Cysts are abnormal cavities covered by a thin membrane that can form anywhere in the body. Teeth that have certain conditions can produce cysts in the surrounding bone, known as odontogenic cysts. Although they are not as common as other conditions that can appear in the mouth such as periodontitis or gingivitis, they have the capacity to produce important lesions in the teeth themselves or in the bone where it is being formed, as well as the potential to become tumors, therefore, its identification and timely elimination is important.
Why dental cysts are produced
In most cases, a cyst is one of the final stages of the evolution of an infection of dental origin that has not been treated properly, or that has simply not been treated. In this evolution, the first lesion is a dental abscess that the organism tries to control with the formation of a granuloma. When a granuloma is not treated, with the passage of time develops a cavity in its interior and a membrane in the periphery, thus forming a cyst.
Another possibility is that the cysts form due to some defect during the development of a tooth that causes the retention of fluid inside a membrane that normally covers the tooth while it is inside the bone during its formation.
Types of dental cysts
There is a large number of cysts, although some are much more frequent than others:
Periodical cyst: It is the result of a granuloma that was not treated properly, and is formed in the final portion of the root of a tooth.
Recurrent cyst: When a cyst is not completely removed after extraction of the affected tooth, it can be re-formed producing this type of cyst
Periodontal cyst: It looks like the first, but appears on the side of the tooth root.
Dentigerous cyst: Caused by the growth of a cavity inside a membrane that covers the crown of the teeth when they are inside the bone.
Rash cyst: It appears in children when the membrane that covers the crown fills up with fluid when the teeth try to erupt.
Gingival cyst: It’s similar to the previous one, but occurs in adults.
Newborn cyst: They appear in the gums of newborn babies and do not need any treatment.
Symptoms of dental cysts
Being a chronic condition, in most cases dental cysts do not produce symptoms, but they can cause discomfort and pain if they become infected. Cysts are cavities that can expand to considerable dimensions and do so at the expense of bone, consuming it as they grow. The larger ones can produce significant bone loss and even create perforations.
When a dental cyst causes the loss of the bone that surrounds the teeth, these can reach a considerable degree of mobility by removing the support. Although dental cysts consume bone, they very rarely consume any part of the structure of a tooth. What they can cause is the displacement of the teeth, being able to move them to spaces completely away from the corresponding one and even preventing them from erupting when they produce their retention inside the bone when they appear at very early ages.
The loss of bone can compromise neighboring structures such as the floor of the eye socket or the walls of the maxillary sinuses, which are part of the airways. It can also compress the nerves when they are close to these, producing alterations in the perception of touch.
Diagnosis of dental cysts
The inspection of the patient allows detecting alterations that may be suggestive of a cyst, such as the alteration of the shape of the bones, mobility and displacement of teeth or their absence without previous history of extractions, and extensive caries in teeth without endodontic treatment. They have never been restored.
In general, the cysts are observed through a panoramic radiograph, although once the cyst is found, a computerized tomography is recommended to determine possible damage.
Treatment of dental cysts
The treatment of a dental cyst always consists in its elimination, since these structures have the capacity to produce bone losses that compromise the stability of neighboring teeth, as well as having the potential to turn into malignant lesions.
The procedure by which it is removed will depend on the type of cyst. In periodical cysts, for example, it is necessary to do a root canal treatment on the affected tooth and then perform a procedure called apicoectomy, which consists of removing the cyst along with the terminal portion of the root.
When the affected tooth is much destroyed and has no possibility of restoration, it is removed after which the cyst is removed and the bone is cleaned. Periodontal cysts can be eliminated without doing any treatment on the tooth, since they are conditions that do not compromise them.
Some more complicated cases, such as in dentigerous cysts, require a more extensive intervention to reach the affected tooth. In most cases the tooth must be removed as well, but when it has a good prognosis it can be left for relocation by orthodontics.
Some cysts may not need any treatment if they do not cause changes on the teeth.
This article is purely informative. We invite you to go to a doctor in the case of presenting any type of condition or discomfort.