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Removal of Cysts and Granulomas

Chirurgia orale Milano

When we talk about cysts and granulomas it is good to make a small distinction between the two. Granulomas are cavities filled with accumulated tissue (cells and lymphocytes) and covered with an epithelial layer.

These generally form in the vicinity of the jawbone area and / or the oral soft tissue area (gum) as a result of necrosis of the dental pulp. Cysts, on the other hand, present with the progress of complications of the granuloma that fills with fluids (serum, blood, exudate, pus). In the following paragraphs we will see specifically what are the causes, symptoms, and how the export of cysts and granulomas occurs.

Causes and symptoms of cysts and granulomas:

Cysts and granulomas are common complications that usually occur in the advanced stages of untreated inflammatory diseases. Some of these conditions can be pulpitis (inflammation of the dental pulp), caries or periodontitis (once called pyorrhea).  They can also be caused by complications from unsuccessful oral surgery. These formations are nothing more than defense mechanisms deployed by the body to counter/ limit the spread of bacteria.

Cysts and granulomas are often asymptomatic escaping the subject's attention, but not always, in fact, in some cases they show symptoms such as:

  • Tooth pain
  • Gingival swelling
  • Malaise
  • Halitosis
  • Swelling of a mandibular/ maxillary area (only in case of cyst)
  • Swelling of the lip (only in case of cyst)
  • Mobility of the tooth/ teeth (only in case of cyst)

In the event of further worsening, the symptoms could spread to other parts of the body thus causing:

  • Headache
  • Enlarged lymph nodes in the neck
  • Pain in the eye

Since cysts and granulomas are formations that often occur in asymptomatic form, there are cases in which the diagnosis takes place long after their origin. Therefore, at the Bracchetti Dental Clinic in Milan, we always recommend carrying out periodic checks to constantly keep oral health under control and be able to diagnose and intervene as soon as possible in case of problems.

Cysts and granulomas: is it necessary to remove the tooth? Is the operation painful?

Before intervening on cysts and granulomas it is essential to have a clear view of the situation in order to exclude other pathologies. Therefore, an accurate diagnosis is necessary that will include specific radiological investigations which will allow the specialist to identify the precise location and type of cyst/ granuloma and, in cases where it is deemed necessary, a biopsy with histological examination will be performed which will allow to exclude that (in the case of cysts) it is a tumor-like formation.

Once the nature and severity of the lesion is known, we will proceed with the most suitable procedure for the specific type of cyst or granuloma. Nevertheless, the treatment aims to eliminate the cause of the lesion so, depending on how far the infection has progressed, the following may be necessary:

  • Drainage - in milder cases it is possible that it is enough to facilitate the expulsion of the secretions that fill the cysts
  • Devitalization of the tooth associated with the lesion - cleaning and sterilization of the tooth root
  • Apicectomy - elimination of the root section affected by the infection
  • Tooth removal - only in the most severe cases when the tooth is irreparably compromised

Drainage, devitalization and apicoectomy operations are almost painless.  Still it is necessary to precisely follow the instructions that the specialist will provide to the patient after the operation, so that the site heals well and the possibility of complications is limited.


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