Periapical granuloma Periapical granuloma is a lesion that is round with a slow development which is located near the apex of the tooth root, usually a complication of pulpitis. Consisted of chronic inflammatory tissue mass berprolifersi between fibrous capsule which is an extension of the periodontal ligament. It appears namely radiographic radiolucent image with a border that is sometimes visible on periapical. Generally spherical. Tooth in question will show the loss of lamina dura picture. Usually not accompanied by resorbsi roots, but some are showing a picture resorbsi roots.
Periapical granulomas can be caused by various irritants to the pulp which continues up to the tissues around the apex or on the periapical tissues. Irritants can be caused by organisms such as bacteria and viruses, and non-organism such as a mechanical irritant, thermal, and chemical.
Research conducted on specimens of periapical granulomas, mostly bacteria and facultative anaerobic organisms most often affects the Veillonella species (15%), Streptococcus milleri (11%), Streptococcus sanguis (11%), Actinomyces naeslundii (11%), Propionibacterium acnes ( 11%), and Bacteroides species (10%) .3 While the organism is a non-factor because of a mechanical irritant after root canal therapy, direct trauma, traumatic occlusion, and failure of endodontic procedures; and chemicals such as irrigation solution.
Dental granuloma is clinically indistinguishable from other lesions of periapical inflammation. To distinguish the other periapical lesions radiographic examination is required. Its size varies, ranging from the small diameter of only a few millimeters to 2 centimeters.
Dental granuloma consists of granulation tissue surrounded by a wall of fibrous connective tissue. In the dental granuloma that is long enough, tend to provide an overview of plasma cells, lymphocytes, neutrophils, histiocytes, and eusinofil, as well as epithelial cell rests of Malassez. In teeth with carious perforation in the microbiological examination will be obtained actynomices microaerophilic bacterium.
Pathological abnormalities caused by inflammation of the pulp reaction to last into the tissues around the apex. Pulpitis itself can be caused by infection with secondary caries, trauma, or failure of root canal treatment. Pulp necrosis will stimulate an inflammatory reaction in periodontal tissues tooth in question.
Pathophysiology of periapical granulomas can also be caused by various irritants to the pulp which continues up to the tissues around the apex or on the periapical tissues. Irritants can be caused by organisms such as bacteria and viruses, and non-organism such as a mechanical irritant, thermal, and chemical arising from necrotic pulp, the first deployment of the network periradikuler pulpal inflammation. Periapical granuloma is a continuation of acute periapical abscess. Iritannya include inflammatory mediators from the inflamed pulp irreversible or bacterial toxins from the necrotic pulp.
The underlying pathogenesis of periapical granuloma is an immune system response to maintain the periapical tissues to various irritants that arise through the pulp, which had metastasized to the periapical tissues. There are a variety of irritants that can cause inflammation of the pulp, the most common is due to bacteria, caries process that continues to make the entrance for the bacteria to the pulp, pulp hold a defense with an inflammatory response.
There are three main characteristics that affect the pulp inflammatory processes. First, the pulp can not compensate adequately for the inflammatory reaction is limited by the hard walls of the pulp. Inflammation will cause dilation of blood vessels and increase in tissue volume due to transudation of fluid. Second, although the pulp has a lot of vascularization, but only one is supplied by blood vessels that enter through a narrow channel called the apical foramen, and there is no other backup supplies. Edema of the pulp tissue will cause constriction of blood vessels that pass through the apical foramen, so that the pulp tissue is inadequate in defense mechanisms, especially the pulp tissue edema will cause the blood flow is interrupted, causing the pulp becomes necrotic. Room pulp and necrotic pulp tissue which will facilitate bacterial colonization. Third, because the teeth are on the jaw, then the bacteria will spread through the apical foramen into the periapical tissues.
Clinical symptoms of periapical granulomas and periapical cysts is very difficult to distinguish, usually patients do not complain of pain, and negative percussion tests. Therefore, the pulp that has been associated with necrosis, thermal stimulation would indicate a negative value. Radiographs will indicate the presence of radiolucent with clear boundaries. Although the radiographic examination is the key diagnostic, the only way to be able to distinguish them accurately is to use microscopic examination; histopathologic picture of periapical granulomas have been described previously, whereas periapical cyst histopathologic picture is characterized by the presence of a cavity is covered with epithelial type of non-keratinizing stratified squamous with varying thickness, the wall can be highly proliferative epithelium and showed plexiform arrangement. Typically the process of inflammation can be seen by the discovery of many inflammatory cells, namely lymphocytes and plasma cells in the cyst wall. Rousel body or round eusinophilic globule are found within or outside the plasma cells resulting in increased synthesis of immunoglobulin.
