Description: The dental granuloma is a foci of chronic inflammation around the apex of a tooth and is a sequela of pulpitis. Radiographically it appears as a periapical radiolucency. The border is usually distinct but this cannot be relied upon. The overlying tooth is ordinarily insensitive to electric pulp testing. While sensitivity to percussion may be present, many patients are totally asymptomatic. An acute infectious episode will result in pain, and often results in a formation of a draining sinus tract and/or parulis formation. Osteomyelitis and cellulitis are an ever present danger.
Etiology: Like the periapical cyst, the dental granuloma is a direct sequela of inflammation of a pulp which has extended into the surrounding periapical tissue. The pulpitis is in itself usually caused by infection secondary to caries but may be caused by trauma.
Treatment: Treatment consists of endodontic therapy or extraction.
Prognosis: Good
Differential diagnosis: Differential diagnosis includes radicular cyst and periapical abscess.