminating the tumor with a laser or treating the canal with pastes, and follow all the specialist’s recommendations. In this case, you will be able to cope with the disease as quickly as possible.

The most dangerous pathologies are those that do not manifest themselves overtly. clinical signs. Granuloma on the root of a tooth occurs almost imperceptibly, but in the absence of proper treatment it can lead to serious complications. What is it? How can you recognize the problem in time?

Description

A tooth consists of a crown and a root. All changes affecting its external part become noticeable almost immediately. It is not always possible to understand in a timely manner what is happening directly under the gum. Granuloma is cystic formation inflammatory nature.

Dead cells, including bacterial ones, are localized in its cavity. Granulation tissue is surrounded by a connective capsule, which can rupture due to any malfunction immune system. As a result, the root of the tooth is exposed, its fixation is lost, and the gums become inflamed. How does pathology develop?

Due to advanced dental diseases, dental pulp accumulates large number microbes The inflammatory process begins in it. At the second stage, due to active reproduction pathogenic microorganisms infection occurs bone tissue. When the bone recedes directly from the source of infection, the formation of connective tissue is observed, from which a capsule with purulent contents is subsequently formed. This is a granuloma on the root of the tooth.

This pathology is characterized by a long asymptomatic course, which allows the formation to gradually develop and spread to neighboring areas. These can be the muscles of the face and neck. In particularly serious cases, pus can reach the heart area.

Causes of dental granuloma

Experts identify a number of factors, the presence of which may contribute to the development of this inflammatory process. These include the following:

Advanced dental diseases (pulpitis, caries).
Mechanical damage to teeth followed by infection.
Failure to comply with disinfection rules during treatment of oral diseases.
Presence pathological processes in dental tissues.

There are also secondary reasons for the development of granuloma, which significantly increase the likelihood of more intensive formation of pathology.

What symptoms indicate the presence of a mass?

For a long time, a granuloma on the root of a tooth may not manifest itself in any way. However, in certain moment occurs in the affected area severe pain. At later stages, the pathology is usually accompanied by the following symptoms:

Painful discomfort varying degrees intensity.
Changing the shade of tooth enamel.
Swelling of the gums.
A sharp increase in temperature.

In the absence timely treatment symptoms become more and more pronounced. The patient may develop a fever, purulent discharge from the affected gum. In addition, granuloma often provokes weakness and deterioration of general condition.

On early stage education can be diagnosed only through x-rays. Since only a few do this in for preventive purposes, detection of a problem most often occurs by chance.

Why is granuloma on the root of a tooth dangerous?

Symptoms should not go unnoticed. If you constantly postpone a visit to the doctor, such root damage can lead to complete tooth removal. As a rule, the granuloma does not exceed 5 mm in diameter. However, even such a small purulent sac can lead to very unpleasant consequences:

Sepsis.
Formation of a cyst (tumor of a benign nature).
Inflammatory process in the gums.
Osteomyelitis of the jaws.
Disruption of vital organs.

Diagnostics

Recognize granuloma by initial stage its development is not possible, because the tooth in this case has a healthy appearance. Pathology can be diagnosed when its first signs begin to appear.

To confirm, the doctor usually prescribes special examination. It includes x-ray and radiovisiography. The latter method is considered the safest for human health. Based on the examination results, the doctor chooses a therapeutic tactic on how to cure granuloma on the root of the tooth. This may be surgery or drug therapy. We will consider each treatment option below.

Drug therapy

You can get rid of the formation only under the supervision of a dentist. First of all, it is necessary to eliminate the existing source of infection and prevent a possible relapse.

The granuloma on the root of the tooth will not disappear on its own. Treatment with antibiotics (Lincomycin, Amoxiclav) and antimicrobial sulfonamides medicines effective only on initial stage development of pathology.

Medicines are prescribed to prevent the occurrence of inflammatory processes. The drugs are injected directly into the root canal. To secure positive result this procedure is repeated several times. For the period between visits to the dentist, the tooth is covered with a special inlay or temporary filling. Otherwise, food particles may get into the canal, which will only worsen the inflammation.

