What is a tooth resection. The technique of resection of the tips of the roots of the teeth: description and essence of the operation

Resection, or apicoectomy, is surgical removal apex of the tooth root along with a focus of chronic infection. The operation allows you to do without the extirpation of the tooth, and is most often combined with cystectomy - removal of the cyst.

The root of the tooth is excised through a small hole in the gum, formed by a dental instrument and a drill. The intervention is performed under a microscope, which eliminates the risk of damage to nerve endings, maxillary sinuses and minimizes postoperative complications.

For effective, 100% anesthesia, the surgeons of the Vse Svoi! take into account the anatomical features of the structure of the dental system and apply infiltration anesthesia when intervening on upper jaw, and the conductor - on the bottom.

The operation is carried out under strict sterility conditions. To this end, our dentistry is equipped with imported autoclaves and ultrasonic baths for sterilizing instruments and endopips, which guarantees safety for the patient's health. And the price of the service is one of the lowest in Moscow.

Root tip resection cost

	Stock!	Price
Cystectomy with resection of the root apex under a microscope	12 110 rubles	13 320 rubles
The procedure is contraindicated during SARS, as well as for pregnant women in the 1st and 3rd trimester.

Terms of resection of the apex of the tooth root

Resection of the apex of the tooth root, in combination with cystectomy, lasts 30-60 minutes. Surgical intervention on the teeth of the frontal group is faster, on chewing teeth - longer, since access to the lateral parts of the jaw is difficult.

Root canal treatment is performed 1-2 days before the apicoectomy.

Why do root apex resection

Resection is the fastest and most reliable way to remove the focus of pain, infection and neoplasm at the root of the tooth. Therapeutic treatment cysts or granulomas is long (3-8 months), expensive and often ends with a relapse of the pathology. There are a number clinical cases in which apicoectomy is indispensable:

• the presence of a cyst with a diameter of more than 8 mm;
• incomplete filling of the tooth canal during endodontic treatment;
• chronic periodontitis, cyst or granuloma on the tooth, which is under the crown;
• fragments dental instrument in the root canal.

Tooth cyst

A cyst is a capsule of connective tissue with fluid inside, which is formed as a result of a chronic inflammatory process in the root canals. Pathology develops for a long time (sometimes 5-6 years) and makes itself felt with aching pain, the appearance of a bulge on the gums.

Until recently, tooth extraction was considered the simplest and most effective method of dealing with a cyst. Today, modern dentistry has absorbed all the achievements of medicine, science and technology and is primarily aimed at conservative methods. Fortunately, a procedure called root resection has been developed to save the tooth and fight various forms of periodontitis and other infectious diseases. It is a gentle treatment.

Resection - what is it?

The main threat to the safety of the tooth is posed by bacteria that have penetrated to the root itself. An apicoectomy is used to treat foci of infection. To find out to whom this technique is indicated, it is important to define what resection of the apex of the tooth root is. This procedure is an operation aimed at combating an infection that has penetrated to the base of the root in the form of a cyst, granuloma, periodontitis. Apicoectomy is quite painful, so it is performed under local anesthesia. During the operation, the gum layer is removed in order to get close to the source of infection. After that, the top of the root is cut off, and then sutures are applied, which contribute to the proper fusion of soft tissues. Since in infectious diseases the channel is blocked by an inflammatory focus, further treatment is not possible. Therefore, resection of the apex of the tooth root in this case is the only effective method to avoid further development of infection.

Indications

Resection of the apex of the tooth root is performed in the following cases:

• in the presence of periodontitis, which implies the presence of inflammatory processes, cysts, infections in the upper part of the root;
• side effects of endodontic treatment of narrowed and deformed canals, resulting in a fracture of the pulp extractor, bur in the tooth canal;
• trauma to the apex of the tooth root as a result of exposure to boron;
• treatment of osteomyelitis, which involves the removal of pus from bone structures with boron.

Contraindications

Resection of the apex of the tooth root is contraindicated in the following cases:

• advanced stage of periodontal disease;
• acute infectious diseases and viral infections;
• the root is too mobile;
• there are no prospects for further prosthetics;
• exacerbation of periodontitis;
• destruction of the crown of the tooth;
• root pathology;
• disruption of the heart;
• the presence of cracks in the root of the tooth.

