What is the resection of the apex of the tooth root? What is it for? You will find answers to these and other questions in the article. Resection of the apex of the tooth root is a procedure that is performed with a cyst or granuloma of the root for medicinal purposes. This operation allows you to save the integrity of the dental arch. It is used to eliminate the focus of inflammation through the gum, or rather, the upper zone of the root. We will consider the resection of the root apex in more detail below.
Modern medicine
Today's dentists, when treating teeth, try to save them to the last. They always try to prevent the resorption of the tissues of the alveolar crest and leave the physiological activity of the dentition. Tooth extraction is considered a last resort.
To save teeth when conservative treatment is powerless, special operations help. They do not involve the removal of masticatory organs and are the excision and disinfection of infected tissue areas. To do this, doctors often have to correct the root of the tooth itself,subjected to inflammation. The benefits of these surgical interventions are as follows:
- save money on implants;
- minimum oral injury;
- maintaining a he althy and aesthetic smile;
- inhibiting the development of the infectious process by eliminating affected tissues, adding tooth life;
- full, but temporary preservation of the function of the dentition for an unknown period (sometimes saved teeth served for decades).
Surgery
One of the tooth-saving operations is the microsurgical action of incomplete root cutting. Its execution allows you to eliminate various formations and save the tooth from the irradiation of inflammation.
The most important condition for the execution of such an operation is the timely appeal of a person to the dentist.
In advanced cases, when the bone defect is 2 cm across, these interventions are not successful.
A preventive annual visit to the doctor with a picture immediately reveals the presence of cysts. And long-term ignoring the symptoms of a pathological process in the mouth leads to the fact that the implementation of a tooth-saving operation becomes impossible, and the dentist has to completely amputate the tooth and then replace it with an implant.
The essence of the operation
Surgery for resection of the root apex is a process of excision of pathological foci of inflammation in the root zone or near it in the event that conservative treatment fails or the canal is patencyclosed by foreign bodies.
This type of surgical treatment used to be considered time-consuming and minimally traumatic. The function of the tooth is not fully preserved, because its length is reduced. More often, the surgical procedure is performed on incisors and canines, and much less often on multi-rooted teeth. The operation in dentistry is called an apicoectomy, which literally means “removal of the apex.”
Current dentistry allows you to perform an emergency resection of the root apex without risks to the patient. The rehabilitation period does not cause him much discomfort and takes a little time. The most important advantage of this procedure is the complete healing of the dentition from the bacterial process, which is steadily progressing.
Indications for surgery
We continue to further study the resection of the root apex. The indications for this procedure are as follows:
- Clogging of the canals of the tooth. The reason for the appearance of such a situation can be a congenital anomaly of development, poor-quality filling, fixation of a ceramic-metal crown on a tooth, an installed pin, and so on. The doctor has no choice but to perform an operation to save the tooth.
- The presence of a growth in the form of a granuloma that destroyed the root, or a cyst. The dead root zone and cyst are removed with minimal resection. Such a diagnosis was previously a verdict for the tooth, because it was simply eliminated. Today this problem is solved by apicoectomy.
The cyst is the underlying problem,requiring resection of the apex and cystectomy. It is a separate zone of inflammation, which looks like a sac with a cavity, usually filled with pus. The cyst may escalate and be able to cause major transformations in the patient:
- enlarged lymph nodes;
- headache;
- discomfort in the area of the tooth itself and so on.
It can also be a major cause of the spread of inflammation to nearby structures: ears, sinuses, tonsils.
Cyst treatment
Many people ask the question: "Resection of the apex of the tooth root - what is it?". In the current conditions, the treatment of a tooth cyst is reduced to cystectomy with excision of the highest point of the root, but it is better with grinding the root and saving it.
If the tooth filling was carried out with cement during the Soviet era, then this process is not recommended to be repeated due to the high risks of perforation and other complications. Usually, conservative treatment is useless, and the cyst, instead of resolving, continues to grow. Surgical intervention is best done as soon as possible, since the involvement of new tissues in the pathological process may become a contraindication for apicoectomy.
X-ray
In the process of preparing for root excision, full-fledged X-ray testing is important, since surgical intervention is possible only if there is at least 5 mm of he althy bone tissue of the alveolar crest.
Otherwise, during the operation, a crack may appear on the bone. Since each patient's situation is special, the doctor makes a private decision about performing a resection. He personally assesses the risk of manipulation, thinks through other options and tends to the most optimal.
