If damage occurs in teeth due to insufficient oral care or poor nutrition and is left untreated, bacteria in the mouth increase. Bacteria can concentrate in decayed teeth and occasionally reach the tooth root, causing inflammation. When a tooth becomes infected and decay progresses, root canal treatment is applied. However, in some cases, root canal treatment may not be sufficient to save the tooth. After a failed root canal treatment, apical surgery may be required to preserve the tooth. This procedure is called apical resection. Apical resection is a minor surgical procedure performed to save at-risk teeth and prevent potentially serious complications. During this procedure, the tip of the tooth root and the surrounding inflamed tissue are removed.
What Is Apical Resection?
Apical resection is a surgical procedure performed to treat infections occurring at the tip of a tooth root. It is applied when the infection in the tooth cannot be eliminated by root canal treatment or other methods. Apical resection involves removing the infected portion of the root and the surrounding inflamed tissue to heal the inflammation and preserve the tooth. It is also known as **apicoectomy** or **root-end surgery**.
What Is a Tooth Root?
The tooth root can be defined as the part of the tooth that extends into the bone and holds the tooth in place. The root makes up approximately two-thirds of the tooth and consists of several parts:
The root canal, which is a passage containing the pulp.
Cementum, a hard tissue covering the tooth root and connected to the periodontal ligament.
The periodontal ligament, composed of connective tissue and collagen fibers. It contains nerves and blood vessels and, together with cementum, anchors the teeth to the tooth sockets.
What Is a Tooth Root Infection?
The pulp is the innermost part of the tooth and contains nerves, blood vessels, and connective tissues that nourish the tooth. Inflammation in this area due to various reasons is called a **tooth root infection**. If left untreated, a tooth root infection can lead to serious oral and dental health problems.
What Causes a Tooth Root Infection?
The enamel and dentin layers at the top of the tooth play a key role in protecting the tooth root. Any deformities in these layers can compromise the tooth’s integrity, allowing harmful bacteria to reach the roots. When the roots are infected by bacteria, **root inflammation** occurs.
Causes of tooth root inflammation include:
- Insufficient oral hygiene,
- Untreated cavities,
- Frequent consumption of carbohydrates and sugary foods,
- Cracks or fractures in the tooth enamel,
- Poor cleaning of food debris after meals,
How Is Apical Resection Performed?
Apical resection is a surgical procedure performed by a dentist. It begins with anesthesia. An incision is made in the gum tissue to access the tooth root tip, and the infected or inflamed tissues are carefully removed. The root tip is reshaped, and sutures are placed. Recovery can take several weeks, and the patient may take painkillers and antibiotics according to the dentist’s instructions.
Which Teeth Can Undergo Apical Resection?
Apical resection can be performed on different types of teeth, including incisors, canines, premolars (especially upper premolars), and molars. The specific tooth for the procedure is determined based on the patient’s X-rays and the dentist’s evaluation. This procedure is used to treat infections, cysts, root fractures, and other root-related problems following root canal treatment.
