Root canal treatment is carried out to preserve the tooth. The key to the success of this treatment is careful cleaning of the extremely fine root canal system. Even using optical magnification and delicate instruments, in some cases old root filling materials or dental posts, for example, cannot be removed from the canal. Despite the utmost care and the latest treatment technology, bacteria can also remain, which cause problems.
A supportive surgical procedure can also be necessary after non-surgical root canal treatment, if it is failing to heal. In these cases, inflamed tissue usually forms at the root tip or there is discomfort.
If the option of repeating the root canal treatment does not seem promising, in most cases surgical root canal treatment in the form of root tip resection (apicoectomy) is the only way to preserve the tooth.
If my tooth is “dead” why does it still hurt?
During root canal treatment the vascular nerve bundle is removed. But the tooth is embedded in a tooth socket which is supplied with nerves and blood vessels and can also become inflamed. If acute inflammation of the tooth socket arises, this can result in pain, swelling and pus formation around the tooth.
If I am not in pain does that mean my tooth is healthy?
With chronic forms of infection there is often no discomfort at all. Often the infection is only discovered on an X-ray. You then see that bone has disintegrated from around the root of the tooth. This bone degradation at the tooth socket is progressive and can turn into an acute form with pain, swelling and pus formation at any time.
How is root tip resection (apicoectomy) carried out?
Generally it is often necessary to replace the root canal filling that has already been carried out, in conjunction with root tip resection. This means that the root canal is cleaned, disinfected and filled again (retreatment). The surgical procedure takes place in the following stages:
1. EXPOSURE OF THE ROOT TIP
In the first stage, after administering an anesthetic, the oral mucosa above the root tip is loosened and lifted to expose the bone above the root tip. Then in a second stage the inflamed tissue is removed and the area around the root tip is cleaned.
2. CLEANING THE ROOT CANAL
The root canal is prepared and cleaned from the root tip upwards using delicate ultrasonic tips. For a gentle and safe procedure, especially in terms of cleaning and filling of the root canal starting from the root tip, delicate specialist instruments such as fine ultrasonic tips, the finest filling spatulas and condensers are necessary.
3. ROOT CANAL FILLING AND WOUND CLOSURE
After cleaning, the root canal is refilled through the root tip and the wound area is stitched up. The result is checked using an X-ray.
4. HEALING AND FOLLOW-UP CHECKS
Following successful treatment, the bone defect heals within a period of several months. The healing process is checked using X-rays at regular intervals.