Preparing for the operation

Before the operation, sanitizing procedures should be carried out - all teeth should be cured in order to reduce the risk of complications. The tooth to be apicoectomy is treated one or two days before the proposed procedure, access to the canals is opened with a steel or titanium drill-bur or a pulp extractor. The canals are sealed using pins or cellers (phosphate cements). In the preparatory stage, expansion is carried out using a file, disinfection and filling with liquid cement so that it penetrates to the top of the tooth root. A permanent filling or crown is then placed.

Anesthesia

The operation is painless for the patient, as it is performed under local anesthesia. When performing an intervention on the upper jaw, infiltration anesthesia is used as an anesthetic, which provides a stable and lasting effect, and also penetrates to a sufficient depth of the soft tissues of the gums. Lidocaine or Ultracaine are used as anesthesia drugs. Painkillers are injected into the submucosal zone using a syringe. Anesthesia acts on the nerve endings of the gum fibers, penetrating into bone tissue. In addition, there is a bleeding effect, whitening of the gums. When performing an operation on the lower jaw, conduction anesthesia is used, which is injected next to the trigeminal nerve.

Technique

1. The operation of resection of the apex of the tooth root begins with an arcuate incision on the gum. Bone tissue and periosteum are released. In the region of the root base, a hole is cut with a bur.
2. Using tweezers, the top of the tooth root and the cyst (if any) or the focus of inflammation are removed through the formed channel.
3. The cavity is washed with a disinfectant solution.
4. To restore regenerative processes in the event of the formation of significant voids after removal of the cyst, the free space is filled with synthetic bone tissue.

Wound closure

Resection of the apex of the tooth root ends with the suturing of the mucous membrane by suturing. To ensure the outflow of the ichor between the seams, a drainage made of glove rubber is installed. The final step is the application of a pressure bandage for 12 hours in the area of ​​the upper and lower lips. Ice is recommended to reduce the risk of bruising.

Recovery and rehabilitation after resection of the apex of the tooth root

To reduce pain during the rehabilitation period, the patient is prescribed drugs containing analgesics to relieve discomfort. As a preventive measure infectious diseases it is necessary to take antibiotics ("Sumamed", "Azitral", "Lincomycin", "Azithromycin").Rehabilitation care includes rinsing the mouth with antiseptics - "Furacillin", "Iodinol", "Chlorhexidine", "Eludril", "Hexoliz", soda solution To improve tissue healing, anti-inflammatory and analgesic drugs are recommended - Meloxicam, Ketorol, Ketonal, Voltaren, Indomethacin. recovery period it is recommended to exclude physical activity, visiting baths, saunas, staying in the cold. Foods that are too hot or cold, alcoholic drinks, garlic, and spicy foods should not be consumed. Too aggressive toothpastes and mouthwashes should also be avoided. In the first 2 days, swelling may appear, as well as pain, which is relieved by analgesics. A few months after the operation, it is recommended to undergo an X-ray examination to prevent the development of relapses and evaluate the effectiveness of the procedure. Within 10-15 weeks it is not recommended to eat solid food, including nuts, gozinaki, roasted meat.

Consequences and complications

Apicoectomy is a rather complicated operation that requires knowledge and experience from a specialist. In case of violation of technological and hygienic rules, as well as non-compliance with recommendations for postoperative care, complications for the patient and side effects may occur. If the resection of the apex of the tooth root was performed poorly, the consequences may be as follows:

• infectious diseases of the wound surface, including purulent complications in the form of a flux, abscess;
• bleeding resulting from damage to the integrity of blood vessels, so it is important to check blood clotting during the preparation for surgery in order to exclude large blood loss;
• damage to the maxillary sinuses of the nose during the operation - most often this situation is due to the peculiarities anatomical structure of the osseous and facial skeleton, in which the upper teeth are located too high in relation to the maxillary sinus ( side effect can be prevented by more careful movements and wide incisions);
• defeat of the trigeminal nerve, which can cause pain, lowering the threshold of sensitivity after the resection of the apex of the tooth root has been performed; complications are treated with the use of physiotherapy - UVF, electrophoresis;
• re-formation of cysts in the event that the wound cavity was not completely sanitized.

