Removal of a cyst without tooth extraction [surgical method]

Inflammatory processes that form around the root are very dangerous, because they not only destroy the cement of the root and the adjacent bone tissue of the jaw, but also affect the gums. If a dentist discovers a cyst, then soon a trip to the surgeon will be necessary, but this does not mean that the patient will lose a tooth. At the Implantmaster clinic, cyst removal is performed without tooth extraction. Our specialists use the latest surgical techniques and equipment.

Removal of a dental cyst is a serious operation in dental surgery. Two decades ago, the presence of a purulent formation on the root led to the removal of a possibly healthy tooth. Modern treatment options for cysts are more varied. There are many therapeutic (conservative) and surgical methods to combat tumors. If doctors have the necessary knowledge and professional skills, patients can count on receiving quality treatment.

In the innovative dental clinic "Implantmaster" in Moscow, cyst removal is carried out by specialists of the highest category, who regularly improve their skills in the best clinics in Europe. We are able to solve complex problems in the fastest possible time and satisfy the needs of even the most demanding patients, setting loyal prices for the services provided. Our doctors are constantly improving their skills, mastering new techniques for removing cysts. The latest materials are used, modern equipment is used for diagnosis and treatment.

Next we will talk about the very concept of “cyst” and methods of its treatment. You will also learn about the main stages of removing a dental cyst, and will be able to get acquainted with the indications for the surgical operation.

What is a dental cyst and how to remove it?

Radical dental cyst is a complex chronic disease. It has its own shell and is filled with purulent contents. The disease progresses on the roots and under the gum. A cyst appears when early infectious inflammation, which is based on pathogenic microflora, is not treated.

Removal of a dental cyst is performed surgically . The tumor can grow, affecting the gums and cheeks from the inside of the mouth. In some cases, sepsis may develop.

All this makes it difficult for the patient to function normally. To cure the disease, conservative methods are used:

at the beginning of the procedure, the doctor informs the patient about the possible consequences (it is worth making this the first point);
the doctor performs an opening of the dental cavity;
cleansing the cavity from affected tissues;
treatment with solutions of antibiotics and antiseptics;
Then, within half an hour, the tooth cyst is removed without removing the tooth .

The patient will have a chance for recovery and further normal life. The main feature of this disease is its asymptomatic course. The patient may remain unaware for a long time. The consequences of this disease can lead to another complex process - sinusitis (if the cyst is located near the sinuses). It is imperative to monitor the cleanliness of the oral cavity and the condition of the gums, and also come to the doctor for sanitation on time.

When deletion is indicated

Modern dentistry strives to preserve teeth and their roots whenever possible, but this is not always possible. Dental surgeons remove teeth with cysts for the following indications:

the infectious process was caused by an advanced form of periodontal disease;
there is a vertically located crack on the root of the tooth or on itself;
the dental root canals are impassable, as a result of which therapeutic treatment becomes impossible;
severe tooth decay, and restoring it does not make sense (too expensive and time-consuming);
the tooth is located entirely in the cavity of the neoplasm;
the cyst has grown into the nasal cavity, or the size of the tumor is more than 10 mm;
the root of the tooth has fused with the neoplasm;
the tooth is very loose.

The dentist decides to remove a tooth with a cyst after a thorough examination of the patient, which includes examination, history taking, radiography or visiography.

Causes of dental cysts

Ten percent of patients have indications for removal of a dental cyst. Most do not suspect anything, because the disease proceeds secretly for a long time and does not manifest itself in any way. Often, cyst formation is a hereditary disease, and sometimes it indicates poor oral hygiene. But more often the reasons are untreated diseases or the use of low-quality products and drugs, leading to the need to remove the dental cyst. If you identify this disease in time and immediately consult a doctor, it will not be difficult to cope. But if you leave a formation with pus and mucus for several months, it can grow up to 2-3 cm. In this case, proper surgical removal of the dental cyst should be entrusted to a qualified specialist.

Implantmaster employs highly qualified specialists; they have the necessary skills for comfortable and high-quality treatment. Also, to correctly diagnose the disease and determine the exact size of the cyst, the clinic has a CT scanner (the images are more accurate and the radiation is even less), it is possible to take a panoramic image of all teeth, as well as targeted radiography of a specific tooth. The diagnosis becomes more accurate.