Granuloma on the root of a tooth under the crown usually provokes painful sensations. That is why patients are additionally prescribed non-steroidal anti-inflammatory drugs (Nise, Ketonal).

In combination with antibiotics, baths and rinses with the addition of antiseptics are also recommended. Most often used by everyone famous drug"Chlorhexidine." At the end of therapeutic treatment, the doctor may decide on the need for surgical intervention to restore the shape of the tooth.

When is surgery required?

IN advanced cases surgical intervention is necessary. During the operation, the doctor cuts the gum and installs a special drainage, through which pus is removed from the tissue. This design is usually left for three days. In addition to direct surgical intervention, patients with this diagnosis require anti-inflammatory therapy.

Despite the availability of well-developed surgical techniques, it is not always possible to save a tooth. The following factors may hinder this:

Tooth decay.
Vertical root crack.
The periodontal pocket is in a neglected form.
Prosthetics or bite correction are planned.

The cost of such treatment depends on the prestige of the dental clinic, the qualifications of the staff and related services. The price, as a rule, varies from 2500 to 4000 rubles.

Granuloma on the root of a tooth: treatment with folk remedies

Many patients prefer conservative therapy traditional treatment. Below we list the most popular recipes healers:

Rinse your mouth with an herbal mixture of eucalyptus, sage and chamomile.
Wipe the affected area with a mixture of vegetable oil and tinctures of celandine.
Make applications. In a decoction of oak bark and nut leaves, moisten a cotton swab and apply to the problem area.
Rinse the mouth with a solution of raw chicken egg and a pinch of salt.

The above procedures should be repeated as often as possible. It is possible that after some time swelling and painful discomfort will decrease. Such a rapid disappearance of symptoms does not mean that the granuloma on the tooth root has gone away. Treatment without the participation of a dentist is not possible. Using Methods traditional medicine allowed after consultation with a doctor, otherwise the risk of further spread of inflammation and worsening of the clinical picture increases.

How to prevent the problem

Granuloma on the root of a tooth is an insidious formation. Its development can be prevented using the same methods as in the case of other dental problems.

First of all, doctors recommend visiting the dentist at least twice a year. If carious processes occur, it is necessary to treat them in a timely manner and not wait for complications to develop. Should be changed periodically toothbrush, do not use too hard options, so as not to further injure your gums. For preventive purposes, you can rinse your mouth with specially designed products or herbal infusions. Certainly correct and balanced diet, playing sports increases the body’s resistance to various kinds of ailments, and granuloma on the root of a tooth is no exception.

Photos of education make many people think about the condition of the oral cavity. Treatment often involves surgery, which is really scary. Despite such simple measures prevention, many people do not follow them. But think about what is better: going to the dentist twice a year or being “stuck” in his chair indefinitely?

Dental diseases are not always easy to treat. One of these complex diseases is a dental granuloma. Not so long ago it was a direct indication for its removal.

Currently, methods have been developed and are actively used in dentistry effective treatment with complete or partial preservation of the tooth. They allow you not to violate the integrity of the dentition and ensure healthy functionality of the dental system.

Therapy of basic forms

As a rule, granuloma develops asymptomatically, which quickly leads to minor inflammation to a complicated pathology. All forms of development have different clinical picture, and therefore different treatment. There are 2 forms of granuloma:

Simple.
Complex.

For successful treatment a simple form of granuloma diagnosed at the initial stage, antibacterial and antimicrobial therapy at home is sufficient.

In pathology complicated by inflammatory exudate and with a small capsule, it is necessary to resort to conservative dental treatment.

Surgical methods are indicated for the treatment of complex granulomas.

Therapy at home

Treatment at home is only permissible if little education granulation tissue with no purulent exudate. In such cases, it is most often used medical supplies and folk remedies.

