An endodontics is performed when the nerve of the tooth is affected, either by causes such as caries where the bacteria have come into contact with the dental pulp (the nerve of the tooth) after having damaged the enamel (outermost layer of the tooth) and dentin (intermediate layer between enamel and dental pulp); or for any trauma that tooth has received and the nerve has been damaged. If with the treatment of the ducts, that is to say performing the endodontics, it is not possible to eliminate the infectious process of the bone, we have two options; you can try to perform the duct treatment again or you can do an apicoectomy .
Apicoectomy, also known as endodontic surgery, is a small surgical procedure, with which the aim is to eliminate the infectious process of the tooth and bone and to close (seal) the canal correctly so that the infection does not recur. It is a process by which the removal of the apical portion (the tip) of the root of a tooth, as well as the infected tissue involved, is carried out, through radiographs the tip of the root is located at the height of the gum and is created a “little window” through the gum and the bone to perform cleaning and filling the tip of the root.
WHEN IS IT INDICATED TO PERFORM AN APICOECTOMY?
Apicectomy is indicated in teeth with periapical processes such as:
- The failure of root canal treatments (endodontics).
- In teeth where the root canal treatment can not be repeated.
- In teeth that present curves or in which the apex (or tip of the root) becomes inaccessible.
- In teeth that have false ducts.
- In ducts where an endodontic instrument has been fractured and housed.
- Acute processes because it bleeds excessively and makes local anesthesia insufficient.
- If the bone has been destroyed, reaching the middle zone of the root.
- In case of massive destruction of the radicular portion.
- If the affected area is very close to the maxillary sinus.
The surgical process consists of opening the gum at the level of the affected tooth, exposing the underlying bone of the piece and removing the affected tissue. Once this procedure is done, the apex of the root of the affected tooth is removed. Once the apex is removed, the obturator is placed, which is a sealant in the root canal called MTA, trioxide aggregate material, in the place where the apex of the tooth has been removed and the gum is sutured where the incision has been made. After a few months, the bone around the apex of the root will heal completely and the infection will have disappeared.
WHAT CARE SHOULD I HAVE AFTER PERFORMING THIS SURGICAL PROCEDURE?
You must follow the medication guidelines indicated by the specialist, once at home you should apply cold on the cheek or jaw of the treated area intermittently during the following 12 hours, that is to say applying it for about 15 minutes and removing it from other 15 minutes At bedtime try to sleep with your head elevated with several pillows or cushions.
It is important that you rest and avoid doing physical activities. Above all, do not use the surrounding teeth to chew, try to maintain a soft and cold diet during the first 24 hours after the intervention. When brushing your teeth you should avoid brushing the affected area , do not lift your lips to see the area of intervention. It is important that during the first 24 hours you do not smoke, or spit, that you avoid alcoholic beverages since they will not help the correct healing of the wound.