Each individual tooth in your mouth is anchored into your jawbone by roots. The number of roots present depends on which tooth it is - the front teeth tend to have one root holding them in position, whereas the teeth further back, known as the molars and premolars, have at least two roots. The roots have an area called the apex located at the end. The apex is the place where the blood vessel and nerves go into the tooth. Such nerves manoeuvre through the root canal and into the chamber in the crown of the tooth. Sometimes, these root canals can become infected or inflamed and require root canal treatment.
Sometimes root canal treatment can fail to remove the infection if it is lodged in smaller nerve branches as opposed to just the main ones. This subsequently leads to the need for an apicectomy. In the apicectomy procedure, either the root tip is removed or the apex is. This area is then substituted with a filling to ensure that the root ending is completely coated and sealed. This treatment procedure is often performed using an operating microscope and are therefore commonly known as endodontic microsurgery.
Prior to the actual apicectomy, you will be required to attend a consultation with the dentist, endodontist or oral surgeon who will perform your treatment. Throughout this consultation, you will learn about the procedure and exactly what it entails. It is often considered best to have the apicectomy under the hand of an experienced endodontist due to the increased and better use of endodontic microsurgery. During this meeting you will be questioned on your dental and medical history and it is vital that you tell the dentist everything.
Also before the apicectomy, you will have a number of X-rays taken of the tooth that requires treatment as well as the bone and tissue that surrounds it. This just increases the knowledge of the precise location of treatment. After this, your medical professional will provide you with an antibacterial mouthwash, antibiotics as well as certain medications that can limit the amount of inflammation.
During the actual apicectomy procedure, the endodontist will remove the gum that surrounds the tooth. This is done so the roots can be accessed with ease. This allows the endodontist to be able to extract any infected tissue. This process involves the root canals being cleaned using ultrasonic instruments very accurately due to the use of a specialised microscope. Then the endodontist will cut off the tip of the root – this is usually just a couple of millimetres – and the tissue is stitched back into position as seen by the X-rays.
A primary risk of an apicectomy is simply that it will be unsuccessful. In such circumstances, your tooth may require removal. Other potential risks are associated with where the tooth is located in the mouth. Treatment on those that are found in your upper jaw near the back may have a negative impact on your sinuses. To try and prevent infections or other problems of the sinuses, the dental professional may prescribe decongestants and/or antibiotics. Alternatively, apicectomies performed on the lower jaw's back teeth carry a risk of nerve damage due to here being the location of major nerves. To minimise this hazard, the X-rays taken during the consultation can be analysed and the nerves are located precisely so the endodentist is aware of which areas the nerves are in to avoid.
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