The cost of resection of the tooth root and reviews of patients who underwent surgery

To find out how much the resection of the apex of the tooth root costs, it is necessary to compare the cost in various medical clinics. In Moscow, resection is carried out at 385 addresses of dentistry. The price for the operation varies from 627 to 23,000 rubles, depending on the qualifications of the clinic and the quality of the operation. To obtain a more effective treatment result, it is worth reading the reviews of patients who have undergone surgery before resection of the apex of the tooth root is performed. Reviews indicate that the highest quality operation is carried out in multidisciplinary medical centers:

• "On-Clinic".
• "SM-Clinic".
• "Nearmedic".
• Clinic number 1.
• ABC Medicine.
• "Grandchildren of Hippocrates".
• "ONMED".
• "Royal clinic".
• "Clinic of dental art".
• OAO "Medicine".

According to patients, the operation is painless, there are unpleasant sensations when drilling a hole. After resection, swelling of the cheeks and lips remains, which causes some discomfort. Unpleasant sensations while eating, when the wound has not yet healed, and food is stuffed into it. The sutures are made of self-absorbable threads, so they do not have to be removed. The wound heals fairly quickly. In general, the procedure is worth it in order to prevent dental complications and tooth loss in the future. And the effectiveness of the operation is largely due to the qualifications and experience of the dentist-surgeon. The swelling may last for three to five days.

Thus, the resection of the apex of the tooth root changes the idea of ​​treating cysts, periodontitis and other infectious diseases, allowing you to save the integrity of the tooth. Timely access to the dentist for diagnosis can avoid serious consequences in the future.

One of the principles of modern dentistry is the preservation of living teeth as long as possible. Removal is resorted to only in extreme cases.

One of the ways to get rid of the focus of infection located inside the gums, which is used quite often, is surgery. apexectomy. In other words, it is called resection of the root apex, because the latent infection is most often located in this area.

In the case of such an intervention, only the infected part of the root, which cannot be cured, as well as a cyst or similar formation that serves as a focus, is subject to removal. But healthy tissue should remain intact.

With this approach, the tooth does not need to be restored and put artificial roots and crowns. Minimal intervention in most cases gives the maximum positive effect.

Causes of complications in the postoperative period

Photo: Resection of the apex of the tooth root - before and after the operation

There are several reasons that can lead to subsequent complications. Here are listed the main ones, concerning both the methodology of this operation, and inadequate reactions of the body.

Consequences and complications

However, like any surgical procedure, resection of the root apex does not pass without a trace for the body. Of course, complications and unpleasant consequences do not always occur, but it is quite possible if any mistakes were made during the operation or the technique was not thoroughly observed.

Of course, the ideal option would be the complete removal of the cyst and the focus of infection. This can only be achieved by fully following the procedure and following the developed operation plan. However, if one of the reasons described above took place, unpleasant consequences are possible in the form of complications:

Bleeding

If the recommendations for the absence of loads (not only chewing, but also general physical) are not followed, heavy bleeding may begin. It happens almost impossible to stop on your own so you have to go back to the doctor.

In addition, blood can accumulate in the cavity formed after removal if it is not filled with synthetic tissue that replaces bone. This is especially common if the cyst was large.

Perforation (penetration) of the bottom of the nasal or maxillary sinus

The fact is that the roots of the teeth in the upper jaw are located close to the sinuses. Penetration of their bottom is fraught severe pain, edema, respiratory disorders, the appearance of bloody and purulent discharge from the nose.

relapse

Re-inflammation and cyst formation are also among the consequences of this operation. This is possible if if not all damaged tissues were removed, parts of the cyst or granuloma shell remained in the cavity.

Usually, to avoid recurrence, the patient is recommended to conduct an X-ray examination every three months during the first year - nine months after the resection of the root apex.

The danger of the return of the infection or cyst is that much more tissue will then be involved in the process, since the resection has already been carried out and the root has become shorter.

Also, repeated processes usually proceed at a faster rate, so complex long-term treatment and reoperation may be necessary. However, in this case, it is possible to lose the entire tooth, as with a root split.

The appearance of fistulas

In the case when a rather large cavity remained in the bone tissue and all infected tissue particles were not thoroughly removed, infection with localization in the jaw bone itself is possible. Then it is necessary to carry out a second operation to remove all the pus and completely clean the cavity.

Nerve damage

Nerve endings are located not only in the root canals, but in general in the jaw area. In case of careless resection of the root apex, the doctor can damage them. This can lead to both constant pain , so to complete loss of sensation in a particular area including gums, oral mucosa and even lips.

