Periapical Cyst Treatment

What is a Periapical Cyst?

Also known as a radicular cyst, the periapical cyst is a common occurrence in the jaw. Necrosis of the pulp occurs as a result of infection of the tooth. Due to toxins emerging from the apex of the tooth periapical inflammation settles in. The Malassez epithelial rests are stimulated in the periodontal ligament causing the formation of a periapical granuloma. Blood supply is arrested in the epithelium and a necrosis develops. The lesions are incidentally discovered on radiographs more often. A periapical cyst develops between 20 years and 60 years of age with the maxilla being affected more than the mandible.

Clinical features of Periapical Cyst

The periapical cyst is progressive and forms slowly. It is usually asymptomatic but can cause pain secondary to infection. There is swelling, which expands rapidly due to inflammatory edema. As it advances, part of the mouth wall is resorbed and a soft fluctuant swelling bluish in color beneath the mucous membrane is formed. The bone has the thickness of an egg shell and upon pressure a crackling sensation is felt.

Phases of the Periapical Cyst

The radicular cyst pathogenesis is divided into three phases:

Initiation: Epithelial cell rests of Malassez respond to stimulation due to bacterial infection of the pulp and as a response to necrotic pulp tissue.
Formation: The proliferating epithelium lines the central cavity in the periapical area. The epithelial mass increases in size with the peripherial division of cells and the cells from the mid portion of the mass are separated from nutrition. The epithelium-lined cavity is filled with fluid due to liquefactive necrosis of the innermost cells.
Enlargement or expansion: The innermost cellular debris raises the lumen of the cyst increasing the size of the cyst. Gamma globulin levels are found in the fluids of radicular cysts.
Radiologic evaluation

Ovoid to round radiolucency is noticed with a narrow, opaque margin. The margin is indicative of rapid enlargement of the cyst and is contiguous with the lamina dura. Most cysts are < 1.5 cm in diameter and root resorption of the offending tooth and the adjacent teeth are noticed in long-standing periapical cysts.

Treatment of Periapical Cyst at Dental Solutions

At Dental Solutions, cyst enucleation is performed with the use of conventional laser techniques. Research indicates that Nd:YAG and Er:YAG lasers can successfully eliminate the E.Faecalis and Escherichia coli thus making laser the most appropriate device for the treatment of periapical cysts. Some efficacious wavelengths that are used: ER:YAG 2940 nm and Nd:YAG 1064 nm diffuse dentin infections of varied thicknesses. The microbial population in the canals is removed with the maximum effect when the laser is combined with sodium hypochlorite in ideal concentrations for irrigation. Laser penetrates areas of the secondary canal where irrigation solutions cannot reach

Testimonials

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Parthapradhan recently underwent a Wavelength Optimized Periodontal Therapy (WPT) for treating periodontitis at Dental Solutions Bangalore. Treatments for Periodontal diseases range from nonsurgical to surgical. Non-surgical treatment would include cleaning, scaling and root planning whereas surgical would include Flap surgery, pocket reduction surgery, bone or tissue grafting, guided tissue regeneration and bone surgery. Dentists now… Read more “Parthapradhan – Wavelength Optimised Periodontal Therapy”

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Fabrice from France tells us about his experience at Dental Solutions Clinic. He was suffering from gum disease for quite a while; and while he did seek various opinions, none of them helped him discover the root cause of the problem. He is very thankful to Dental Solutions and Dr Balasubramanya for diagnosing it at… Read more “Fabrice from France – Wavelength Optimised Periodontal Therapy”

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Irshad Ahmed from Canada

It is testimonials like these that brighten our smile. Irshad Ahmed from Canada visited our dental clinic in Bangalore for periodontal treatment, he initially suffered from the consequences of the gum disease, but after the treatment, he is happy and completely relieved of the pain and the treatment has already started showing great results.… Read more “Irshad Ahmed from Canada”

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Hidris Barro from Ivory Coast

Hi, I’m Hidris Barro from Ivory Coast. I was having few issues with my teeth, so I search online and I found Dental Solutions in Bangalore and I came and met Dr. Balasubramanya. I got my issues treated along with some filling and cleaning, now I feel very good. Here the service is very nice,… Read more “Hidris Barro from Ivory Coast”

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Hi, I’m Claude Yao from Ivory Coast, West Africa, I had an issue with gum bleeding, so I came to Dental solutions to meet Dr. Balasubramanya. I got the gum bleeding issue treated along with some fillings and I’m very satisfied. The hygiene in this hospital is very nice and the service is very fine.… Read more “Claude Yao from Ivory Coast”

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