Who is the operation contraindicated for?
Patients should be aware that, as with any surgical intervention, there are pros and cons of root resection, the suitability of which is assessed by the doctor. Disadvantages of healing by excision of the highest point appear most often in the case of an operation in the presence of simple general clinical contraindications.
Therefore, at the initial stage of the examination, it is necessary to exclude conditions that do not allow for resection. These include:
- involvement in the pathological process of more than 1/3 of the tooth;
- excessive tooth mobility;
- cracks in a damaged tooth root;
- too close placement of adjacent defective tooth roots;
- damage to the highest point of the tooth without the possibility of its reconstruction;
- mental illness in the acute stage;
- poor blood clotting;
- presence of cancer;
- immune deficiency in severe stages;
- decompensation and exacerbation of protracted severe ailments of the body (asthma, diabetes mellitus, hypertension, coronary artery disease, and so on).
Risk assessment here for each patient is done individually.
Preparation for surgery
Surgery is very simple and is performed under local anesthesia. First, the specialist seals the canals of the tooth with special antiseptics, and then with BeeFill sealant. He thoroughly cleans them in advance, and then hermetically clogs them. If such manipulation is not possible, then retrograde filling is performed. The procedure is carried out no later than two days before resection, so that an inflammatory reaction does not appear.
Pain relief
For resection anesthesia is always local, but it can be of two types:
- Conductor. For the lower jaw, the following anesthesia is used: the medication is injected into the area near the nerve. Usually, segments of the branches of the trigeminal nerve are used for this.
- Infiltration. It is implemented during operations on the upper jaw and consists in the injection of ultracaine or lidocaine derivatives into the gums.
Steps of operation
The operation consists of the following steps:
- First, the dentist gets through all the infected layers to the root of the tooth. It performs an arcuate micro-incision of the gums and exposes the periosteum by about 5 mm. Then it exfoliates the periosteum and exposes the damaged alveolar crest of the jaw. As a rule, the bone in the cyst area has already melted and sawing is not necessary here. Next, the doctor prepares a tiny hole through which he opens access to the damaged area.
- Elimination of the cyst and correction of the highest point of the root from the foci of inflammation. The doctor cuts off the dead root perpendicular to the upper axis of the tooth. He carefully removes it along with the cyst and affected tissues through the hole. Then it fills the empty space left after removal with osteoplastic material. Resection is best avoided if possible, as weakening the root reduces the life of the tooth.
- Wound area closure. Closure of the wound is performed with the installation of a microdrainage through which the ichor should flow. It remains between the stitches after the operation for two days.
Recovery period
What happens after resection of the apex of the tooth root? This operation lasts about an hour, and the rehabilitation period takes three days. Soft tissues regenerate within the first seven days, and bone heals for a couple of months.
On the first day after the intervention, the patient may experience moderate pain and swelling. Within a week, they should imperceptibly decrease, and then disappear.
Advice after apex resection:
- stay away from hard brushes, too powerful rinses and toothpastes;
- limit exposure to chemical irritants in the mouth (sour, spicy, s alty, spicy foods);
- do not exercise for the first seven days after surgery;
- use antibacterial solutions to rinse your mouth (according to doctor's instructions);
- take a full course of antibacterial medications to prevent the development of an infectious process;
- to evaluate the results of the intervention, perform x-ray testing a couple of months after resection;
- you can eat only 3 hours after the completion of the manipulation (food should be warm and crushed);
- avoid eating too hard foods during bone healing (approximately 3 months).
The doctor and patient should also be aware of possible complications that may arise after surgery.
Cost
What is the price of root apex resection? It is set according to:
- volume of surgical intervention (number of operated teeth) - up to 15,000 rubles;
- additional costs for the material - 10,000 rubles (Bio-Oss Spongiosa granules) or 12,000 rubles (for anesthesia and a container).
The price of resection of the apex of the tooth in different clinics varies depending on the experience and qualifications of the dentist, the use of special equipment and other manipulations performed as necessary. Be careful when choosing a clinic for treatment so that you don’t have to visit the dentist additionally and spend extra money if the cyst recurs.
Reviews
Patients about the resection of the apex of the tooth root reviews are mostly positive. They write that thanks to this operation, they were able to avoid more serious surgical interventions and financial expenses. After all, it is cheaper than removing a tooth with subsequent prosthetics. People report that it was the resection that became a real salvation for them. Also, patients note that it is absolutely painless.
