Inflammation at the tooth root apex, granuloma, and resection

Inflammation near the tooth root apex can occur due to infection inside the tooth. Sometimes it does not cause intense pain and is only detected during examinations.

Why does inflammation develop?

Deep caries, a damaged filling, tooth crack, or trauma can damage the pulp and open a path for infection into the root canals. Inflammatory changes can also appear around the root apex. It is also assessed whether the issue persists in a previously treated tooth.

What is a granuloma?

A granuloma near the root apex is an accumulation of inflammatory tissue associated with a longer-lasting inflammation. On an X-ray, a change can be seen, but based on its image alone, the exact nature of the tissue cannot always be determined. The examination and treatment are selected by the dentist.

What symptoms may occur?

The tooth may hurt when chewing, be sensitive; sometimes a gum bump, pus formation, or bad taste appears. Some people have almost no symptoms. If the face swells, fever develops, or the condition worsens, seek urgent care; if breathing or swallowing is impaired, call 112.

How is the infection source treated?

After examination and necessary tests, root canal treatment or retreatment of previously treated canals may be recommended. Further restoration of the tooth depends on the remaining tissues. Antibiotics are not always necessary and do not by themselves replace treatment of the infection source.

When is root apex resection considered?

If inflammation persists after canal treatment or retreatment and the tooth is worth and possible to preserve, a specialist may discuss surgical treatment. During resection, access to the root apex is gained, damaged tissues and a small part of the root tip are removed, and the canal end is sealed if necessary.

The operation is not suitable in every case. The decision is made based on the tooth’s condition, root anatomy, examinations, and other alternatives.

What is important to know after treatment?

Follow the care and control instructions provided by your doctor. A follow-up examination or X-ray may be needed to evaluate healing. If pain and swelling increase, fever appears, or other worrying symptoms occur, contact the treating clinic.

What tests may be needed?

The doctor asks about pain, previous canal treatment or trauma, inspects the tooth and gums. Tooth response is assessed, and necessary X-ray tests are performed. Sometimes more information is needed than a routine X-ray provides; the choice of tests depends on the specific clinical question.