A positive result can be achieved with the use of antibiotics and antimicrobials, which can be combined traditional methods treatment. Sometimes the latter can be used as independent means fight against granuloma. But they are best used as maintenance therapy.

Antibiotic therapy

Regular use of antimicrobial drugs and antibiotics effectively combats the resulting granuloma, but only at the initial stage of its development. Drugs of this type actively resist infection and relieve inflammation, after which the granulation capsule disintegrates.

In dentistry they give preference antimicrobials from the group of lincosamides (), which have high concentration in bone and muscle tissue. Antibiotics from the group of penicillins (Amoxiclav) and aminoglycosides (Gentamicin) are often prescribed.

In severe cases, injections are prescribed; in other cases, drugs in the form of tablets or capsules are indicated.. Some dental clinics use antibacterial films that are applied to the affected area. After which the antibacterial substances are gradually released and penetrate deep into the gum tissue.

In addition to the listed drugs, non-steroidal anti-inflammatory drugs (Nise, Nimesil, etc.) are prescribed. Antibacterial drugs are also prescribed local action in the form of a cream or gel (Cholisal, Metrogyl-Denta).

Antibiotic therapy is indicated not only in the case of the initial stage of pathology, but also as a concomitant method for dental treatment running forms.

Traditional methods

Folk remedies in the treatment of granuloma are most often used as first aid. For this they use agents aimed at relieving symptoms of inflammation and antiseptic effect.

One of the symptoms of granuloma is swelling, which creates pain. To remove it, you need to rinse your mouth as often as possible. soda solution, room temperature. Traditionally, one teaspoon of soda is dissolved in one glass of water, but the solution can be made stronger.

Contrary to most opinions about the benefits of heat for granuloma, dentists categorically prohibit any thermal effect to the problem area.

Used as antiseptics herbal infusions calendula, sage, chamomile, pine needles. Typically, infusions are prepared at the rate of 2-3 tablespoons per 250 ml hot water, after which they infuse for 15–20 minutes.

An infusion of oak bark and applications with sea buckthorn oil have an anti-inflammatory and wound-healing effect.

Despite the described positive properties, alternative treatment is not recommended for use as the primary treatment for granulomas. It should be used together with other methods of therapy only after consulting a doctor.

Conservative methods

Conservative treatment is indicated for a simple form of granuloma, which has a capsule with purulent exudate no more than 5 mm in size. This type of treatment involves direct action on the tooth and surrounding tissues. In this case, the effects are carried out with minimal tissue damage.

The goal of conservative therapy is to eliminate the source of inflammation. It is achieved by exposing the source of infection to a special drug, which leads to the destruction of the granuloma. This type of treatment has its drawback - in 30% of cases, the granuloma only subsides for a while, after which the pathology progresses.

Procedure

After x-ray examination The dentist decides on a plan and methods of therapy, after which he begins treatment. Most often, granuloma therapy is divided into stages that require several visits.

Work order at stage 1:

the doctor dissects the diseased tooth, opening the canal cavity;
The channels are thoroughly cleaned and disinfected with a special solution. Modern physiotherapeutic methods are also used for aseptic processing;
a drug with an antimicrobial effect, which includes iodine derivatives and antibiotics, is administered through the treated canal. This contributes to the destruction of the granulation sac;
temporarily close the cavity until inflammation is completely relieved and granulation formations are destroyed.

Work order at stage 2:

the cavity is opened, after which the channels are washed, disinfected and dried;
Dental paste containing calcium is injected into the prepared canal, restoring the affected tooth tissue;
Finally, the tooth is filled with a composite and the crown is restored;
The dentist sets a date for the next visit.

In the absence negative symptoms next appointment needed only after six months. During this appointment, the doctor takes x-rays and draws conclusions about the treatment.

Physiotherapeutic methods

Photo: apparatus for depophoresis

To remove pathogenic flora and destroy the capsule, non-introduction is often used. special drugs, and physiotherapeutic methods. Modern physiotherapeutic methods for treating dental granuloma include depofresis and laser treatment.