What to rinse?

The entire rehabilitation period, which can last from several days to several weeks, doctors recommend rinsing the mouth with various infusions, decoctions and preparations.

This is necessary to prevent inflammation of the wound and the suture area, because the gum tissue was severely injured (cut) during the operation.

Medicines

There are some of the most common products recommended for antiseptic rinses that will help to avoid infection of the wound and, as a result, suppuration and complications.

• Chlorhexidine. used water solution drug with a concentration of 0.05%. Its main advantages are that the solution is already ready, it does not need to be further diluted, the cost of the drug is quite low, and the antimicrobial activity, on the contrary, is very high.
• Miramistin. It is somewhat inferior to chlorhexidine in terms of the severity of the effect, in addition, its price is higher. However, the drug is also active against the herpes virus, which may be useful in some cases.
• Baking soda and salt. These substances also contribute to the qualitative removal of microbes from the oral cavity and disinfect the wound. To prepare the solution, it is necessary to add half (sometimes take a whole) teaspoon of soda and salt to a glass of clean, preferably boiled, water at room temperature.

Herbal infusions and decoctions

Along with medications, they are also successfully used for rinsing after surgery for resection of the root apex and various infusions, as well as decoctions. medicinal herbs and plants. Many of them have a lot of useful properties in this case - antiseptic, restorative, and so on.

When using herbs and medicinal plants for rinsing, you need to follow a few rules:

• mandatory cooling to room temperature;
• thorough straining to total absence small particles;
• compliance with the frequency of rinsing (at least 3-4 times a day).

Recovery reviews

The operation of resection of the apex of the tooth root is not uncommon. However, the period of rehabilitation after it cannot be exactly the same for different patients. Here the location of the tooth, anatomical features, the qualifications of the doctor and much more play a role.

In the next video - you will find a review of a patient who has already had this operation:

If you find an error, please highlight a piece of text and click Ctrl+Enter.

• Andrey Pichugin

  January 18, 2016 at 09:54 pm

  Be that as it may, it all comes down to banal hygiene and the absence of fear of visiting a dentist, who is the doctor who will help overcome ailment - in this case, a toothache. People are not afraid to go to a therapist, but very much to a dentist. But it's better to go. It is good that there are described ways to recognize diseases and the first measures to prevent them. Perhaps this will help someone cancel a trip to the doctor. The main thing is not to be late.

• Igor

  February 21, 2016 at 4:57 am

  I had this operation general anesthesia from a cyst at the tip of the root. There were two options: remove the tooth or make a resection and save it. Since the tooth is front, I preferred the second option. Everything went well, though he spent five days in the hospital. The sutures were removed on the seventh day, and antibiotics were injected for another three days, as with any operation. 1.5 years have passed since then, everything is fine with me.

• Vera

  March 8, 2016 at 08:05 pm

  In September 2013, at the Dobry Doktor clinic, I put metal-ceramic crowns and everything was fine, except mandible there was constant pain on the left, it was impossible on this side. I went to the dentist who treated and put crowns on me, but she didn’t see anything and didn’t find anything. to another dentist, he made a crown cutting with a laser after this manipulation, the pain remained as it was, then the doctor took a picture and sent it to the implantologist surgeon. then he cleaned again and the pain still does not go away already 2016 has come The question is what is wrong they are doing why the pain keeps

  Lala

  October 2, 2016 at 08:46 pm

  Hello!
  Yesterday they had an operation on the upper incisors with replanting, the next morning the upper lip was swollen and the nasolabial folds parted, I rinse with chamomile and calendula, I don’t take an antibiotic, my state of health doesn’t allow, the blue lines that sewed up the gums interfere most of all, they scratched the inside of the lip very much, brrr. on the second evening, a slight temperature rose and when I lift the upper (very swollen) lip, the ichor flows down the tooth. What can be done with these terrible blue threads? Withdrawal scheduled for 6 days later...

• Anna

  March 13, 2018 at 09:42 pm

  I had a resection 5 days ago. I still don’t feel a gum or a tooth, as if the frost hasn’t passed. I think nerve damage? so now the sensitivity will not return?

• Make an appointment Callback

  Modern dentists in the treatment of teeth try to save them to the last in order to leave the physiological functioning of the dentition and prevent the resorption of the tissues of the alveolar ridge. Tooth extraction is a last resort.

