Apical resection is a surgical procedure in which the tip of an infected tooth root and the adjacent infected bone tissue are cut and removed. It consists of the extirpation of the tooth apex along with the surrounding infected bone tissue, and may or may not be preceded by correct endodontic treatment and perfect canal obturation.
When is apical resection indicated?
- When there are some anatomical issues that prevent the correct cleaning and obturation of the canal through classic endodontic treatment, issues represented by calcifications along the canals, severe root curvatures, very narrow root canals.
- When there are issues concerning the prosthetic restoration of involved teeth. In this case, prosthetically restored teeth with periapical infections can pose a problem if endodontic retreatment is attempted. The resistance of the prosthetic crown can be compromised by access to the root canal. Additionally, some teeth are restored with post-and-core (metal post) devices, the removal of which from the canal can lead to root fracture.
- In the event of a horizontal root fracture with apical necrosis, as the endodontic approach for this case is not very certain
- When there are blockages along the length of the root canal that cannot be overcome by endodontic treatment, blockages such as fractured instruments, (broken root canal files), restorative materials, fragments of fractured posts.
- In the situation of procedural errors in endodontic treatment, such as incomplete or overfilled root canals, perforations, or residual granulomas
- When there are large periapical lesions that no longer resolve with root canal treatment, to avoid reactivation of the chronic infection by seeding with germs from the oral cavity.
- Apical resection is performed to remove an infection at the tip of a tooth's root.
- As no prosthetic work, even if it is on a latest-generation implant, will perfectly replace the function and long-term resistance of a healthy natural tooth, it is recommended to save it through endodontic therapy and surgical intervention where possible.
Rezectia apicala poate fi efectuata pe orice grup dentar.
- Apical resection can be performed on all groups of teeth, but it depends on the different anatomical situations of the roots in relation to the bony surfaces of the jaws and the relationship with nearby anatomical cavities. Usually, this type of intervention is limited to the upper and lower second molars and lower premolars, where the operative difficulty lies in the proximity to the mental foramen and implicitly the mental neurovascular bundle (the possibility of damaging it).
How is an apicoectomy performed?
- This surgical procedure is part of the dento-alveolar surgery category, therefore it is performed under local anaesthesia or, in some cases (difficult or anxious patients), under general anaesthesia, as the patient must be cooperative and not feel pain.
- The operation is frequently performed in the dental chair and takes place in an aseptic environment treated with ozone, with sterile and disposable drapes and clothing.
- The procedure involves making a small incision in close proximity to the affected tooth root to access the affected portion of bone. All infected tissue, including a part of the root, is removed, and a retrograde filling of the root canal is then required. The newly formed cavity will be treated with ozone to achieve a completely aseptic area.
- In certain situations, the bone defect remaining after curettage is quite large and the body's regeneration capacity is exceeded. In these situations, artificial bone and/or bone-stimulating substances are added.
What is recommended after an apicoectomy?
- protect your teeth for a period, avoiding hard foods and excessive chewing,
- Pay more attention than ever to your oral hygiene.
- continue the prescribed antibiotic and anti-inflammatory treatment,
- If pain appears a few days after the procedure, consult your doctor to avoid septic complications.