There are several causes of cysts:

A complicated form of caries is severe destruction of the enamel, through which microbes penetrate inside and form purulent foci.
Untreated pulpitis, when part of the nerve is outside, is a good flora for the growth of bacteria.
The complication of periodontitis, with inflammation of the connective tissue, is the most difficult to detect.
Removal of a dental cyst is often necessary for children when replacing milk teeth with permanent ones; microbes can penetrate into the sockets.
The injured mucous membrane of the palate, cheeks, tongue, and gums can serve as an excellent route for the penetration of microorganisms.
Past disease of the ENT organs. Colds, chronic tonsillitis, pharyngitis, sinusitis can cause a tumor and the need to remove a dental cyst, otherwise dangerous complications cannot be avoided.

When is it necessary to remove a dental cyst?

Is surgical removal of a cyst on a tooth necessary? In some cases, such a radical method cannot be avoided. If the affected tissue is not eliminated, the bubble with purulent contents will increase in size and create pressure on the gum. The outcome may be tumor formation.

Indications for removal:

capsule diameter is more than 1 cm;
the presence of a pin in the root canal, which prevents refilling;
the canal is not completely sealed, there is no material near the very top;
Conservative treatment is not effective.

Methods for removing dental cysts

Correct treatment of a dental cyst without removal depends on the causes and clinical course. The clinical picture becomes clear after examination in a chair, a targeted photograph, a panoramic photograph of all teeth, . These examination and diagnostic methods for the necessary removal of a dental cyst are available at Implantmaster in Moscow. Examinations are performed before surgery to determine the specific location of the inflammation. If possible, conservative therapy is used to prevent further increase in inflammation. It consists of using a rubber dam to isolate the working field and provide comfort during treatment. Next, the pulp chamber is opened, cleaned, treated with an antiseptic solution and the canals are sealed. Therapy involves taking antimicrobial drugs, vitamins and other medications. If conservative tactics are not effective, then various surgical techniques are used to remove the tooth cyst without removing the causative tooth.

Cystotomy

Used for large cysts. The doctor removes parts of the formation that are not in contact with the vessels. Afterwards, an obturator is installed into the resulting cavity - a device that prevents tissue fusion. After some time, the remaining portion of the cyst joins the epithelium of the oral cavity, changes its structure and becomes safe for the body.

Hemisection

During the operation, the root to which the formation is attached and the adjacent coronal part are removed. The resulting space is restored using an orthopedic structure. The above method is quite traumatic, so it is considered outdated.

Cystectomies

The Implantmaster clinic answers the question: is it possible to cure a dental cyst without removing the tooth itself? – positive. Our specialists use the most modern technique - cystectomy. The tumor is completely removed without affecting healthy tissue. The operation takes place under local anesthesia in the surgical office and involves the use of a Labomed Magna dental microscope.

At the beginning of the procedure, the specialist determines the location of the patient’s formation based on examination and x-ray images. He “opens” it, cleans out the contents with special tools, puts antiseptic inside and stitches it up. After some time, the cavity remaining after the operation heals on its own, without requiring additional replanting of bone blocks. Cystectomy surgery takes 15-40 minutes, depending on the size of the cyst and bone structure. After an hour, the patient can go home.

Indications and contraindications for removal of an ovarian cyst

Resection of an ovarian cyst using a laparoscope is prescribed if it does not disappear on its own or as a result of drug (hormonal) therapy within 3 menstrual cycles. Indications for this operation are also:

The appearance of a cyst after menopause - in this case it is not a violation of the natural process of ovulation and, therefore, will not go away on its own;
Cysts and neoplasms are relatively small in size (up to 10 cm).

There is a list of situations in which laparoscopic removal of an ovarian cyst is not recommended or is strictly excluded - these include:

Obesity of 3-4 degrees due to an increased fat layer of the abdominal wall, which interferes with the use of a laparoscope;
High risk of stroke or myocardial infarction, decompensation of chronic pathologies;
Infectious process, massive bleeding, peritonitis (inflammation) in the abdominal cavity;
Malignancy of a cyst is its transformation from a benign tumor to a malignant one, in this case laparoscopy can only be used to biopsy its sample;
Excessive (over 10 cm) size of the cyst, due to which it cannot be removed without an incision on the abdominal wall;
A bleeding disorder that, if treated surgically, can cause extensive blood loss and death;
Extensive adhesive process, making it difficult for the laparoscope camera to view the problem area.

At the request of the patient, the operation can be performed without any clear indications. For example, if she does not have the opportunity or desire to wait 3 months until the cyst goes away on its own (which may not happen). However, doctors still recommend using drug therapy first as the most gentle way to get rid of the problem.

