Apex resection of tooth root

Endodontic (root canal) treatment is fraught with a high risk of early (during treatment) and late (several months or years after treatment) complications. The most common early complications, which are an indication for tooth apex resection, include: 

• fracture of the instrument in the root canal, 

• significant pushing of the filling material beyond the apex of the tooth, causing severe pain, 

• underfilling of the root canal along its entire length, 

• inability to obstruct the root canal up to the apex of the tooth root. 

These lesions can, at different times, result in distant complications such as granulomas, cysts and periapical abscesses. Most of these lesions can be successfully treated with root canal re-treatment (Endodontics - root canal treatment). 

When re-treatment of the root canal (so-called reendo treatment) is not possible or the periapical lesions do not lend themselves to such treatment, the only valid therapy is the following apical resection of a tooth root. 

Teeth with large (10mm and more) periapical lesions are indicated, as well as teeth that have spontaneously died without pain for many years, during which an inflammatory process developed in the area of the top of the tooth's root, in the form of a granuloma, cyst or abscess. Such teeth must undergo a root tip resection after planned root canal treatment. Teeth on which an aesthetically pleasing and functional prosthetic restoration is made in the form of a root-canal post and prosthetic crown, and an inflammatory lesion has developed in the area of the apex of the tooth root that cannot be treated in any other way, are also an indication for root tip resection. 

The procedure is performed under local anaesthesia. Root resection consists of a mucosal incision in the area of the apex of the tooth root, excision of the bone window and cutting off the apex of the tooth root with simultaneous removal of inflammatory lesions. It is advisable to replace the bone missing after the procedure with Bio-Oss bone substitute material. This procedure saves the tooth from extraction in most cases (effective in approx. 95%). 

It is possible to carry out the procedure on any tooth that requires it, including premolars and molars of the maxilla and mandible!