Introduction
A minor surgical treatment called an apicoectomy also known as root-end surgery or apical surgery is frequently performed on both children and adults. Its main goal is to save threatened teeth and prevent further complications. If the dentist advises an apicoectomy it is usually because the tooth has had a root canal but still has inflammation or infection near the tip of the root that extends into the jawbone.
What Is Apicoectomy?
An apicoectomy also known as a root-end resection is a common dental operation that includes removing inflamed gum tissue and the tip of the tooth's root while leaving the tooth's crown intact. This particular surgical procedure targets the root's apex or tip.
What Are the Distinguishing Features Between Apicoectomy and Root Canal?
A root canal treatment is a dental operation used to treat swelling and infection in the tooth's inner pulp tissue. Deep decay and abscesses can cause inflammation in the pulp of the tooth; if left untreated, these problems can spread to the neighboring bone. A damaged tooth is opened by a dentist who then removes the infected pulp carefully cleans the root area fills it and closes it. By performing this operation decay can be efficiently managed while protecting the natural tooth. In contrast, an apicoectomy treats only the tip of the tooth's root and is frequently performed following a root canal to treat certain problems with the root or the surrounding tissues.
What Are the Indications of Apicoectomy?
The dentist may perform an apicoectomy for various reasons, with the most common being an attempt to save a tooth that has previously undergone root canal therapy. Most of the time, root canals provide a permanent solution. However, occasionally, the tooth may not heal completely, leading to the possibility of reinfection. In such cases, the dentist will conduct an apicoectomy to remove the affected tissue and preserve the tooth rather than opting for extraction. A root-end resection may also be necessary in the following circumstances:
-
Active Periapical Inflammation: Inflammation that occurs after endodontic therapy which can be because of many factors such as curved root, calcified root, breakage of the small instrument in the root canal, perforation of the root, and presence of any foreign body.
-
Persistent or Recurrent Infection: When an infection in the tooth persists or returns after one or more root canal treatments, an apicoectomy may be considered.
-
Resorption: When root resorption occurs, which is the breakdown or destruction of the tooth's root structure, an apicoectomy may be performed to remove the affected portion of the root and preserve the tooth as much as possible.
-
Calcium Deposit Removal: To eliminate persistent calcium deposits inside the root canal.
-
Treating Fractures: To manage dental structural fractures.
-
Handling Complex Tooth Anatomy: When a tooth has additional roots that are challenging to treat using standard procedures.
-
Managing Bone Loss: To address mobile teeth caused by bone loss.
-
Addressing Root Flaws: This is useful for correcting structural flaws or perforation in the tooth's root.
Apicoectomies are commonly used when children experience dental damage. This procedure is often successful in preserving a child's tooth that has fractured or cracked due to trauma.
What Is the Procedure for Performing an Apicoectomy?
The dentist might take X-rays of the teeth and jaw before performing an apicoectomy to evaluate the health of the roots and the surrounding bone and tissue. To guarantee the area is pain-free a numbing lotion and local anesthetic injection are given before the surgery. The dentist will then make a tiny incision in the gum tissue to access the bone and examine it while removing any contaminated tissue. The root canal tip may be sealed and the end of the root may be trimmed if necessary. In order to aid in gum healing the dentist will then cover the incision with a few sutures. Eventually, the bone will spontaneously rebuild around the treated root.
Is Apicoectomy a Painful Procedure?
An apicoectomy normally causes only minor discomfort. There is no need for general anesthesia during this quick operation that is done in the dentist's office. After the surgery, the patient can often drive home and resume normal activities the next day. Due to the incision and stitches in the gum tissue, some bleeding can be expected after the procedure. But this bleeding will stop in an hour or two. Resting with the head raised helps reduce blood flow and encourages clotting which can help further control bleeding.
What Are the Post-operative Procedures and Recovery Steps Following the Apicoectomy?
The patient can experience slight soreness and swelling following an apicoectomy as the effects of the anesthesia wear off. However, these symptoms usually subside in the following days, allowing them to resume their normal activities within a day or two. The doctor may prescribe antibiotics to treat any existing infection or prevent postoperative complications. Typically, over-the-counter anti-inflammatory drugs like Ibuprofen can be used to manage pain. During the first week after getting stitches removed, one should be cautious when brushing and flossing close to the surgical site to avoid compromising the healing process.
What Is the Success Rate of Apicoectomy Procedure?
Apicoectomies are commonly performed as standard non-invasive outpatient dental procedures. A 2020 study found that up to five years after surgery, approximately 97 percent of cases showed excellent results, and more than 75 percent of cases still had outstanding outcomes 10 to 13 years later. Additionally, a 2020 study indicated that apical surgery had a success rate of 91.4 percent after just one year, making it a reliable procedure for saving teeth affected by infections or root-related problems. After an apicoectomy, there is a minuscule possibility of developing new infections or experiencing nerve damage, both of which are extremely rare. It is important to note that these issues can arise with various dental procedures, not just apicoectomies. An apicoectomy, although uncommon, is considered ineffective if the symptoms are not relieved, or the wound does not heal adequately. When performed by skilled dentists or endodontists, such incidents are rare. According to findings from a 2011 study, a gap in the final filling of the root is the primary reason why apical surgery fails, as it allows bacteria to re-enter the tooth.
Conclusion
A common outpatient surgical technique called an apicoectomy is used to salvage teeth when conventional root canal therapy is ineffective. It may be crucial in preventing major issues with the function of the jaw and mouth. When a root canal operation fails and there is an infection at the tooth's root tip apicoectomies are typically advised. Be informed that removing the entire tooth is an option in addition to an apicoectomy. Therefore if the dentist suggests root tip surgery one must seriously consider it.
