Resection of the apex of the root of the tooth: what it is and when it is applied

In the oral cavity there is a huge number of pathological microorganisms, the activity of which often leads to infection of the gums, the spread of inflammatory processes.

In some cases, pathological formations( cysts, abscesses, fistulas, furuncles, etc.) appear on the soft tissues, which require immediate treatment.

The essence of the procedure

In the article, we will consider one of the methods of surgical treatment of these pathologies - resection( soft tissue or tooth).The procedure allows you to remove defects and foci of inflammation, while maintaining the health of a nearby tooth.

Many patients are interested in what it is "resection of the root of the tooth" and why it is prescribed.

Manipulation is an operative intervention, which is performed by a dental surgeon in the field of the dental root.It allows you to amputate affected areas of the root and block the inflammatory( infectious process).

As a rule, resection is prescribed in the case when the standard

did not help the endodontic treatment, since the operation is very laborious and complex.As a result, it is possible to maintain a healthy tooth and arch, removing pathological formation without consequences and complications.

Also, the need for the procedure can cause defects in the root canals( perforation, change in structure, poor filling, fracture of the apex, etc.), the consequences of wearing prostheses and implants, the doctor's mistake( the tool remains in the channel).

There are also contraindications for the operation:

• periodontitis with the mobility of teeth;
• parodontosis( exposed to the neck of the tooth);
• is a tumor in the tooth growth zone.

When it becomes necessary to resect

Let's consider in more detail when and why this procedure is used.

1. Infringement of root canal filling technology .As a rule, the filling is a stage in the treatment of pulpitis or it is used before preparing the teeth for wearing prostheses.The surgeon removes the nerve from the canal, after which the filling material is laid along its entire length, reaching the top of the root.If, for some reason, the canal section is left without a composite, then an inflammatory process may occur or an infection may occur, leading to the formation of a cyst, granuloma, abscess or fistula on soft tissues near the tooth. Resection of the tooth root in this case is carried out at the very tip of the , after which the undersplated section of the canal is drilled by a drill.This will allow you to get to the education, remove it, rehabilitate the area and keep the health of the depulled tooth.
   

   Resection allows you to get to the top of the root and remove the undersized channel section without affecting the artificial elements inside the tooth.

2. Pin or tab in the root canal. Often they are fixed with a heavy-duty medical composite, so extraction can lead to destruction of the root and amputation of the tooth.Resection in this case will allow you to get to the top of the root and remove the undersplanted section of the canal without affecting the artificial elements inside it( pins, cultic tabs, etc.).
3. A crown is installed on the tooth, the channels of which are sealed. Resection allows you to treat cysts and other formations through resection of the tip of the root without affecting the crown.
4. Significant size of the formation( diameter greater than 10 mm). In this case, medication can be very delayed and accompanied by serious complications.A more reasonable solution will be the excision of the cavity of formation, the provision of an outflow of pus and the installation of drainage, after which the wound is delayed for a couple of weeks.
   Otherwise, the cyst will become inflamed, and the infection will spread to the gums, cheeks, teeth and even bones( a complication in the form of osteomyelitis).

Stages of operation

Dentists explain to patients that this is a gum and tooth resection, how long it lasts and what stages it includes.

The duration of the operation varies from half an hour to one hour. Its duration is affected by the location of the formation and the tooth, the size of the capsule, the stage of the disease and other factors.

1. Preparation of .The doctor discusses with the patient the need for an operation, introduces important conditions for rehabilitation, indicates possible complications and relapses.Also, the dentist should prepare a tooth for the procedure - to conduct a competent root canal filling( up to the top) a couple of days before resection.
2. Anesthesia .The procedure is performed under local anesthesia - injections into the field of surgical intervention.After the end of the anesthetic, slight painful sensations and aching pain in the wound area are possible.
3. Preparing the area. The doctor provides comfortable access to the tip of the tooth.The incision of the gum is performed, after which the tissue flap is bent and the jawbone is exposed.Then the doctor finds a section of the root bone, where the formation was diagnosed.In this department, the surgeon makes a small hole using dental burs and a drill.
   

   Gum closure

4. Resection of the tooth is carried out( which is what we discussed above). The doctor uses a hole to find the top of the root and the nearby cyst.With the help of a drill, the surgeon resection( cutting off) the apex from the root.He then uses tweezers to remove the debris( apex) and the pathological formation attached to it from the resulting wound.
5. Restoration of a bone. Carried out in case the diameter of the formation was significant.In the cavity formed after resection, the doctor places an artificial tissue that simulates bone.Over time, a normal bone fills the space.
6. Stitching. The last step is to sanitize the oral cavity, wash the wound with an antibacterial solution.After that, the doctor sews the mucous gums, inserting between the sutures drainage for the outflow of blood and the sycamore.Then, for half an hour, cold objects are applied to the area of ​​the operation and a pressure bandage is organized.This allows to reduce postoperative edema and hematoma in the area of ​​resection.You can eat not earlier than 3-4 hours after the manipulations.Drainage is removed after a few days.
7. Rehabilitation .The main rule of postoperative care is the maintenance of high-quality and regular oral hygiene.Also the doctor can prescribe anti-inflammatory therapy - a course of drugs, applications, baths, rinses.Additionally, immunomodulators may be prescribed.

Until the day the joints are removed, the patient should take leave, avoid weight lifting, stressful situations, physical and psychological stress.

complications after resection

As a rule, the effects of resection of apex( photo below) mayArise for several reasons.

1. The channels before the operation were not sealed in time.As we mentioned, this procedure is carried out for a couple of days before the appointed day.If the canals have been sealed long before the operation, then they are rasping and refilling the gutta-percha channel.
2. The root canals were repaired ( the composite hit the cavity of the cyst and provoked repeated inflammation).
3. Perforation in the tooth .During the preparation for the event, the doctor allowed perforation of the bone wall.In this case, repeated infection of the tooth and the occurrence of relapses are possible.
4. Tool breakage in the cavity of the tooth .
   Unqualified use of dental appliances, lack of experience, failure to comply with technical regulations can lead to breakage( splitting, crumbling) of the tool.
   Enveloped smallest pieces fall into the cavity of the tooth or open wound, injuring soft tissues.During the procedure, it can be and do not notice, and then begins a strong inflammatory process, tissue suppuration, and in some cases, an allergy to the metal.
5. Incomplete resection of .Sometimes it happens that the dentist does not find and does not remove all foci of infection.This means that the inflammatory process will resume with time and will capture healthy tissues.
   

   Infection after tooth treatment may cause resection of the apex of the tooth root

6. Joining of a new infection.The doctor works with the mucosa, performs incisions in soft tissues and sutures the wound.These processes can not occur in conditions of ideal sterility, in addition, an inexperienced doctor may not comply with all requirements of aseptic.So through the open wound and blood can join a secondary infection, grab a soft tissue and even bone.
7. The tooth root of is split.If the doctor, using a drill, does not calculate the pressure, then instead of cleavage of the smallest apex, a complete cleavage of the root may occur.Then the inflammatory process can intensify, which will lead to the regular formation of purulent capsules and, as a result, amputation of the tooth.

Statistically, resection yields good results, and in most cases completely eliminates pathologies( infections, foreign bodies, granulomas and cysts, other formations).

However, in some cases, serious postoperative complications are still possible, which will require expensive and prolonged treatment.