Aristotelis Zervoudis

Surgical procedure to remove the tip of a tooth's root

Apicoectomy, also known as root-end resection, is a type of endodontic surgery that involves the removal of the tip of a tooth's root, along with the surrounding infected tissue. This procedure is typically performed when a standard root canal treatment has failed to eliminate the infection or when there is persistent inflammation or infection at the root tip.

Indications

Apicoectomy is indicated in cases where:

• There is persistent infection or inflammation at the root tip that does not resolve with conventional root canal therapy.
• There is a need to remove a cyst or other pathological tissue at the root tip.
• The root canal filling material has extruded beyond the root tip and is causing irritation.
• There is a fractured root tip or other anatomical anomaly that cannot be addressed through the root canal.

Procedure

The apicoectomy procedure involves several steps:

Preparation

The patient is typically given local anesthesia to numb the area around the affected tooth. In some cases, sedation may be used to help the patient relax.

Incision and Access

A small incision is made in the gum tissue near the affected tooth to expose the underlying bone and root tip. The dentist or oral surgeon will then use a drill to remove a small portion of the bone to gain access to the root tip.

Root-End Resection

The infected or inflamed tissue surrounding the root tip is removed, along with a few millimeters of the root tip itself. This helps to eliminate the source of infection and allows for better healing.

Retrograde Filling

After the root tip is removed, the end of the root canal is cleaned and sealed with a small filling material, often made of mineral trioxide aggregate (MTA) or other biocompatible materials. This is known as a retrograde filling and helps to prevent future infection.

Closure

The gum tissue is then sutured back into place, and the area is allowed to heal. The sutures are typically removed after a week or so.

Recovery and Aftercare

After an apicoectomy, patients may experience some swelling and discomfort, which can be managed with over-the-counter pain medications and ice packs. It is important to follow the dentist's instructions for oral hygiene and to attend follow-up appointments to ensure proper healing.

Complications

While apicoectomy is generally a safe procedure, there are potential complications, including:

• Infection
• Bleeding
• Damage to adjacent teeth or structures
• Persistent pain or discomfort

Related pages

• Root canal treatment
• Endodontics
• Dental surgery

Gallery

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  X-ray showing the initial condition before apicoectomy.

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