Root tip resection
Oral surgery specialists
Root tip resection: A deep insight
What is an apicectomy?
Root apex resection, an established procedure in dental surgery, is used to preserve the health of the periodontium and avoid the removal of a tooth. It is used when a conventional Root canal treatment is not enough to treat inflammation or infection at the root tip of a tooth. The goal is to remove inflamed tissue and the part of the root where the inflammation is located.
The procedure is performed under local anesthesia and begins with a small incision in the gums to gain access to the affected root tip. Using specialized instruments, the dentist or oral surgeon removes the tip of the root and the inflamed tissue. In some cases, a small filling material is used to seal the remaining part of the root and prevent further infection. Finally, the gums are closed again and stitched up so that they can heal.
This procedure is particularly valuable for teeth that have a complex root structure or where previous root canal treatments have been unsuccessful. By removing the source of infection, apicectomy can save the tooth and avoid the need for extraction.
When is a root tip resection necessary?
Sometimes the path to a healthy smile takes unexpected detours. A root tip resection is necessary when inflammation or infection at the root tip of a tooth cannot be cured with conventional root canal treatment. This can have different causes:
- Recurrent inflammation: Sometimes the inflammation returns after root canal treatment. This may be due to complicated root canal systems or residual bacteria that were not completely removed during the initial treatment.
- Complex root structures: In some cases, root canals are so narrow or twisted that dental instruments cannot completely clean them.
- Cracks or fractures in the tooth: Fine cracks can allow bacteria to enter the tooth and cause infections that are difficult to treat.
- Cysts or granulomas at the root tip: These small growths can cause chronic inflammation that must be removed through an apicectomy.
So if you notice persistent pain, swelling, or a recurring infection around a previously treated tooth, an apicectomy could be the solution. Your dentist will conduct a thorough examination to decide if this is the best route for you.
Find out more about root tip resection in our videos:
The sequence
An apicectomy requires precise planning and careful execution to effectively treat and preserve the affected tooth. Here at Denta1 Clinic, we make sure you understand exactly what the procedure involves and how it works.
After the apicectomy you can go home immediately, but you should rest for the rest of the day. It is normal to experience some pain or swelling following the procedure, but this can be easily managed with painkillers recommended by us.
Once the anesthesia takes effect, the treating dentist or oral surgeon makes a small incision in the gums to gain access to the root tip.
The inflamed root tip is then precisely removed using specialized instruments. A particular focus is on protecting the surrounding healthy tissue as much as possible.
After the root tip and the inflamed tissue are removed, the root canal is cleaned from the tip and sealed with a biocompatible material. This material helps seal the root against future infections.
Biological root tip resection
By using modern technologies and methods, such as autologous blood therapy and the introduction of bone grafting material, the probability of success of an ESR can be significantly increased. This “biological” approach promotes healing and reduces postoperative discomfort.
Aftercare and healing after a root tip resection
After a root tip resection, appropriate aftercare is crucial for rapid and complication-free healing. At Denta1 Clinic, we attach great importance to providing our patients with detailed instructions and support post-procedure.
Immediately after the procedure
Immediately after the apicectomy, it is normal for the treated area to be somewhat swollen and tender. To minimize swelling, you can apply a cold compress to the outside of your face for the first few hours after the procedure. Pain can usually be easily controlled with painkillers recommended or prescribed by us.
Diet and lifestyle habits
In the first few days after surgery, you should eat soft foods and avoid hot, particularly hard or sticky foods. Smoking and alcohol consumption can delay the healing process and should therefore be avoided.
oral hygiene
Careful oral hygiene is particularly important after a root tip resection. We recommend rinsing your mouth with a mild salt water solution to promote wound healing and prevent infection. However, direct brushing of the wound should be avoided until suture removal has occurred.
Follow-up appointments
Follow-up checks with your dentist or oral surgeon are an essential part of aftercare. During these appointments, we will check healing and remove stitches if necessary. These appointments also provide a good opportunity to discuss any questions or concerns.
Risks and possible complications
With any medical procedure there is some risk of complications, and an apicectomy is no exception. But knowing these risks and how to manage them can help minimize them and ensure a smooth healing process. Possible risks include:
- Infections: Despite careful cleaning and sealing during the procedure, there is always a small risk of bacteria remaining or re-invading, which can lead to infection.
- Damage to neighboring teeth: There is a small chance that adjacent teeth or their roots will be damaged during the procedure.
- Nerve damage: Particularly during procedures in the lower jaw, temporary or permanent damage to nerves can occur, which can lead to loss of sensation or numbness in the lips, teeth and gums.
- Bleeding or swelling: As with any surgery, swelling and bleeding may occur after an apicectomy, but this usually resolves within a few days.
It is important to talk to your dentist or surgeon about these risks and understand exactly how they can be minimized in your specific case. Careful follow-up care and following your doctor's instructions can help reduce the risk of complications and promote rapid healing.
Alternatives to root tip resection
Before deciding on an apicectomy, it is important to consider alternative treatment options. Depending on your specific situation, the following alternatives may be available:
- Renewed root canal treatment: In some cases, a second (or even third) root canal treatment may be successful, especially if the previous treatment did not reach all infected areas of the root canal system.
- Tooth extraction: If the tooth is too badly damaged or if the apicectomy would not be successful, the tooth can be removed and replaced with a Bridge, Implant or a partial denture may be a viable solution.
- Wait and watch: In cases where symptoms are mild and there is no immediate threat to adjacent teeth or general well-being, your dentist may suggest observing the situation first rather than operating immediately.
Choosing the best treatment depends on many factors, including the location and severity of the infection, the condition of the tooth, and your personal health and preferences. An open and honest discussion with your dentist or endodontist is crucial to making the best decision for your dental health.
Frequently Asked Questions
Is root tip resection painful?
The apicectomy is performed under local anesthesia, which means you should not feel any pain during the procedure. After the anesthesia, there may be slight discomfort or swelling, but this can be easily controlled with the painkillers we recommend. Our patients typically report minimal discomfort that resolves within a few days.
How long does it take to heal after a root tip resection?
The healing time after an apicectomy varies depending on the individual situation, but most patients can return to normal within a week. However, it may take several months for the bone around the treated root tip to fully heal. It is important to follow your dentist's follow-up appointments and instructions to ensure optimal healing.
Can I eat and drink normally after an apicectomy?
Immediately after the procedure, you should wait to eat or drink until the anesthesia has completely worn off to avoid injury to the soft tissues in your mouth. In the first few days we recommend eating soft foods and avoiding extreme temperatures and hard, sticky or grainy foods so as not to disrupt the healing process.
How successful is a root tip resection?
The success rate of an apicectomy is generally between 85% and 95%, depending on various factors such as the complexity of the case and the general health of the patient. At Denta1 Clinic we use the most modern techniques and materials to maximize the chances of success and maintain the health of your tooth in the long term.
Do I need to take any special precautions after an apicectomy?
It is advisable to avoid physical exertion in the first few days after the procedure and to keep your head slightly elevated while sleeping to minimize swelling. Smoking and alcohol consumption can affect the healing process and should be limited. In addition, careful oral hygiene is essential, although direct brushing in the surgical area should be avoided.
Can an apicectomy be repeated?
If an apicectomy is not successful or the infection recurs, repeat apicectomy may be considered in some cases. However, each case is unique and the decision to proceed depends on various factors, including the structure of the tooth and surrounding bones. At Denta1 Clinic we carefully evaluate all options to find the best solution for your individual situation.
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