  To save teeth in situations where conservative therapy is powerless, specific operations help. Surgical interventions that do not involve the extraction of teeth are the excision and sterilization of infected tissue areas, for which sometimes it is necessary to correct the inflamed tooth root itself.

  The advantages of such operational manipulations:

  • Minimum injury oral cavity;
  • Saving money on the installation of implants;
  • Full, but temporary preservation of the function of the dentition for an indefinite period. There are cases when saved teeth serve for decades;
  • Bringing the infectious process to the stage of remission by removing the affected tissues, adding a lifetime to the tooth;
  • Preservation of an aesthetic, healthy smile.

  One of the tooth-saving operations is microsurgical manipulation of partial root excision. Such a surgical intervention allows you to get rid of various formations and save the tooth from the spread of inflammation. The main condition for the successful implementation of such an operation is the timely appeal of the patient to the dentist, in advanced cases, when the bone damage is several centimeters in diameter, these operations are not successful. People should be aware that an annual screening visit with a picture immediately detects the presence of cysts. And long-term ignoring the signs of a pathological process in the oral cavity leads to the fact that the implementation of a tooth-preserving operation becomes impossible and the dentist has nothing left but the removal, complete amputation of the tooth, followed by prosthetics on the implant.

  The essence of the operation for resection of the root apex

  The operation for resection of the root apex is a procedure for excision of pathological foci of inflammation in the root area or near it in case the patency of the canals is blocked foreign bodies or failure of conservative treatment.

  This type of surgical intervention was previously considered minimally traumatic and requiring little time. The function of the tooth is not fully preserved as the length of the tooth decreases. The surgical procedure in the vast majority of cases is carried out on canines and incisors, but much less often on multi-rooted teeth, since it is easier to remove the root completely there. In dentistry, the operation is called an apicoectomy, which literally means the removal of the top.

  

  Modern dentistry allows for forced resection without any risks to the patient. The recovery period will take a little time and will not cause much discomfort to the patient. The main advantage of this procedure is the complete cure of the dentoalveolar apparatus from the infectious process, which is steadily progressing and affecting more and more structures of the oral cavity.

  We have not performed classical tooth root resection in our Center for many years. We have developed an ultrasonic protocol for tooth-preserving surgery without root resection.

  Indications for root resection

  Excision of the root apex is required in the following situations:

  
  

  The cyst is the main problem requiring cystectomy and apex resection. It is a delimited area of ​​inflammation that looks like a sac with a cavity filled with liquid contents, usually pus. The cyst can become aggravated and cause serious changes in the patient's condition: headache, increase lymph nodes, discomfort in the area of ​​​​the tooth itself and others. She can also become main reason the spread of inflammation to the surrounding structures: sinuses, ears, tonsils.

  Treatment of a tooth cyst in modern conditions is reduced to cystectomy with resection of the root apex, but it is better with root polishing and its preservation.

  

  If the tooth was sealed with cement in the USSR, then repeat this process not recommended due to high risk of perforation and other complications. As a rule, conservative therapy is useless, and the cyst continues to grow instead of resolving. Surgical intervention is better not to delay, since the involvement of new tissues in the pathological process may become a contraindication for apicoectomy.

  In the process of preparing for root resection, a full-fledged X-ray examination is important, since surgical intervention is possible if there is at least 5 mm of healthy bone tissue of the alveolar ridge. Otherwise, the risk of bone fracture during the surgical approach is too great. Since the situation of each patient is special, the doctor decides on a resection on an individual basis. He assesses risk surgical procedure, thinks through alternative options and tends to the most optimal.

  To whom is the operation contraindicated?

  Patients should understand that, as in any surgical intervention, there are pros and cons of root resection, the ratio of which is evaluated by the dentist. The disadvantages of treatment by excision of the apex appear, most often, in the case of performing surgery in the presence of the usual general clinical contraindications. Therefore, the initial stage of the examination should be aimed at excluding conditions that do not allow resection.

  These include:

  • Excessive tooth mobility;
  • Involvement in the pathological process of more than a third of the tooth;
  • Too tight contact of adjacent tooth roots with the affected ones;
  • Destruction of the top of the tooth without the possibility of its restoration;
  • Cracks in the affected tooth root;
  • Exacerbations or decompensation of severe chronic diseases organism ( diabetes, ischemic heart disease, hypertonic disease, asthma, etc.);
  • Violation in the blood coagulation system;
  • Immunodeficiencies in severe stages;
  • Mental pathologies in the acute stage;
  • The presence of an oncological process of any localization.

