Which symptom is typical for periapical granuloma or cyst when not acutely inflamed?

• A. Facial swelling
• B. Mild to no pain (unless acute exacerbation)
• C. Fever
• D. Severe constant pain

Answer: (B)

When a periapical granuloma or cyst forms, it’s typically a chronic, slowly evolving lesion at the tip of a nonvital tooth. Because it isn’t acutely inflamed, the patient often has little or no pain. Pain, if it occurs, tends to appear only during an acute flare or secondary infection. In contrast, facial swelling, fever, or a severe, constant pain point to an acute odontogenic infection rather than a stable chronic lesion. Many cases are asymptomatic and are found incidentally on routine radiographs. So the symptom that best fits a non-acute periapical granuloma or cyst is mild to no pain, unless there is an acute exacerbation.