What is a root apex resection? Why is it needed? You will find answers to these and other questions in the article. A resection of the apex of a tooth root is a procedure that is performed with a cyst or granuloma of the root for medicinal purposes. This operation allows you to preserve 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. A more detailed resection of the apex of the root will be considered below.
Modern medicine
Current dentists try to preserve them to the last when they treat their teeth. They always try to prevent the resorption of tissues of the alveolar ridge and leave the physiological activity of the dentition. Tooth extraction is considered a last resort.
To preserve teeth when conservative medicine is powerless, special operations help. They do not imply the removal of masticatory organs and are the carving and disinfection of infected tissue sites. For this, doctors often have to correct the root of the tooth itself, which has undergone inflammation. The advantages of such surgical interventions are as follows:
- saving money on implantation;
- minimal trauma to the oral cavity;
- maintaining a healthy and aesthetic smile;
- inhibition of the development of the infectious process by eliminating the affected tissues, adding a lifetime to the tooth;
- full, but temporary preservation of the function of the dentition for an unknown period (sometimes saved teeth served for decades).
Surgical intervention
One of the tooth-saving operations is the microsurgical action of incomplete root carving. Its execution allows you to eliminate various formations and protect the tooth from the irradiation of inflammation.
The most important condition for performing such an operation is the timely visit of a person to the dentist.
In advanced cases, when a bone defect takes 2 cm across, these interventions are not successful.
A preventive annual visit to the doctor with a snapshot immediately reveals the presence of cysts. And long-term ignoring of the symptoms of the pathological process in the mouth leads to the fact that the implementation of the operation preserving the teeth becomes impossible, and the dentist has to completely amputate the tooth and then replace it with an implant.
The essence of the operation
The operation for resection of the apex of the root is the process of excising pathological foci of inflammation in or near the root if conservative treatment is unsuccessful or the patency of the canal is blocked by foreign bodies.
This type of surgical treatment used to be considered time-consuming and minimally traumatic. The function of the tooth is not completely preserved, because its length is reduced. More often, the surgical procedure is performed on incisors and fangs, and much less often on multi-rooted teeth. Surgery in dentistry is called apicoectomy, which literally means "removal of the apex."
Current dentistry allows you to perform a forced resection of the apex of the root without risk 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 that is steadily progressing.
Indications for the operation
We continue to study the resection of the apex of the root. Indications for the implementation of this procedure are as follows:
- Blockage of tooth canals. The reason for the appearance of such a situation may be a congenital developmental anomaly, poor-quality filling, fixation of the ceramic-metal crown on the tooth, an installed pin, and so on. The doctor has no choice but to perform an operation to preserve the tooth.
- The presence of a growth in the form of a granuloma that destroys the root, or cyst. The dead root zone and cyst are removed with minimal resection. Such a diagnosis was previously a sentence for a tooth, because it was simply eliminated. Today, this problem is solved by apicoectomy.
A cyst is a basic problem requiring the execution of apex resection and cystectomy. It is a separate area of inflammation, which looks like a bag with a cavity, filled, as a rule, with pus. The cyst can become aggravated and in the patient's condition cause serious transformations:
- swollen lymph nodes;
- headache;
- discomfort in the area of the tooth itself and so on.
It can also be the most important cause of the spread of inflammation to nearby structures: ears, sinuses, tonsils.
Cysts
Many people ask the question: "Resection of the apex of the root of the tooth - what is this?" In current conditions, the healing of a tooth cyst is reduced to a cystectomy with excision of the highest point of the root, but better with polishing the root and saving it.
If tooth filling was carried out with cement during Soviet times, then this process is not recommended to be repeated because of the great risks of perforation and other complications. Usually, conservative treatment is useless, and the cyst, instead of resolving, continues to grow. Surgery is best done as soon as possible, since the involvement of new tissues in the pathological process can be a contraindication for apicoectomy.
X-ray
In the process of preparing for root excision, complete x-ray testing is important, since surgical intervention is possible only with at least 5 mm healthy bone tissue of the alveolar ridge.
