Table of Contents
What Is A Cyst?
A cyst is a space-occupying lesion that can be formed in either the hard or the soft tissues of the body. In most cases the center of the cyst is filled with necrotized material and pus. As these cysts grow, they put pressure on adjacent structures like blood vessels and nerves and, in fact, may even obliterate them altogether.
Think of these cysts like balloons that slowly continue to grow and as they grow they keep destroying the surrounding structures to find the necessary space. As a result, of this destruction, patients may experience numbness, hard and soft swellings (depending upon the nature of the cyst), destruction of bone and the roots of the teeth they lie against, and eventually they may even cause the teeth to fall out altogether.
Why Do Cysts Form In The Mouth?
Some of these cysts may be formed because some part of the epithelium (the soft tissue cells lining the bone) gets entrapped into the bone during development. Others may be formed in response to inflammation, infection or trauma and still others may be formed without there ever having been an obvious reason.
Cysts by themselves do not cause any symptoms whatsoever and only start to cause trouble once they have been secondarily infected. The other symptoms that appear are associated with the destruction they cause.
If a cyst is found to be self-contained and causing no apparent symptom or destruction then there is no reason to remove it.
This is by far the most common type of cyst found in the oral cavity. There are several distinguishing features which make it quite easy to identify a periapical cyst. The origin of a periapical cyst is from the necrotized pulp tissue.
This can occur in several ways. Dental caries which have not been treated can extend to the pulp, causing it to become infected and eventually leading it to necrotize. The same can also happen through a blow, fall or any other trauma to the teeth.
This cyst is detected on a standard periapical X-ray of the tooth, however, it can also be recognized in an OPG of the entire mouth.
A periapical cyst is very similar in radiographic appearance to a periapical abscess that also presents itself with very similar symptoms. An untreated periapical cyst can also grow to a size large enough to cause the destruction of neighboring teeth and can even cause a displacement in their position.
The cyst can be distinguished from the abscess by the presence of pus, presence of symptoms of acute inflammation or through the presence of a necrotic pulp tissue. In some cases, however, it can be quite difficult to distinguish between the two since both basically exhibit the symptoms of inflammation.
From a treatment point of view, the presence of both indicates that the affected tooth has to undergo a root canal. An abscess will resolve in due course of time whereas a cyst may persist. Depending upon its size and location, it may then have to be removed.