Depophoresis

Allows you to clean all the canals of the affected tooth through one drilled channel. This is important for very narrow and curved canals, if a dental microscope is not used in the work.

The essence of the method is that a suspension containing copper hydroxide is injected into the prepared channel. A weak electric current, causing copper particles to begin to actively move, moving to all corners of the tooth and destroying pathogenic cells.

For complete cure, at least three depophoresis procedures are required, after which a filling is applied to the tooth filled with copper ions. Getting rid of granuloma using depophoresis is observed in 95% of patients.

Laser Application

Carried out without introduction antibacterial drug into the tooth cavity. With this method, a laser light guide is introduced into the enlarged affected channels. Through it, the infected areas receive laser beam, which evaporates pathogenic cells, including those that form the granulation capsule.

Along with the destruction of affected cells, the treated tissues are sterilized. very effective, but, unfortunately, it is not suitable for curved root canals.

Surgical methods

With a complex form of granuloma, surgical treatment is indicated, the purpose of which is to remove the source of infection and affected tissue, while preserving the main part of the tooth.

IN modern dentistry uses various methods to avoid complete tooth extraction.

Basic surgical methods:

Cystectomy– the longest, but at the same time less traumatic method. With this method, the dentist makes an incision in the gum to remove the purulent contents. To ensure complete drainage of exudate, drainage is inserted into the incision. Complete removal of pus occurs within 2–3 days.
After cleansing purulent cavity, the dentist cuts off the affected part of the root and fills it. After the procedure is completed, a bone-forming preparation is placed and sutures are applied.
Hemisection– removal of the granuloma along with the infected root part. In this case, the crown part of the tooth is also removed. The resulting defect is restored with artificial materials.
Radicular separation. When using this method, the tooth is cut in the middle into two halves, after which the dentist has free access to the infected tissue.
After this interval, the doctor cleans the affected area and fills the individual halves. The result is two incomplete teeth. Separation is used only on molars, forming premolars.

If the root with granuloma has a vertical crack, the tooth is severely damaged or the periodontal pocket is in a neglected state, it is shown complete removal tooth

Price

There probably won’t be a free procedure for treating granuloma while preserving the tooth in public dentistry. This is due to the complexity of therapy and the use of various technologies and equipment, the choice of which depends on the diagnosis.

A standard opening of an abscess costs from 700 to 1500 rubles.
The price of a typical granuloma removal varies from 1,500 to 3,000 rubles.
Resection with further retrofilling – from 3,000 to 7,000 rubles.
Cystectomy of a single-rooted tooth using laser equipment from 7,000 rubles, multi-rooted from 10,000 rubles.
Hemisection of a tooth will cost 2000 rubles. and higher, depending on the materials used.
The use of depophoresis for therapeutic treatment will cost from 300 to 3000 rubles. per channel.
Complete tooth extraction with granuloma from 800 to 4500 rubles.

Features of therapy

The success of treating dental granuloma depends not only on the correct method. There are features on which the result of the therapy directly depends:

Treatment of dental granuloma should be carried out by an endodontist. This specialist has skills in filling canals using the Thermofil method and vertical condensation;
a clinic providing granuloma treatment services must be equipped special equipment, which allows you to carry out the procedure most accurately and efficiently;
the endodontist is obliged strictly follow the treatment protocol which includes maintaining the sterility of dental instruments, necessary methods diagnostics, use special means antiseptics, compliance with the terms of their use.

Diseases of the soft tissues of the oral cavity are a common occurrence. Many of these pathologies cannot be identified at the initial level of development, so only complex methods are used to treat them. Such diseases include dental granuloma, which requires complex therapy.

Definition

Dental granuloma is an inflammation of a limited area of periodontal tissue in the area of the root apex. The focus of inflammation is characterized by a change in the structure of the affected tissue and the formation of a dense granulation sac.