  

  Some of the contraindications for apex resection are direct indications for complete tooth extraction. Another part of the conditions are general contraindications to surgical procedures in principle. Risk assessment occurs for each patient individually.

  In our Center there is no goal to save a compromised tooth at any cost, prolonging its agony, I ask you to be understanding that in some situations we do not undertake the removal of a cyst and root resection, offering removal.

  Preparation for resection and the course of the operation

  Excision of the apical part of the root is carried out quickly, but the overall complexity depends on the location of the affected tooth. It is easiest to work with fangs and incisors, and it is more difficult to get to the areas of inflammation in the roots of chewing teeth. The surgery is simple and is performed under local anesthesia.

  Preparation for the operation consists in preliminary filling of the tooth canals with special antiseptics, and then with BeeFill sealant. First, they are thoroughly cleaned, and then sealed with a special material. If such manipulation is not possible, then retrograde filling is performed. The procedure is carried out no later than 2 days before resection, so that an inflammatory reaction does not occur.

  Anesthesia

  

  Anesthesia for resection is always local, but it can be of two types:

  • Infiltration. It is performed during operations on the upper jaw and consists in injecting lidocaine or ultracaine derivatives into the submucosa of the gums. Gradually, the drug spreads deep into the tissues and completely disables the nerve endings.
  • Conductor. For the lower jaw, anesthesia is used, the essence of which is the introduction of the drug into the area near the nerve. As a rule, branch areas are used for this. trigeminal nerve.

  Operation steps

  • Access. The dentist gets to the root of the tooth through all the infected layers. First, an arcuate micro-incision of the gums is made with an exposure of the periosteum of about 5 mm. Then, the periosteum is detached and the affected alveolar crest of the jaw is exposed. Usually, the bone in the projection of the cyst has already died, dissolved, and sawing is not required. The doctor prepares a small hole through which access to the affected area is opened.
  • Removal of the cyst and correction of the root apex with a focus of inflammation. The dead root is cut off perpendicular to the upper axis of the tooth. It is carefully removed through the hole along with the cyst and tissues affected by the inflammatory process. The empty space that remains after removal can be filled with osteoplastic material. If possible, resection is best avoided, weakening the root can shorten the life of the tooth.
  • Suturing the wound area. The closure of the wound is sometimes carried out with the installation of a microdrainage for the outflow of the sanious discharge. It remains between the stitches for two days after the operation. Also, an ice pack is applied on the side of the lesion to prevent swelling and bruising.

  Recovery period

  Surgery to remove the top lasts no more than an hour, and the recovery period lasts much longer, about three days. Soft tissues recover within the first week, but the bone heals for several months. On the first day after surgery, the patient may experience swelling and moderate pain. They should gradually decrease and disappear during the first week after the operation.

  
  

  Patient and doctor should not forget about possible complications surgical intervention. The task of the dentist is not only to prevent their occurrence, but also to notice the development of an unfavorable outcome in time for its effective relief. Usually, in a skilled surgeon, the risk of complications is minimal, but the following complications sometimes occur:

  • Damage to nearby blood vessels with the development of bleeding;
  • Infection of postoperative wound;
  • Recurrence of cystic formations (occurs due to inadequate cleaning of the cavity);
  • Perforation of the maxillary sinus;
  • Perforation of the nasal passages;
  • Damage to nerve fibers in the region of the alveolar crest;
  • Formation of facial paresthesia.

  !Important: Apex resection is an extreme high-precision surgical manipulation that requires a highly qualified surgeon and extensive experience in performing such interventions, since during the operation it is necessary to quickly decide on the extent of resection, and it is better to only remove the cyst and polish the root without resection!

  Otherwise, the risk of complications becomes very high. In addition, the congenital anatomical features of the structure of the dentoalveolar apparatus can become the cause of the development of complications, so the doctor, in preparation for the operation, must carefully study the shape and structure of the affected area in order to take into account all the nuances found. A detailed diagnosis on a surgical computed tomography is required.