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Removal of a dental cyst by resection

Removal of a dental cyst by resection of the root apex is a tooth-saving operation, i.e., making it possible not to part with the tooth. It is carried out by excision of the root and removal of the affected fragments. Then, to avoid the spread of infection to adjacent areas of hard and soft tissue, the canal is sealed. As a result, this is a good way to cure a dental cyst at the initial stage without removing the entire unit. If a fragment of the tooth remains, it will be replaced with prosthetics in the future. Tooth-preserving methods are valued by specialists because they help preserve the integrity of the dentition. Therefore, resection of the root apex is also used in other cases:

Inflammation of the tooth under the crown. The obvious solution is to remove the prosthesis, remove the abscess, and install a new design. However, these manipulations are more costly and time-consuming than root resection.
Root canal abscess, often irregularly shaped, due to unscrupulous filling or the use of low-quality materials.
With osteomyelitis. There is a need to cut out the affected areas of bone tissue at the border with the roots. This helps prevent deep infection.
When foreign objects are detected in the channels - boron particles, files. This happens when using low-quality equipment. Our clinic uses the latest instruments based on titanium alloy.

However, such an effective operation has contraindications. Removal of a dental cyst by resection is not carried out if: diseased and healthy roots are located critically close; in the presence of extensive chips of the crown; high tooth mobility; in the stage of acute periodontitis. Not recommended for people with diabetes, mental and nervous disorders, chronic heart and vascular diseases, pathologies of the lungs and thyroid gland.

How is surgical removal of a dental cyst performed?

How is the operation to remove a dental cyst performed? It includes the following steps:

Making a diagnosis using x-rays to determine the size of the capsule and the condition of the roots.
Conducting local anesthesia.
Cutting and peeling of the gums.
Drilling out a bony area in the body of the jaw for better access to the formation.
High-quality cleaning of the contents of the capsule and removal of its shell to prevent further illness.
Rinsing the cavity with antiseptics.
In some cases, if necessary, removal of part of the affected root and retrograde filling of the canals.
Filling the cyst location with osteoplastic material (artificial bone).
Suturing the mucous membrane.
After the procedure, it is mandatory to take a control X-ray to ensure that the operation was carried out properly (all infected tissues were removed).

A tooth is removed if its roots are in a cystic formation or if it is completely destroyed.

Laser removal of dental cyst

If the tumor is small, then laser removal may be used. This is a simple and safe way. A laser beam is passed through the root canal, sterilizing it, and the cyst gradually reduces in size.

Positive aspects of using laser:

not painful and bloodless;
fast regeneration;
disinfection of the inflamed area and, as a result, reducing the risk of spreading bacteria.

The disadvantages include the high cost of the procedure, as well as the availability of a laser device not in all clinics.

Why don't we remove the cyst with a laser?

After analyzing all the long-term results of the postoperative period from our department and partner organizations in Moscow, it was decided to abandon the further use of laser cyst removal.

When all the results were analyzed, it turned out that the positive disinfecting effect of the laser was seriously compromised by the longer recovery process. It has been determined that when removing a cyst with a laser, high-temperature exposure, forming burn areas, provokes inhibition of tissue restoration and prolongation of treatment time with a weak antiseptic advantage.

The marketing benefits of “laser treatment” for business were not taken into account in this study. Thus, laser removal of cysts is no longer performed in our Center.

Complications after removal of a dental cyst

After removal of a dental cyst, what unpleasant consequences may be possible? Any surgical intervention using anesthesia, like removal of a cyst, can lead to complications. They arise when the doctor does not fully adhere to the chosen tactics, with incorrect diagnosis at the preparation stage, or with the use of inappropriate equipment. Here at Implantmaster, complications do not arise after cyst removal thanks to the professionalism of doctors, modern equipment and the use of the latest techniques. But every patient should be informed about the likely consequences of the procedure. Body temperature may increase after removal of a dental cyst. Pain in the gum area is possible after removal of a dental cyst. The occurrence of edema and hematomas is inevitable. But their consequences are quickly eliminated by antibacterial drugs and constant cooling compresses. However, there are more serious complications:

It is necessary to first take a blood clotting test to prevent rupture of blood vessels when accessing the root.
There is a possibility of injury to nerve bundles. Therefore, the tooth may continue to ache even after the cyst is removed. Taking painkillers helps minimize this effect.
With poor oral hygiene, suppuration can form again. To prevent this from happening, a course of antimicrobial drugs is prescribed.
Incomplete removal of the affected tissue leads to secondary infection. It is necessary to check everything carefully before applying stitches.
Perforation of the walls of the maxillary sinuses. Today this almost never happens.