At the initial stage of development, the area looks like a nodular compaction and does not exceed 0.5 cm in diameter. As the pathology develops nodule deforms into a capsule filled with inflamed tissue.

Many people confuse granuloma with a cyst, but these are different diseases.

Unlike a granuloma, a cyst is characterized by the formation of a hollow capsule, which gradually filled with exudate. In addition, granuloma accompanied by pain and swelling, which cannot be said about a cyst that has no obvious signs.

Help in the initial stages

The most favorable option is considered the initial period of development. If the pathology was diagnosed at this stage, then therapeutic treatment using general and local drugs.

If it is impossible to see a doctor to prescribe treatment, it is necessary to use local drugs that have a bactericidal and anti-inflammatory effect.

The following drugs have a good effect in this case:

Hydrogen peroxide. Capable of destroying bacteria and flushing out necrotic cells. The drug is used in the form of a 1.7% solution to treat the inflamed area up to 3 times a day;
Sanguinarine. Based on natural ingredients. The main effect is the destruction of pathogenic microbial cells and reduction of their aggregation. The solution is used as a rinse 2 times a day;
Betadine– drug broad action, the main component of which is active iodine. It helps destroy all types of fungi, bacteria and viruses. Used to rinse the mouth up to 5 times a day;
Diplen-Denta – gel, the main substance of which, chlorhexidine, is known for its antibacterial properties. When applied, the drug forms a film that ensures penetration active component into the deep layers of the periodontium. The gel is used no more than 3 times a day;
Metrogil-denta. The gel has anti-inflammatory, analgesic and aseptic properties. It is applied to the periodontal pockets of the inflamed area twice a day.

As a rule, treatment of the disease at the initial level of development has a positive prognosis.

In the absence severe inflammation fabrics use local drugs gives a positive effect and complete cure within 7 days.

Medicines

Treatment of complex forms of granuloma is not complete without prescribing general medications:

Doxycyline. An antibiotic is prescribed for rapidly developing granuloma. The main active component is able to quickly penetrate the inflamed tissue and stop the pathogenic process.
The drug is prescribed to adults and children under 8 years of age in a dosage of 100 to 200 mg per day, depending on age. The cost of the drug, depending on the manufacturer, starts from 30 rubles per package of 50 mg.
Amoxiclav. Combination antibiotic penicillin group, which included two active substances: clavulonate and amoxicillin. The drug penetrates well into all tissues and fluids of the body, reaching concentration within an hour after use.
The antibiotic can be used to treat adults and children early age. The treatment regimen includes taking the drug 3 times a day. The drug is calculated according to the patient’s body weight: 30 mg/kg. The cost of the drug starts from 125 rubles.
Biseptol– antimicrobial agent sulfonamide group. Sulfamethoxazole and trimethoprim, which are part of it, enhance the effect of each other, providing an antibacterial and bactericidal effect.
Active anti-inflammatory effect begins 2 hours after application. Biseptol is prescribed for children in a dosage of 250 mg 2 times a day, for adults 500 mg up to 4 times a day. The price of Biseptol varies from 40 to 130 rubles.
Lincomycin– an antibiotic belonging to the lincosamide group. The main difference from other antibiotics is the ability to accumulate in soft and hard tissues, which enhances the anti-inflammatory effect.
Due to these properties, the drug is prescribed for severe forms granulomas with formation purulent processes. The only disadvantage of this remedy is its narrow focus: lincomycin is effective only for pathologies caused by gram-positive bacteria.

Capsules are prescribed every 8 hours, no more than 500 mg for a single dose. Purchasing the product will cost approximately 140 rubles.
Metronidazole. Refers to antimicrobial and antiprotozoal drugs. The action of the main substance is to inhibit the synthesis of intracellular acids, which results in the death of microorganisms.
The highest concentration of substances is observed in the intercellular fluid. Metronidazole is taken 1 tablet up to 3 times a day. The cost of one package is 80 rubles.