Periapical granuloma is a chronic inflammatory reaction around the tooth apex which is a continuation of the pulp inflammation caused by various irritants, such as bacteria, mechanical trauma, and chemicals. The underlying pathogenesis is the reaction of the body's immune system to the presence of irritants. Periapical granulomas are usually asymptomatic and found incidentally on radiographic examination as a radiolucent image, differential diagnosis including periapical cyst and periapical abscess, which can only be distinguished through microscopic examination. therapy can be performed by non-surgical endodontic treatment or surgery. The prognosis of periapical granuloma is good.
Dental granuloma generally do not cause symptoms for sure. Tooth in question would give a negative response to percussion, thermal tests, and electric pulp tests. In the continuing dental granulomas and left untreated can turn into a periapical cyst.
Apical inflammatory lesions generally caused by the toxic products produced by bacteria in the root canal, so the success of treatment depends on the elimination of bacteria on the teeth in question.
In the teeth can still be retained can be done perwatan root canal. While in dental restoration that can not be done then it should do the extraction. At the root canal-treated teeth should be evaluated in the first year and second to ascertain whether the lesions increase in size or have been cured.
Most of the periapical granuloma found incidentally during routine examination. Because of periapical granuloma is a continuation of pulp necrosis on physical examination will then be obtained negative thermal tests and EPT tests are negative. On radiographs of small-sized lesions that can not be separated clinically and radiographically. Periapical granulomas seen as a radiolucent image attached to the apex of the tooth root. A clear picture or a diffuse radiolucency bounded by a variety of sizes that can be observed with loss of lamina dura, with or without involvement of bone condensation.
The failure of the healing process usually caused by several things, among others:
- Changed the cyst formation
- Failure of root canal treatment
- Vertical root fracture
- The presence of periodontal disease
Clinical symptoms of periapical granulomas and periapical cysts is very difficult to distinguish, usually patients do not complain of pain, and negative percussion tests. Therefore, the pulp that has been associated with necrosis, thermal stimulation would indicate a negative value. Radiographs will indicate the presence of radiolucent with clear boundaries. Although the radiographic examination is the key diagnostic, the only way to be able to distinguish them accurately is to use microscopic examination; histopathologic picture of periapical granulomas have been described previously, whereas periapical cyst histopathologic picture is characterized by the presence of a cavity is covered with epithelial type of non-keratinizing stratified squamous with varying thickness, the wall can be highly proliferative epithelium and showed plexiform arrangement. Typically the process of inflammation can be seen by the discovery of many inflammatory cells, namely lymphocytes and plasma cells in the cyst wall. Rousel body or round eusinophilic globule are found within or outside the plasma cells resulting in increased synthesis of immunoglobulin
Periapical granulomas can be caused by various irritants to the pulp which continues up to the tissues around the apex or on the periapical tissues. Irritants can be caused by organisms such as bacteria and viruses, and non-organism such as a mechanical irritant, thermal, and chemical.
Research conducted on specimens of periapical granulomas, mostly bacteria and facultative anaerobic organisms most often affects the Veillonella species (15%), Streptococcus milleri (11%), Streptococcus sanguis (11%), Actinomyces naeslundii (11%), Propionibacterium acnes ( 11%), and Bacteroides species (10%) .3 While the organism is a non-factor because of a mechanical irritant after root canal therapy, direct trauma, traumatic occlusion, and failure of endodontic procedures; and chemicals such as irrigation solution.
Dental granuloma is clinically indistinguishable from other lesions of periapical inflammation. To distinguish the other periapical lesions radiographic examination is required. Its size varies, ranging from the small diameter of only a few millimeters to 2 centimeters.
Dental granuloma consists of granulation tissue surrounded by a wall of fibrous connective tissue. In the dental granuloma that is long enough, tend to provide an overview of plasma cells, lymphocytes, neutrophils, histiocytes, and eusinofil, as well as epithelial cell rests of Malassez. In teeth with carious perforation in the microbiological examination will be obtained actynomices microaerophilic bacterium.
Pathological abnormalities caused by inflammation of the pulp reaction to last into the tissues around the apex. Pulpitis itself can be caused by infection with secondary caries, trauma, or failure of root canal treatment. Pulp necrosis will stimulate an inflammatory reaction in periodontal tissues tooth in question.
Pathophysiology of periapical granulomas can also be caused by various irritants to the pulp which continues up to the tissues around the apex or on the periapical tissues. Irritants can be caused by organisms such as bacteria and viruses, and non-organism such as a mechanical irritant, thermal, and chemical arising from necrotic pulp, the first deployment of the network periradikuler pulpal inflammation. Periapical granuloma is a continuation of acute periapical abscess. Iritannya include inflammatory mediators from the inflamed pulp irreversible or bacterial toxins from the necrotic pulp.
The underlying pathogenesis of periapical granuloma is an immune system response to maintain the periapical tissues to various irritants that arise through the pulp, which had metastasized to the periapical tissues. There are a variety of irritants that can cause inflammation of the pulp, the most common is due to bacteria, caries process that continues to make the entrance for the bacteria to the pulp, pulp hold a defense with an inflammatory response.
