Microscopic root end surgery

If a non surgical root canal treatment failed, a root end surgery can save the infected tooth.

In general there are two ways of treating an infected root canal treated tooth.

The first option is revision therapy: a new conventional root canal treatment under improved technical conditions, which in most cases is the gentlest and most promising treatment option.

However, if the path to the root apex is obstructed by large post abutments, extensive and expensive dentures, non-removable broken root canal instruments or severely constricted root canals, a microsurgically correct root canal resection can be the solution to the problem.

The process of root end surgery

The aim of the treatment is to clear out the inflamed bone cavity around the root tip and to cap and seal the tooth root “from below” so that it is impermeable to bacteria.
After precise, three-dimensional diagnostics and consultation, a small incision is made in the gum in the area to be operated on, through which the entire treatment is carried out.
The area around the root tip is now cleaned with tiny drills and the root is shortened by a few millimetres. Now, in order to achieve lasting success, root canal treatment must be carried out from the bottom to the top of the root canal using the finest ultrasonic instruments in order to remove the bacteria and dead nerve tissue.

Figures 1-4 Procedure of an apicoectomy (AAE.com)

The cause of the inflammation is to be found inside the affected tooth in the form of bacteria, so the bacteria-proof sealing of the root is of particular importance.

As the end of the root tip is located inside the body, the filling material used must remain sealed in the long term, even under the influence of moisture, in order to be absolutely biocompatible and tissue-friendly.
Clinical studies have shown that mineral trioxide aggregate (MTA) is currently the most suitable material. Only this very high-quality material is used in our practice for every apicoectomy.

Aim of an apicoectomy

The cause of toothache should be remedied as quickly as possible
The highest possible success rate of up to 95% has been proven by studies -> with modern surgical methods and correct
Indication – depending on the tooth region
Preservation of strategically important teeth – e.g. denture abutment teeth, end teeth of the row of teeth or front teeth

What is microsurgery?

In contrast to conventional macrosurgery, the aim of microscopic surgery is to be as minimally invasive as possible. The special instruments used in microsurgery enable a particularly gentle and targeted procedure using a surgical microscope. Thanks to the particularly good visualisation under the dental microscope, even the tiniest structures on teeth and tissue can be treated. The advantages for patients are obvious:

minor intervention
Minimal pain and swelling
Short wound healing time
No/hardly any scarring
perfect aesthetics

What should I do after the procedure?

As with any dental surgery, you should not smoke or drink alcohol in the following days. You should also avoid drinks containing caffeine.
If possible, you should cool the treated area as much as possible and take it easy physically. Unless otherwise recommended by your GP, you are welcome to use the anti-inflammatory and pain-relieving effects of ibuprofen or paracetamol. Unless prescribed by a general practitioner, you should not take aspirin, as the active ingredient ASA reduces blood clotting and can therefore lead to secondary haemorrhaging more easily.
Please consult your dentist immediately in the event of severe discomfort and/or secondary bleeding.

Patient OPINIONS

Great doctor

Thorough diagnosis; honest recommendation not to carry out the planned special treatment in my case, thus saving me unnecessary treatment costs.

Friendly and competent

I felt safe and in good hands from the very first moment. Dr Planert took the time to answer my questions and explained everything clearly.

Outstanding!

I am completely satisfied! Very courteous reception... Advice and treatment at a very high level. Can recommend Leipziger14-Ihre Zahnärzte and Mr Planert with a clear conscience!"