  Tamara Vladimirovna

  I have been contacting Vladimir Igorevich Strigin since 2016 regarding the installation of bridges. The doctor works highly professionally, with minimal adjustments. Often one fitting is enough and new bridges are felt in the oral cavity almost like natural teeth, no discomfort, no inconvenience! I am very satisfied with the quality of Vladimir Igorevich's work!

  Anastasia

  I had veneers done by Strigin Vladimir Igorevich. The doctor is polite and attentive. Aimed at the perfect result and always listens to the wishes of the client. The result is very satisfied. special thanks to the polite staff of the clinic.

  Root resection cost

  Prices for apical resection are set according to the volume of surgery, usually up to 15.000 rub. per tooth(the number of operated teeth), additional expenses for consumables (Bio-Oss Spongiosa (granules) - 10.000 or 12.000 rubles for container and anesthesia. The pricing of different clinics is explained by the qualifications and experience of the dentist, the use of specific equipment and other manipulations performed as needed. The patient should carefully choose a clinic for treatment so that he does not have to visit the dentist additionally and spend extra money twice when the cyst recurs.

  

  Excision of the root apex is one of the operations that, for the most part, positive feedback from patients. It allows you to avoid more serious manipulations and financial costs, as it is cheaper than an operation to remove the entire tooth with subsequent prosthetics. Unfortunately, not all people can afford the recently appeared implantation technique, and therefore partial root excision becomes a real salvation for them.

  !Important: The most unpleasant thing in the treatment of cysts is that often such chronic inflammatory processes go without any symptoms, without pain and swelling. Most of the situations I deal with on a daily basis are randomly discovered huge, neglected cysts, with no symptoms of inflammation in the mouth.
  And after what I saw, I am very grateful to patients who understand that it is not a doctor who needs an annual dental Check-Up. Spend it on insurance anywhere, it is important that the tomograph on which the diagnosis is carried out is specialized in the search for small neoplasms, for example, Galileos.
  Now there are patients who are ready for preventive dentistry and have an annual check-up without persuasion and with gratitude for the attention to their dental health.|

  The surgical removal of the top of a tooth root is called an apicoectomy. This method helps to get rid of a variety of inflammations and infections that penetrate into the tissues around the root tip from the canals.

  As a rule, roots of canines and incisors are subject to resections, in rare cases- multi-rooted. It is believed that chronic sinusitis can be a possible provocateur.

  What it is?

  Symptoms are poor: at first spontaneous pain intensifies when something gets on the tooth, including the other jaw. This is due to swelling. Palpation and X-ray do not give the desired result - nothing is felt or seen.

  In parallel, inside the neoplasm, the pressure of the pus increases, which can ultimately lead to rupture of the membrane. The infection will come out, and the inflammatory processes will worsen.

  Previously, in order to save a tooth from a cyst, it was completely removed. No reason, no problem. However, this decision led to aesthetic discomfort. However, this radical method is still encountered.

  Causes of cyst formation

  Although the cyst occurs from infection, the latter is provoked by 2 cases:

  • Firstly, untreated or untreated caries, the provocateur of which is not bacteria, as is commonly thought, but acids. After it develops into pulpitis - this is caries that has penetrated to the nerve or, as they are otherwise called, the pulp.

    By the way, it can be triggered by microbes and their toxins, dental trauma, alkali or acid, high temperature. Pulpitis then develops into a periodontal abscess, which should be recognized and stopped as early as possible;

  • Secondly, improper filling.

  The latter means the following:

  • if not the entire segment of the root canal was sealed, but an empty piece remained;
  • if it was sealed instead of the entire length of the canal, only its tip;
  • if the canal was sealed only up to the top, and the crown filled the void;
  • if debris remains after a dental failure;

  In all these cases, the development of infection is a matter of course.

  Conservative treatment

  As one of the ways to treat a cyst (not exceeding 1 centimeter in diameter), a special preparation is injected into it, after the treatment of the root canals, due to which infectious and inflammatory processes disappear.

  However, the process lasts a couple of months, does not always bring the expected results, even in the case when the tooth has not been sealed. And if not? Then the process of refilling follows.

  Although it cannot be called effective and ideal in this case, sometimes it is easier to just perform an apicoectomy than to first remove the filling substance, then put it back.

  Indications

  Resection of the apex of the tooth root is reasonable to apply in the following cases:

  • there is a pin - a special design that is fixed in the root canal and prevents its destruction;
  • when is the crown;
  • under-sealing or lack of the possibility of re-sealing;
  • pain and swelling;
  • large neoplasm;
  • excessive tortuosity of the channels;
  • a broken tooth just in the upper third.

