Dental granuloma is the inflammation of periodontal tissue which is a small rounded formation located in the area of dental root. Dental granuloma can have a few different locations in the tooth root, but in most cases, granulomas occur in apex of the tooth root. When located in apex of the root area dental granuloma is usually called Periapical granuloma. Dental granuloma is made of pathological mass of lymphocytes, plasma cells, histiocytes and polymorphonuclear leukocytes that are attached to the tooth apex and surrounded by a fibrous capsule.
Characteristic of dental granuloma is a long asymptomatic course. Under the influence of some provoking factors, dental granuloma can become aggravated and manifest a clinical picture of acute inflammatory process. This clinical picture includes severe pain in the tooth, swelling and redness of the gums. The suppuration of a dental granuloma is also possible and purulent discharge can be present between a tooth and gum. Suppuration may be even accompanied by the development of odontogenic periostitis (flux). Another symptom is a changed color of the tooth. When untreated dental granuloma can be transformed into a cyst. The asymptomatic flow of dental granuloma carries a big risc, because it is not easy to diagnose and treat it in time. Dental granuloma is diagnosed mainly by radiographic imaging of the affected area or in it acute phase.
Therapy of the dental granuloma can be both conservative and operational. The chosen method of treatment depends on the size of granuloma, degree of root destruction and other complications. Conservative methods are endodontic therapy and filing. In order to eliminate infection, antibiotic therapy is prescribed. Surgical treatments of dental granuloma are resection of the apex of the root or hemisection of the tooth and sometimes tooth extraction.
There are some complications which dental granuloma can cause. The growth of the dental granuloma can be followed by destruction of the tooth apex which can lead to tooth loss. The spread of inflammatory process from granuloma to surrounding soft tissues can cause formation of a limited abscess, parathleteal abscess, or development of diffuse purulent lesions called phlegmon. Involvement of bone in the process could lead to osteomyelitis of the jaw. It is also possible to spread the granuloma infectious agents by hematogenous way and possibly cause development of sinusitis, pyelonephritis, infectious myocarditis and even sepsis.
Prevention is very important. Prevention of dental granuloma are regular checkups, dental radiography and professional hygiene of the oral cavity. Dental visits need to be regular and if there are any problems with the oral health they should be treated as early as possible.