We are confident of an excellent result, even when other clinics do not undertake cyst treatment. Much also depends on the patient. It is necessary to follow the doctor's recommendations in the first days after surgery. Limit consumption of hot, cold and solid foods. Do not use hard brushes or aggressive chemical rinses, and avoid sports activities. You should take vitamins and NSAIDs. Proper treatment of the body will allow you to return to normal as quickly as possible.

How is tooth root resection performed?

The meaning of the resection operation is to cut off the apex of the tooth root with a drill along with the “purulent sac”. And many patients are therefore immediately interested in the question of how long the tooth will last after resection. It must be said that the operation does not affect the service life of the tooth in any way, because The size of the root part to be removed is very small.

Tooth root resection is a fairly simple operation and usually lasts from 20 to 40 minutes. The front teeth are operated on faster, which is due to the convenience of visual control of the operation, but the lateral teeth (6-7 molars) require more effort and time from the doctor. In the animation below you can see all the main stages of the operation.

Tooth resection: animation

Preparing for surgery –

Tooth resection can be carried out only if there is no active purulent inflammation in the area of the root apex. If there is swelling of the gums or pain when pressing on a tooth, you must first remove the active inflammatory process.

The essence of preparation for surgery is high-quality filling of the root canal (Fig. 4). If resection is planned as the final stage of therapeutic treatment of chronic periodontitis, then the root canal is filled no more than 1 day before surgery (24stoma.ru). It is important that the canal is very tightly filled with a filling substance (for example, gutta-percha), because if the obstruction of the canal is not dense, the granuloma/cyst will then appear again.

If the operation is planned on a tooth where the root canals have already been filled, then the strategy may be different. For example, if the canal of this tooth is well sealed along its entire length (except at the very top of the root), it is not necessary to unseal such a canal, because the top will still be cut down. In all other cases, root canal refilling will be required.

Operation technique –

The operation is performed under local anesthesia and is absolutely painless. Moderate pain occurs only after the operation is completed, which will require taking painkillers. Below you can see the progress of the operation in detail on schematic images and videos, but first we will draw your attention to the main points during the operation.

Main stages of the operation –

Creating access to the root apex - the gum is dissected and moved away from the bone in the projection of the root apex of the causative tooth. After this, a “window” is drilled into the bone with a drill, through which the apex of the root is cut off and the granuloma or cyst is scraped out (Fig. 4b).
Root resection and cyst removal - through a hole created in the bone, the surgeon cuts off the tip of the root and scrapes out a chronic source of inflammation (this can be a granuloma or a cyst). The latter differ from each other only in size. The cyst shell must be removed completely, because if you leave even a small fragment of it, the cyst will form again.
Suturing the wound - after antiseptic treatment of the wound, the edges of the gum mucosa are put in place and the wound is sutured. In good clinics, immediately after the operation the patient will be given ice to hold, pressing it to the cheek in the projection of the operation (this will reduce the amount of swelling). The stitches are removed after 8-10 days.

Operation diagram (Fig. 5-10) –

If the cyst was large, then bone healing can be stimulated with special osteoplastic materials based on synthetic hydroxyapatite - the preparations “Kolapol” or “Kollapan”. In some cases, retrograde root canal filling may also be used during resection surgery (see below).

Where can I remove a dental cyst without extracting a tooth?

If you are concerned about this problem, then we invite you to visit the Implantmaster dental clinic to get rid of a cyst on a tooth by treatment or tooth extraction. For you - qualified specialists, all the necessary ultra-modern equipment and reasonable prices.

The price for removing a dental cyst is determined by the services of an endodontist and a surgeon. Endodontic treatment is required with a microscope, including anesthesia, materials, etc., starts from 6,500 rubles. Removal of the cyst by a surgeon is paid separately—about 10,000 rubles. This cost includes all surgical procedures. Lifetime guarantee for treatment at Implantmaster.

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Removing a tooth with a cyst: does it hurt or not?

In the “Optimal Choice” dental clinics, when removing teeth with benign formations at the roots, the latest anesthetics and modern equipment are used. Therefore, patients do not need to be afraid of anything at all. The doctor selects anesthetics on an individual basis; in some cases, general anesthesia may be recommended (we do not use it). Minor pain may occur after tooth extraction, when the anesthesia wears off. To relieve pain, your doctor may prescribe painkillers.