Bone Overgrowth in Lower Right Molars: Risks and Treatments

Q: Bone Overgrowth in Lower Right Molars: Risks and Treatments

Hello Mr. <br>Su： Osteophyte formation typically occurs on the lingual or buccal aspects of the maxilla. <br>Generally, it is caused by prolonged excessive growth. <br>In severe cases, it can protrude in pearl-like nodules, potentially affecting the mobility of the tongue. <br>Mo

Bone hyperplasia in the medial aspect of the lower right molar?

Hello Doctor,
This week, I experienced swelling and pain in my lower right gum, accompanied by bleeding.
I went to the hospital's dental emergency department at midnight, where the emergency dentist took a full-mouth X-ray.
After that, they performed an incision and drainage, followed by a medicated rinse, which slightly alleviated my symptoms.
Before I left, the doctor informed me about the lesions he observed on the X-ray and mentioned that there is bone hyperplasia on the inner side of my lower right molar.
I explained to him that I have been aware of this bone hyperplasia for about 5-8 years, as a dentist had previously told me during a cleaning that it was a normal phenomenon and not something to worry about.
However, the emergency dentist warned me that my bone hyperplasia could potentially undergo pathological changes in the future or may already be in the process of doing so.
At that moment, my condition was attributed to gingival inflammation, so he could only address that issue, and the status of the bone hyperplasia would need to be evaluated in subsequent treatments.
Today, due to ongoing gingival inflammation, I returned for a follow-up examination.
The attending dentist indicated that my inflammation was caused by a cavity in my wisdom tooth.
During the oral examination, he also noted that my bone hyperplasia seemed unusual.
I informed him of what the emergency dentist had told me and mentioned that the surface of my bone hyperplasia used to be smooth, but now it appears irregularly swollen.
After listening to my concerns, the dentist stated that the wisdom tooth must be extracted due to the cavity and its difficult cleaning position.
If it is not removed, it will only lead to recurrent inflammation.
As for the bone hyperplasia, further examination will be necessary during future visits, and it is likely that the irregularity is related to the inflammation.
Perhaps once the inflammation resolves, my bone hyperplasia may return to normal.
I have a question regarding the potential pathological changes associated with bone hyperplasia.
What kind of changes should I be concerned about? Is there any relation to cancer? I would appreciate your response.
Thank you for your patience in reading this lengthy message.

Su Xiansheng, 30~39 year old female. Ask Date: 2020/10/29

Dr. Zeng Guanghui reply Dentistry

Hello Mr.
Su: Osteophyte formation typically occurs on the lingual or buccal aspects of the maxilla.
Generally, it is caused by prolonged excessive growth.
In severe cases, it can protrude in pearl-like nodules, potentially affecting the mobility of the tongue.
Most osteophytes are benign; however, if there are any concerns, it is advisable to seek further evaluation from the oral surgery department at a major hospital.
Dr.
Tseng Guang-Hui, Department of Dentistry, Nantou Hospital.

Reply Date: 2020/10/29

More Info

Bone overgrowth, particularly in the context of dental health, can be a complex issue that may lead to various complications if not properly managed. In your case, the presence of bone overgrowth in the area of your lower right molar, combined with the inflammation and infection of the gums, raises several important considerations.

Firstly, bone overgrowth, or hyperostosis, can occur for various reasons, including chronic irritation, inflammation, or as a response to dental issues such as cavities or periodontal disease. In your situation, the inflammation caused by the impacted wisdom tooth (or third molar) and the associated infection could indeed contribute to changes in the bone structure surrounding the tooth. This is often a protective response by the body, but it can lead to complications if the underlying issues are not addressed.

The concern raised by your emergency dentist regarding the potential for the bone overgrowth to undergo pathological changes is valid. While not all cases of bone overgrowth lead to serious complications, there is a risk that chronic inflammation can lead to more significant issues, including the possibility of developing osteomyelitis (an infection of the bone) or, in rare cases, bone tumors. However, it is important to note that the majority of bone overgrowth cases are benign and do not progress to malignancy.
The irregularity you described in the surface of the bone overgrowth is noteworthy. Changes in texture or shape can indicate that the area is undergoing some pathological process, especially if it has changed from a smooth surface to an irregular one. This is why your dentist's recommendation to monitor the situation closely is crucial. Regular follow-ups and imaging studies, such as X-rays, will help assess whether the bone overgrowth is stable or if it is progressing in a concerning manner.

As for the treatment options, addressing the source of inflammation is paramount. The extraction of the wisdom tooth, as recommended by your dentist, is a critical step. Removing the source of infection can help reduce inflammation and may allow the bone to heal and return to a more normal state. After the extraction, it is essential to maintain good oral hygiene and follow any post-operative care instructions to minimize the risk of further complications.

If the bone overgrowth persists or worsens after the extraction and resolution of the inflammation, further evaluation may be necessary. This could include additional imaging or even a biopsy if there are significant concerns about the nature of the bone changes.
In summary, while bone overgrowth can be a benign condition, it is essential to monitor it closely, especially in the context of ongoing inflammation and dental issues. The extraction of the problematic wisdom tooth is a necessary step that may alleviate the inflammation and allow for better assessment of the bone condition. Regular follow-ups with your dentist will be crucial in ensuring that any potential complications are addressed promptly. If you have further concerns about the nature of the bone overgrowth or its implications, do not hesitate to discuss these with your dental care provider. They can provide you with the most accurate information tailored to your specific situation.

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