Apical Resection

Is it possible to treat root tip infections that do not heal despite root canal treatment?

It is observed that some teeth with root tip lesions do not heal despite treatment.

These teeth:

1. Cysts on teeth
2. Stubborn infected teeth
3. Teeth with extremely curved canals
4. Clogged root canals
5. Teeth with broken instruments in the canal during root canal treatment require apical resection to restore health.

Apical root resection is a successfully applied treatment approach to save teeth from extraction where root canal treatment is inadequate or unsuccessful.

What is Apical Root Resection?

Apical root resection is a surgical procedure that involves removing a specific portion of the root tip and the infected tissue surrounding the root of teeth that cannot be saved with root canal treatment alone. Apical root resection is a treatment approach that is used to keep teeth in the mouth for which root canal treatment alone is insufficient and has the potential to prevent tooth extraction.

On Which Teeth Can Apical Root Resection Be Applied?

• In teeth with cysts at the root tip,
• In teeth where the infection in the root canal has spread to the surrounding tissues and a stubborn infection occurs in the surrounding tissues that cannot be resolved with root canal treatment alone,
• In teeth where the entire root cannot be reached with root canal treatment,
• In teeth where the root canal instrument was broken during previous root canal treatment,
• In teeth that have had a root canal filled longer than necessary, that is, protruded, during previous root canal treatment, your teeth can be saved from extraction by performing apical root resection.

Is There Pain During Apical Root Resection?

Since the area in question will be completely anesthetized, there will be no pain during the procedure. Local anesthesia applied to the tooth will be sufficient during this procedure. However, if our patient has a phobia about surgery, a sedative can be applied before starting the operation by consulting your doctor.

How is Apical Root Resection Performed?

A local anesthetic is applied to numb the area of ​​the tooth. For patients with needle phobia, topical anesthesia can be applied to the area beforehand.

After the full effect of the anesthesia is observed, the gum and bone tissue on the tooth to be resected are removed. Approximately 3 mm of the tip of the tooth root is cut and removed. In addition, infected tissues and pathological tissues such as cysts are also removed at this stage. Then, a cavity approximately 3 mm deep is created at the tip of the root and this cavity is filled using a material compatible with the surrounding tissues. In this way, a barrier is created between the root canal filling and the surrounding tissues, preventing the tooth from becoming infected again. After this procedure, the surgical area is closed and stitched. The stitches are removed 2 to 7 days after the procedure.

How Long Does Apical Root Resection Take?

Apical root resection is a procedure that takes approximately 45-90 minutes, depending on the ease of surgical access to the tooth to be treated. Our patients do not feel any pain during this procedure.

Will There Be Pain or Swelling After Apical Root Resection?

Although not always, pain and swelling may occur in the surrounding tissues following apical root resection. This usually returns to normal within 4-7 days.  For post-procedure pain, the use of over-the-counter painkillers is sufficient. Ozone therapy is applied to the area to reduce pain and heal the wound.

After ozone therapy application, if necessary, our patient is invited to our clinic the next day for both ozone and stitch control.

Is It Necessary to Use Antibiotics After Apical Root Resection?

After apical root resection, your doctor will prescribe a painkiller and antibiotic if deemed appropriate. You must use the antibiotic regularly and apply ice completely.