Therapy through channels

If there is no positive result after drug therapy intracanal therapy is prescribed, which involves opening the tooth cavity.

Besides this, this procedure indicated in the following cases:

constant intense pain, which is difficult to relieve with painkillers;
edema, spreading to the entire jaw;
presence of purulent formation larger than 5 mm.

Direct impact on inflamed area takes place in several stages:

After the X-ray examination, the doctor performs administration of local anesthesia injection method. Most often, ultracaine is used for this.
Dentist opens the tooth cavity by preparing the crown using a dental bur or milling cutter.
After opening they carry out cleaning and aseptic treatment of canals.
Through the prepared channels, a medicinal substance with pronounced antimicrobial effect.
The greatest effect in this case is provided by a combination of iodine-containing drugs with antibiotics. These components contribute to the destruction of the membrane of the affected tissue and relief of the inflammatory process.
After drug administration the cavity is covered with temporary filling material.
At the next visit, the cavity is opened again and cleans the canals and removes dead tissue.
Then a calcium-based preparation is injected to the base of the root, promoting the restoration of hard tissues.
Next are the crowns filled, completely restoring the coronal part.

Average cost of this procedure dental clinics is in the range of 2000 – 4000 rubles.

This technique allows you to quickly stop the process, but practice shows that in 1/3 of cases the granuloma is only temporarily stops its development, and under certain factors, pathology relapses.

Surgery

The main indication for surgical intervention is a complex form of granuloma with its growth exceeding 1 cm. In this case, several techniques are used:

Cystectomy. Refers to less traumatic methods. To relieve the problem, the doctor dissects the gum tissue in the area of inflammation to extract exudate.
A tourniquet is inserted into the incision, which ensures complete drainage of fluid within several days. After the purulent capsule is completely emptied, part of the root apex is cut off and then the tooth is filled.

The cost of this service starts from 5,000 rubles. If laser equipment was used, the price could increase to 10,000 rubles.
Hemisection. This involves removing part of the tooth along with the granuloma. During the procedure, the dentist cuts the crown with a bur. After this, the infected part of the tooth is completely removed, along with the crown and root.
After removal, the missing part is immediately restored using filling material. The cost of hemisection can vary from 1000 to 5000 rubles.
Radicular separation. In this case, the tooth is completely divided into two halves. Then the affected tissue is removed through the resulting gap, and the walls of the halves are sealed. As a result, instead of one crown, two small teeth are formed. The price of the service is about 2500 rubles.
Complete tooth extraction. It is carried out only when a vertical crack has formed in the affected crown. The procedure takes place under local anesthesia. By using special tools The dentist tears the periodontal ligaments around the neck and root of the tooth and removes it from the socket.
Removing a crown will cost an average of 1,000 rubles.

Physiotherapy

In addition to the listed methods, physiotherapeutic methods are additionally used to treat granuloma:

Depophoresis. This method allows you to achieve a positive result in the presence of curved or narrow canals. Using a microscope, a suspension containing copper hydroxide is introduced through one of the channels.
A weak current is then passed through the liquid. Reacting to it, copper begins to actively move, destroying the affected cells. Depending on the tooth, the cost of treatment can cost 300 – 2500 rubles.
Laser treatment. The essence of the method is the introduction of a laser light guide and exposure of the pathogenic area to the beam, during which the affected cells evaporate. Laser therapy costs about 3000 rubles.

Therapy at home

Traditional methods of treatment can be additionally used as maintenance therapy. Good reviews got the following methods:

Rinse with soda-saline solution, prepared at the rate of ½ teaspoon of each product in half a glass of water.
Irrigation of the inflamed area with infusion prepared from oak bark, chamomile and sage. To do this, you need to take equal quantities of each plant, pour boiling water and leave for 30 minutes.
Propolis infused with calamus. 30 grams of propolis and 15 grams of calamus are poured into 0.5 liters of vodka. To rinse, you need to dilute 3 large spoons of tincture with a glass of water.

This video shows how a granuloma develops:

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