Main types of dentoalveolar pathologies

Cysts are closed cavities lined by a membrane that form in the bone or soft tissues of the mouth. They are filled with fluid or semi-solid material. The most common dentoalveolar cysts are:

• Radicular cyst: Develops around the root of a tooth, usually as a consequence of a chronic infection due to advanced tooth decay or trauma.
• Dentigerous cyst: Appears associated with teeth that have not erupted, especially third molars (wisdom teeth) or canines.
• Residual cyst: Remains after a tooth with a cyst has been extracted and the cyst was not completely removed.

Cysts usually grow slowly and, although they often cause no symptoms, they can lead to pain, swelling, tooth displacement, or infections if not treated in time.

Impacted molars—especially third molars or wisdom teeth—are teeth that fail to erupt properly and remain partially or completely trapped in the jawbone or gum tissue. This may occur due to lack of space, an abnormal position, or obstruction by other teeth.

Impacted molars can cause pain, swelling, infections, damage to neighboring teeth, or cysts. Sometimes, they go unnoticed and are only detected on X-rays.

• Abscesses: Collections of pus caused by bacterial infections in the tooth tissue, gums, or bone. They are usually painful and require urgent attention.
• Granulomas: Chronic inflammatory lesions around the root of a tooth, generally due to long-standing infections.
• Dentoalveolar fractures: May involve the tooth and surrounding bone, most often due to trauma.

Dental procedures and treatments

The first step when dentoalveolar pathology is suspected is diagnosis. The dentist performs a clinical evaluation, often accompanied by imaging studies (such as panoramic X-rays or CT scans) that allow visualization of the teeth and bone.

• Enucleation: Complete removal of the cyst, ensuring that no remnants remain that could cause recurrence. It is usually performed under local anesthesia, although complex cases may require general anesthesia.
• Marsupialization: Used when the cyst is very large. It involves opening the cyst and creating a communication with the oral cavity so it can drain and reduce in size before being completely removed.
• Endodontic treatment: In cases of radicular cysts, a root canal treatment may be performed to eliminate the infection and preserve the tooth.

The specific treatment depends on the type of cyst, its size, and location. In all cases, regular follow-up with the dentist is recommended.

• Surgical extraction: This is the most common procedure. An incision is made in the gum, the bone covering the molar is removed, and the tooth is extracted. It may require sutures and a recovery period that varies depending on complexity.
• Radiographic follow-up: In cases where the impacted molar causes no symptoms or complications, the dentist may recommend periodic check-ups to monitor its evolution.

The decision to remove an impacted molar depends on factors such as the risk of infection, damage to neighboring teeth, and the patient’s discomfort.

• Abscess drainage: The dentist makes a small incision to release the accumulated pus, which relieves pain and reduces the risk of complications.
• Antibiotic treatment: In cases of infection, antibiotics may be prescribed to control bacterial proliferation.
• Root canal treatment or extraction: If the tooth is irreversibly affected, a root canal may be performed or, ultimately, the compromised tooth may be extracted.

Fractures require careful evaluation. Treatment may include repositioning and stabilizing the tooth, surgery to repair the bone, and follow-up to ensure proper recovery.

Aftercare and recommendations

After any dentoalveolar procedure, it is essential to follow the dentist’s instructions for optimal recovery:

• Maintain rigorous oral hygiene by brushing your teeth and using dental floss.
• Avoid hard or hot foods during the first few days after surgery.
• Do not smoke or drink alcohol during the healing process.
• Take prescribed medications and attend postoperative follow-up appointments.
• If you develop symptoms such as severe pain, persistent bleeding, or fever, consult a specialist immediately.