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Q. What are the treatment options for dental cysts?

Answered by
Dr. Tinu Thampy
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Mar 25, 2017 and last reviewed on: Oct 09, 2018

Hello doctor,

I have two cysts in relation to upper right canine and premolar. Since I did not know anything about it, I ignored it. But last year I got an OPG, and I saw the cysts in it. I do not have pain or swelling, but whenever I touch the root of the upper teeth on the gums, I feel a sensation. Can an oral and maxillofacial surgeon extract the two concerned teeth and then remove the cysts? I am scared of an enucleation surgery. I am attaching the OPG.

Dr. Tinu Thampy

Dentistry Maxillofacial Prosthodontist Oral And Maxillofacial Surgery Oral Implantologist
#

Hello,

Welcome to icliniq.com.

The OPG (attachment removed to protect patient identity) shows a cystic lesion extending from your upper right canine to the last molar. Maxillary sinus floor is also involved. Enucleation is a surgical procedure to remove the cystic lesion, depending on the cyst size and location. It can be done under local anesthesia or general anesthesia. The treatment of a cyst involves following steps.

Teeth in the cystic area will be checked for tooth vitality and mobility. If the teeth are not grossly decayed, then root canal treatment will be done for the concerned teeth. If multiple teeth are involved (in your case canine to molar is in the cystic area), splinting will be done to stabilize your teeth during surgery. Then cyst enucleation is done. There are different methods available now for filling the bone cavity after cyst enucleation to improve and accelerate healing. OPG is not conclusive for a maxillary posterior region pathology. CBCT of maxilla gives the best picture regarding the size, location, association with adjacent structures, bone quality, and tooth prognosis. Due to the thickness and curvature of the lower jaw, OPG will not give a clear picture. For that, you have to take an intraoral periapical radiograph (IOPA).

For further queries consult a maxillofacial prosthodontist online --> https://www.icliniq.com/ask-a-doctor-online/maxillofacial-prosthodontist



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Hello doctor,

I appreciate your detailed explanation. I will get back to you if needed.

Dr. Tinu Thampy

Dentistry Maxillofacial Prosthodontist Oral And Maxillofacial Surgery Oral Implantologist
#

Hello,

Welcome back to icliniq.com.

You are always welcome. Do not hesitate to get back.

For more information consult a maxillofacial prosthodontist online --> https://www.icliniq.com/ask-a-doctor-online/maxillofacial-prosthodontist



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Hi doctor,

Could you please go through the OPGs and the CTBT report and then tell me I have cysts or abscesses on the teeth #3 & #4 on the right-upper jaw? Do you think that the two cysts or abscesses have perforated the maxillary sinus floor? Also, I have soft-tissues formed inside both my right and left maxillary sinuses. Please see the CBCT scan and report. Do you think that I should treat my sinus issue first considering the involvement of the cysts in the sinus and then the dental issue or the vice versa? If I treat the dental issue first, then how much will be the chance in % of a complication like fistula?

Dr. Tinu Thampy

Dentistry Maxillofacial Prosthodontist Oral And Maxillofacial Surgery Oral Implantologist
#

Hello,

Welcome back to icliniq.com.

The OPG radiograph that you have send before was not taken in the proper method. According to that I suspected cystic growth in upper posterior region. The maxillary sinus was overlapped over the tooth extensively due to improper positioning of the x-ray tube or x-ray film or patient angulation, which gave an impression of a large cyst in maxilla.

The CBCT image that you have send now is giving a clear picture. According to this no cystic growth is present in maxilla. Instead periapical (below the root) infection is there in respect to upper right first premolar and upper left second molar. You have to get done root canal treatment for upper right first premolar (14). Upper left second molar is grossly decayed involving root bifurcation. So, RCT cannot be effective and extraction of the tooth is the best option. Upper right central incisor (11), lateral incisor (12),and canine(13) are root stumps. It cannot be saved. So, extraction of 11, 12 and 13 has to be done. Maxillary sinus wall thickening is due to periapical pathology. So, after RCT of 14 & extraction of 27, that will subside. Get the treatment done as early as possible. If delayed, it can progress to cyst and further complications.

For further doubts consult a maxillofacial-prosthodontist online --> https://www.icliniq.com/ask-a-doctor-online/maxillofacial-prosthodontist



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