There are three main characteristics that affect the pulp inflammatory processes. First, the pulp can not compensate adequately for the inflammatory reaction is limited by the hard walls of the pulp. Inflammation will cause dilation of blood vessels and increase in tissue volume due to transudation of fluid. Second, although the pulp has a lot of vascularization, but only one is supplied by blood vessels that enter through a narrow channel called the apical foramen, and there is no other backup supplies. Edema of the pulp tissue will cause constriction of blood vessels that pass through the apical foramen, so that the pulp tissue is inadequate in defense mechanisms, especially the pulp tissue edema will cause the blood flow is interrupted, causing the pulp becomes necrotic. Room pulp and necrotic pulp tissue which will facilitate bacterial colonization. Third, because the teeth are on the jaw, then the bacteria will spread through the apical foramen into the periapical tissues.
Clinical symptoms of periapical granulomas and periapical cysts is very difficult to distinguish, usually patients do not complain of pain, and negative percussion tests. Therefore, the pulp that has been associated with necrosis, thermal stimulation would indicate a negative value. Radiographs will indicate the presence of radiolucent with clear boundaries. Although the radiographic examination is the key diagnostic, the only way to be able to distinguish them accurately is to use microscopic examination; histopathologic picture of periapical granulomas have been described previously, whereas periapical cyst histopathologic picture is characterized by the presence of a cavity is covered with epithelial type of non-keratinizing stratified squamous with varying thickness, the wall can be highly proliferative epithelium and showed plexiform arrangement. Typically the process of inflammation can be seen by the discovery of many inflammatory cells, namely lymphocytes and plasma cells in the cyst wall. Rousel body or round eusinophilic globule are found within or outside the plasma cells resulting in increased synthesis of immunoglobulin.
Periapical granuloma is a chronic inflammatory reaction around the tooth apex which is a continuation of the pulp inflammation caused by various irritants, such as bacteria, mechanical trauma, and chemicals. The underlying pathogenesis is the reaction of the body's immune system to the presence of irritants. Periapical granulomas are usually asymptomatic and found incidentally on radiographic examination as a radiolucent image, differential diagnosis including periapical cyst and periapical abscess, which can only be distinguished through microscopic examination. therapy can be performed by non-surgical endodontic treatment or surgery. The prognosis of periapical granuloma is good.
Dental granuloma generally do not cause symptoms for sure. Tooth in question would give a negative response to percussion, thermal tests, and electric pulp tests. In the continuing dental granulomas and left untreated can turn into a periapical cyst.
Apical inflammatory lesions generally caused by the toxic products produced by bacteria in the root canal, so the success of treatment depends on the elimination of bacteria on the teeth in question.
In the teeth can still be retained can be done perwatan root canal. While in dental restoration that can not be done then it should do the extraction. At the root canal-treated teeth should be evaluated in the first year and second to ascertain whether the lesions increase in size or have been cured.
Most of the periapical granuloma found incidentally during routine examination. Because of periapical granuloma is a continuation of pulp necrosis on physical examination will then be obtained negative thermal tests and EPT tests are negative. On radiographs of small-sized lesions that can not be separated clinically and radiographically. Periapical granulomas seen as a radiolucent image attached to the apex of the tooth root. A clear picture or a diffuse radiolucency bounded by a variety of sizes that can be observed with loss of lamina dura, with or without involvement of bone condensation.
The failure of the healing process usually caused by several things, among others:
- Changed the cyst formation
- Failure of root canal treatment
- Vertical root fracture
- The presence of periodontal disease
Clinical symptoms of periapical granulomas and periapical cysts is very difficult to distinguish, usually patients do not complain of pain, and negative percussion tests. Therefore, the pulp that has been associated with necrosis, thermal stimulation would indicate a negative value. Radiographs will indicate the presence of radiolucent with clear boundaries. Although the radiographic examination is the key diagnostic, the only way to be able to distinguish them accurately is to use microscopic examination; histopathologic picture of periapical granulomas have been described previously, whereas periapical cyst histopathologic picture is characterized by the presence of a cavity is covered with epithelial type of non-keratinizing stratified squamous with varying thickness, the wall can be highly proliferative epithelium and showed plexiform arrangement. Typically the process of inflammation can be seen by the discovery of many inflammatory cells, namely lymphocytes and plasma cells in the cyst wall. Rousel body or round eusinophilic globule are found within or outside the plasma cells resulting in increased synthesis of immunoglobulin
I know this post is a few years ago, and I am definitely not a professional medical person- however I have a concern that you might be able to answer. Could a dental granuloma cause dizziness and a headache for a prolonged period of time? Short story- my 31 yr old son, who has perfect teeth with no cavities or fillings, had to have two front teeth pulled, they were being absorbed by his body and were just shells, this started last year and was due to a trauma 10 years ago. He has had a headache and dizziness since the surgery 5 months ago. Cat scan, MRI and bloodwork do not show anything.
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