  Contraindications

  As contraindications for surgical intervention, the following are distinguished:

  • very high tooth mobility;
  • exacerbation of any cardiovascular diseases and SARS;
  • acute stage of periodontitis. Symptoms, for example, purulent: the pain becomes pulsating, and the tooth becomes mobile.

    First, pus accumulates in the tooth gap (microabscess), then it impregnates the bone tissue, then it gets under the periosteum, which eventually destroys. When the process was completed and the pus got into soft tissues, the pain subsides in proportion to the increasing swelling of the face;

  • numerous cracks at the root;
  • destruction of the outer coronal part of the dentin - tooth tissue.

  Holding

  Like any operation, apicoectomy is divided into stages: preparation, anesthesia, access, the operation itself, wound closure. But more about everything.

  Preoperative preparation

  Not earlier than 2 days, so that the inflammatory process does not begin, root canals are filled with phosphate cement.

  The canal is expanded, disinfected, a significant amount of cement fluid is injected so that it penetrates beyond the top of the diseased tooth, and then the filling of the canal is checked with a special device.

  Anesthesia

  If the operation is performed maxillary, then infiltration painkillers are used., which act for a long time and penetrate deep enough. They are introduced into the submucosa of the gums, "freezing" the bone and soft tissues of the nerve endings, bleeding the periodontium. The gums turn white from the injection.

  Moreover, it has been proven that the injection between the second small molars and the first upper teeth is the least effective than between the upper central and lateral. Vascular injury and hematoma formation are possible.

  If the operation is mandibular, then conduction anesthesia or local anesthesia is used.. Its essence lies in the introduction of the drug into the region of the trigeminal nerve, where the tissue around the nerve fibers and they themselves are impregnated and blocked. It works a little faster and does not penetrate so deeply.

  Availability

  The doctor, at the location of the cyst, cuts the gum in an arcuate manner, and cuts a hole using a drill, exfoliating the mucous membrane, followed by the periosteum, exposing the bone tissue.

  Apex resection

  The previously sawn hole will serve as the channel, thanks to which the dentist will first find the top of the root, cut it off from the entire tooth, and extract it together with the focus and cavity, using a special spoon or tweezers.

  Bone tissue of synthetic origin fills a huge empty space, which can form after the extraction of infected neoplasms. It, in turn, contributes to the speedy restoration of natural bone tissue.

  We sew up the wound

  Suturing the mucous membrane, the specialist lays drainage between each suture. It helps not to accumulate sanious secretions, which are possible during the first two days, but to come out naturally.

  For the first 10-12 hours after the end of the operation, a special bandage is applied to upper lip and chin, and ice on the side of the face where the resection was performed.

  Possible complications

  
  Although the resection lasts literally half an hour, it is still a complex process that requires the dentist to be qualified for this.. Otherwise, complications are possible:

  • suppuration of the wound;
  • secondary cyst formation;
  • paresthesia - a violation of sensitivity due to nerve damage;
  • rupture of the sinus mucosa or a hole in the nasal cavity;
  • damage to the trigeminal nerve;
  • vascular injury.

  However, the anatomy of the structure of the jaws can also be the cause of the development of adverse postoperative factors. But this is overcome by a wider cut and delicate handling.

  Postoperative period

  Approximately a day after the operation is required to refrain from any factors that irritate the tooth: hard physical labor, toothpaste, mouthwash, carbonated drinks, salty and spicy.

  The fact that the first two days will be accompanied by soreness (quite moderate) and swelling is normal. If the disease is very strong or even pulsating, go to the dentist immediately, otherwise the consequences can be very unpleasant.

  Three months later, an x-ray should be taken to ensure a good outcome of the operation. And during these three months, you should give up any solid foods, including nuts.

  Issue price

  Dentistry is one of the most expensive medical industries. And it is impossible to name a certain amount of an apicoectomy, since it is selected taking into account the complexity of the task and is calculated for each absolutely individually. Approximate frames - from 4,500 rubles to 15,000 rubles.

  What forms the price?

  

  Perhaps for some, this cost will turn out to be unreasonably high, but if we compare the timely treated tooth and its removal with subsequent prosthetics, the amount turns out to be ridiculous.