Periapical cysts are the most common tooth-related cysts, affecting non-vital teeth and causing little pain unless infected. Tooth extraction or root canal are recommended treatments, but the cyst may persist. They can affect multiple teeth and are caused by tooth destruction. Infections are diagnosed by pain and treated with antibiotics. Periapical cysts can cause jaw fractures and fill with brownish discharge.
Sixty-five percent of all tooth-related cysts are periapical cysts. Also called root cysts, periapical cysts are usually painless unless they become infected. Most periapical cysts affect non-vital, pulpless teeth. Tooth extraction is the recommended treatment for such cysts.
Periapical cysts appear most commonly in adults between the ages of 40 and 60, although they can appear at any age after teeth are present. Slightly more men than women develop cysts and they occur more often in the white population than in the black population. Some patients show a propensity for developing periapical cysts and may develop several throughout their life.
A number of teeth may be involved if the cyst is large enough. When more than one tooth is affected, it is not uncommon for the teeth to become loose and mobile. A tooth with a periapical cyst will have connective tissue attaching the cyst to the tooth.
The cause of a periapical cyst is the destruction of the teeth, either through a cavity or a lesion. As the cyst grows, it will appear on an X-ray as a dark spot near the root of the tooth. The cyst can be discovered during a routine dental exam or it can cause pain to the patient, prompting a visit to the dentist.
An infection is easily diagnosed by touching the affected tooth. If infected, the patient will experience excruciating pain. Treatment for a periapical cyst infection usually includes a course of antibiotics.
Once the infection is under control, a tooth extraction is scheduled. Extraction is the recommended treatment for a periapical cyst, although extraction does not guarantee that the cyst will be gone forever. The cyst can grow back even if the tooth has been removed.
An alternative treatment to tooth extraction is a root canal. This procedure saves the tooth, even though it will require a crown. The cyst may persist after the root canal has been completed.
About 52% of cystic lesions of the jaw are caused by periapical cysts. Also, some cyst channels lead to the sinus cavities. The cyst may fill with a brownish discharge caused by infection and blood. Rarely, a periapical cyst can cause a jaw fracture.
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