Otherwise, a crack may appear during bone surgery. Since each patient has a special situation, the doctor decides to perform a resection in private. He personally assesses the risk of manipulation, thinks out other options and tends to the most optimal.
Who is contraindicated in surgery?
Patients should be aware that, as with any surgical intervention, there are minuses and pluses of the tooth root resection, the compliance of which the doctor assesses. The disadvantages of healing by excision of the highest point are most often manifested in the case of the 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 resection. These include:
- involvement in the pathological process of more than 1/3 of the tooth;
- excessive tooth mobility ;
- cracks in the damaged tooth root;
- too close placement of adjacent tooth roots with defective;
- damage to the highest point of the tooth without the possibility of its reconstruction;
- mental illness in the acute stage;
- poor blood coagulation;
- the presence of cancer;
- severe immune deficiency;
- decompensation and exacerbation of prolonged severe illnesses of the body (asthma, diabetes mellitus, hypertension, coronary heart disease and so on).
Risk assessment is here for each patient individually.
Preparation for surgery
Surgery is very simple and is performed under local anesthesia. First, a specialist seals the tooth canals with special antiseptics, and then BeeFill sealant. He thoroughly cleans them in advance, and then seals hermetically. If such manipulation is not possible, then retrograde filling is performed. The procedure is implemented no later than two days before the resection, so that an inflammatory reaction does not appear.
Anesthesia
For resection, anesthesia is always local, but it can be of two types:
- Conductor. The following anesthesia is used for the lower jaw: the medication is injected into the area near the nerve. Usually for this, segments of the branches of the trigeminal nerve are used.
- Infiltration. It is realized during operations on the upper jaw and consists in performing an injection of ultracaine or lidocaine derivatives into the gum.
Operation stages
The operation consists of the following steps:
- First, the dentist gets through all infected layers to the root of the tooth. It performs an arcuate micro-incision of the gums and exposes the periosteum about 5 mm. Then exfoliates the periosteum and exposes the damaged alveolar crest of the jaw. As a rule, the bone in the cyst zone has already melted and there is no need for sawing. Next, the doctor prepares a tiny hole through which 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 remaining after removal with osteoplastic material. If possible, it is best not to perform a resection, since weakening the root reduces the life of the tooth.
- Suturing the wound area. Closing the wound is performed with the installation of microdrainage, through which the sucrose should flow. He remains between the sutures after surgery 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 tissue regenerates within the first seven days, and the bone heals for a couple of months.
On the first day after the intervention, the patient may experience mild pain and swelling. Within a week, they should quietly decrease, and then disappear.
Tips after resection of the apex of the tooth root:
- refuse hard brushes, too powerful rinses and toothpastes;
- limit the effect of chemical irritants on the oral cavity (acidic, spicy, salty, spicy foods);
- during the first seven days after surgery do not play sports;
- use antibacterial solutions to rinse your mouth (according to the instructions painted by the doctor);
- take a full course of antibacterial medications to prevent the development of an infectious process;
- to assess 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 chopped);
- refrain from eating too hard food during bone healing (about 3 months).
The doctor and patient should also be aware of possible complications that may arise after surgery.
Cost
What is the price of a root apex resection? It is installed in accordance with:
- the volume of surgical intervention (the number of teeth operated) - up to 15,000 rubles;
- additional expenses for the material - 10,000 rubles (granules Bio-Oss Spongiosa) or 12,000 rubles (for anesthesia and container).
The cost of resection of the apex of the root 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. Carefully approach the choice of a clinic for treatment so that you do not have to visit the dentist additionally and spend extra money when a cyst recurs.
Reviews
Patients about resection of the apex of the root of the tooth reviews mostly leave positive. They write that thanks to this operation they were able to avoid more serious surgical interventions and money expenses. After all, it is cheaper than tooth extraction with subsequent prosthetics. People report that it was the resection that became their real salvation. Also, patients note that it is absolutely painless.