Tooth root resection (apicoectomy) is a surgical procedure that simultaneously removes the periapical lesion (chronic inflammation above the root of the tooth), removes the tip of the tooth root (apex), and performs its obturation.
Apical surgery is approached when it is necessary to remove a periapical lesion (process) and preserve the tooth.
TOOTH ROOT RESECTION – INDICATIONS FOR THE PROCEDURE
Tooth and jaw trauma, inadequate oral hygiene, and the development of cavities can lead to the penetration of microorganisms into the interior of the tooth and the occurrence of dentogenic infection. The infection, which occurs in both adults and children, primarily affects the pulp, and eventually spreads to the entire root canal.
This problem is often successfully resolved with endodontic conservative therapy in many patients. However, sometimes endodontic treatment is ineffective or not possible due to the curvature of the root, blockage of the root canals, or the presence of endodontic posts or build-ups. In such cases, the infection reaches the apex, and the body responds by creating a lesion (periapical lesion). An untreated process can develop into a cyst after a prolonged period.
In such cases, tooth root resection is recommended as the most appropriate solution.
TOOTH PROCESS – SYMPTOMS, DIAGNOSTICS, AND APICOECTOMY
Periapical lesions are generally asymptomatic and are most commonly discovered incidentally through dental or jaw radiographs.
Symptoms that may indicate the presence of a periapical lesion include: pain, swelling in the area around the tooth, and the presence of a fistula.
Diagnosis is made after clinical examination through the analysis of retroalveolar dental radiographs or orthopantomography.
The therapy is performed surgically with the use of local anesthetics.
Tooth root resection involves accessing the root of the tooth through the oral mucosa and alveolar bone. During this procedure, the lesion along with its pathological contents is removed, and the infected apex is excised. Following the resection, the bony defect heals spontaneously.
Apicoectomy also includes the filling of the root canal (orthograde or retrograde).
Orthograde filling is identical to endodontic treatment of the tooth. The root canal is cleared and filled with gutta-percha and paste through access via the crown of the tooth. Retrograde filling is performed by shortening the root tip, creating a preparation in the canal, and placing a suitable material (similar to mini-filling of the tooth).
By performing tooth root resection, the aim is not only to avoid the loss of an individual tooth but also to prevent serious complications that can affect the entire jaw.
The Belgrade Center clinic is renowned for its experience in apicoectomy on molars with processes, especially those that have crowns, build-ups, or have been unsuccessfully treated endodontically.