Apicectomy
Valeria Dahm is a freelance writer in the medical department. She studied medicine at the Technical University of Munich. It is particularly important to her to give the curious reader an insight into the exciting subject area of medicine and at the same time to maintain the content.
More about the experts All content is checked by medical journalists.With a root tip resection (WSR, tooth root tip resection), the tip of a tooth root is removed (resected) so that the tooth does not have to be completely removed despite caries or other infections and inflammations. Read here how an apicectomy works, when it is necessary and what risks the procedure entails.
What is apicectomy?
The root tip resection (WSR) describes the removal of a tooth root tip. So the whole root is not removed, only its tip. Therefore, it is not correct if the procedure is casually referred to as a root resection or tooth root resection.
When do you do a tip resection?
The spread of tooth decay can cause inflammation inside the tooth. This leads to an expansion of the blood vessels that press on the tooth nerve and cause severe pain. If the bacteria penetrate to the tip of the root - the most inner part of the tooth - they can also spread to the bones and soft tissues of the face from here. In the worst case, the bacteria migrate throughout the body via the blood. To prevent this from happening, the dentist can perform a root canal treatment. If this remains unsuccessful, the tip resection is often the last alternative to pulling the tooth.
The procedure may also be necessary if a root canal treatment is not possible due to a severely curved root or the root canal is blocked.
Other possible reasons for an apicectomy are, for example, a broken tooth root and non-removable, broken parts of root canal instruments.
How does the tip resection work?
Before the actual tip resection, the doctor takes an X-ray of the teeth so that he can get a precise overview. Then he usually gives the patient a local anesthetic; General anesthesia is only necessary in rare cases.
In the next step, the doctor cuts the gums and periosteum of the affected tooth. He folds over the surrounding tissue and now looks directly at the part of the jawbone under which the root tip lies. At this point, the bone is removed with special burs or lasers until the tip of the root is visible. This is then shortened by two to three millimeters. Inflammatory tissue is also removed.
After careful disinfection, the dentist places a special filling in the canal of the tooth root and thus seals the tooth. Finally, he folds back the surrounding tissue and sutures the wound. With the help of a final X-ray, he checks the apicectomy and the filling.
Root resection: duration of the procedure
The duration of an apicectomy cannot be precisely stated. It depends on the patient, the severity of the procedure and any complications that may arise. The position of the tooth also plays a role. In the case of a root tip resection on the molar, for example, the view is restricted, which can prolong the procedure. In most cases, however, an apicectomy does not take longer than about 45 minutes.
What are the risks of a root resection?
Pain and swelling are common side effects of apicectomy. As with any intervention, there are also general and special surgical risks. These include:
- Infections
- Bleeding
- Injury to muscles, bones and nerves *
- Damage to surrounding teeth
- Loss of the operated tooth
- Opening of the maxillary sinus
* Under certain circumstances, the mandibular nerves can be irritated or even injured during a root tip resection. This leads to a mostly temporary feeling of numbness and possibly also taste disturbances.
Only in very rare cases does a root resection cause complications of a more severe degree.
What do I have to consider after the apicectomy?
As long as the anesthetic is still working, you should not eat anything or participate in road traffic. In addition, refrain from smoking, coffee and tea for at least 24 hours after the tip resection.
Swelling and pain can be relieved by cooling. Only take pain relievers that your doctor prescribes, as some drugs make you more likely to bleed.
Good oral hygiene supports the healing process after a root tip resection. If necessary, have your dentist explain what to look out for.
The sutures are removed on average after seven to ten days. An X-ray after three to six months serves as a control of the success of the apicectomy.
Sometimes an inflammation develops after the apicectomy - recognizable by increasing throbbing pain a few days after the procedure. Then go to your doctor as soon as possible.
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