A dental granuloma is chronically inflamed tissue around the tip of the root. It is usually caused by a mild infection spreading from the root towards the adjacent bone causing chronic periapical inflammation (granuloma). The affected tooth is usually painless. The pathology may persist for a long time without symptoms. It is typically discovered by accident, during radiographic analysis of the adjacent teeth. There may also be a change in the tooth colour and a sinus track, fistula, present in the gingiva close to the tooth. Under certain circumstances, this quiet, dormant pathology may develop into acute inflammation, causing very severe toothache, swelling and high tenderness during mastication. This transformation of pathology is called phoenix abscess. The symptoms and treatment are the same as those for acute apical abscess.
Successful root canal treatment on the lower first right molar with granoloma (before & after)