Cystostomy on the tooth

What is a cystostomy on the tooth?

A cystostomy is a treatment procedure for the large cysts (chambers in the jawbone that are filled with fluid) that make it possible to spare neighboring tooth roots and nerves. The mucous membrane and the jawbone are opened over the cyst. Access to the cyst is made through a small incision window. The so-called cyst bellows remain in the bone. This creates a secondary indentation to the oral cavity, which steadily shrinks because the cyst can no longer grow due to the opening. The cavity becomes smaller and the cyst bellows is converted into the oral mucosa after a few weeks.

What are the indications for a cystostomy?

There are several indications for performing a cystostomy. For one, a cystostomy is done for very large cysts with thin bone walls that are at risk of breaking the bone walls in another operation or in the near future. The method is also used for cysts in the lower jaw, from which the alveolar nerve or the neighboring teeth would be at risk if they were removed. If the cysts are infected, the method of a cystostomy is also indicated. Furthermore, cysts in the anterior region of the upper jaw are an indication, as there is a risk that they border on the bony floor of the nose and damage it.

Preparing for a cystostomy

A cystostomy needs specific preparation. Depending on the course of the surrounding nerves and the severity of the cyst, the operation must be well planned. As a person affected, you have to be aware that the follow-up treatment time can take several months. It is characterized by constant rinsing and changing of tamponade. If necessary, further follow-up treatments are due. In preparation for a cystostomy, all possible complications that may result from the operation and treatment must be clarified. These include Vascular or nerve injuries, inflammatory reactions or secondary bleeding.

Course of the cystostomy

When performing the cystostomy, an incision is usually made in the oral vestibule first. Often times, different nerves can be visualized depending on the size of the cyst. He gives access to the cyst. A window is made to the cyst. Depending on the strength of the bone, the thin bone lamella can be opened with a knife or the thicker bone with a chisel or drill. The contents of the cyst, usually a cloudy liquid, are removed. The cyst is opened so wide that no undercuts remain. The cyst bellows is left in the remaining cavity. The oral mucosa is sutured to the cyst bellows at the remaining bony edges of the cyst. After a while, the mucous membrane grows together with the remaining cyst follicle. Depending on the success, the cavity created by the cyst can be completely closed.

Follow-up treatment after a cystostomy on the tooth

As part of a follow-up treatment, the tamponades must be changed every two to three days. This is carried out until the cyst follicle has grown together with the oral mucosa. This occurs with an acceptance of the color and texture of the oral mucosa after about two weeks. After healing, the cavity must be rinsed out after meals. A second treatment is often necessary to replace bone material or to perform a cystectomy. Ideally, the cyst cavity will gradually flatten out. If the course goes very well, it can also happen that the cave is completely filled again.

Pain after a cystostomy on the tooth

A cystostomy is a surgical procedure and, once it has been performed, causes the healing pain that is usual for this treatment. These are often expressed in a throbbing or knocking. Furthermore, the affected areas are very sensitive to pressure. Heat or excessive physical exertion should be avoided after surgery to rule out an inflammatory reaction. Pain relievers such as ibuprofen can be used to relieve the pain associated with the healing of the wound. Painkillers can be prescribed by the attending physician.

You can find more information here: pain relievers for toothache, ibuprofen for toothache

Inflammation after cystostomy on the tooth

Inflammation in the affected area after a cystostomy is an undesirable side effect, but it has no serious consequences. There are a lot of bacteria in the oral cavity. For this reason, inflammation of the exposed and treated area is a common complication of a cystostomy. To prevent inflammation, one should avoid vigorous physical exertion, smoking and excessive heat. Rinsing with disinfecting rinsing solutions prescribed by a doctor is also suitable. If an inflammation has developed, it may be necessary to fight it with antibiotics to prevent further damage to tissue and nerves.

This article may also be of interest to you: Inflammation of the jaw

How long does a tooth cystostomy last?

The operation, i.e. the actual cystostomy, does not take more than a few hours depending on the degree of difficulty. In the follow-up treatment of a cystostomy, the cyst entrance must be kept open for weeks after the operation. The cavity has to be rinsed and cleaned repeatedly. If the lumen of the cyst has shrunk over the weeks, the cyst can either be completely removed with a second operation. The success and thus the duration of a cystostomy depend largely on your own cooperation and oral hygiene.

More information can be found here: Oral hygiene

What is a Radicular Cyst?

Radicular cysts are fluid-filled cavities that only form on non-vital (no longer living) teeth and start at the root of the tooth. This means that the formation of the cyst must have been preceded by the death of the tooth pulp, the tooth pulp. The cyst comes from an inflammation at the tip of the root, one Apical periodontitis, emerge. A radicular cyst develops from this inflammation. The formation of a radicular cyst is usually painless. A lightening in the area of ​​the cyst can be seen in the X-ray image. However, a clear diagnosis can only be made with a histological examination, since a cyst in the X-ray image looks like apical periodontitis. The teeth receive a root canal treatment if an x-ray shows apical whitening. During a follow-up check, the brightening in the X-ray image must have receded. Otherwise, it is a radicular cyst.

More information can be found here: jaw cyst