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Root apex resection – why the operation is needed and how it is carried out

Root apex resection full description

Resection of the tooth is a microsurgical operation to remove a cyst at the top of its root. Usually, pus formations are formed about a cyst, tumors which without timely treatment cause negative consequences for the organism. The main ones include the appearance of headaches, the development of chronic sinusitis, a common ailment.

The operation is carried out in dental clinics by experienced surgeons using modern equipment and anesthetics.

The main stages of operation

The duration of the tooth root resection procedure can take from half an hour to one and a half hours. Thus, the front incisors and canines are easily accessible for the physician place, the operation will take place quickly and without complications. But back teeth are much more difficult to operate. The whole process is performed under strong local anesthesia.

Preparatory process

Before the surgery, the doctor examines the patient. Tooth channels should be sealed, otherwise, the pre-filling of them is held a few days prior to resection.

Sealing channel includes the following steps:

  • opening access to them;
  • purification and expansion with a help of file;
  • filling of the empty root canal;
  • installation of permanent fillings or crowns.

As a sealing material phosphate cement is used that has a long service life. The solidification of a sealing material extends over several minutes.


Resection of the root of the tooth on the upper jaw is carried out using an infiltration anesthesia, on the bottom jaw- with a conduction anesthesia. As an anesthetic ultrakain or lidocaine are used.

The essence of an infiltration anesthesia: anesthetic is injected into the gums submucosa, extends through the bone tissue and blocks the nervous response to pain.

The essence of conduction anesthesia: an anesthetic is injected into the tissue adjacent to the tooth nerve, the nerve analgesic is impregnated, resulting in blocking of the nervous reaction to the pain.

Gums in a place of inputting an anesthetic is getting white, indicating the beginning of action of the drug. Type of anesthesia – local.

Gingiva autopsy

Gingiva autopsy operationBefore the operation, it is necessary to provide access to the root. For these purposes, a surgeon struts the gum using a scalpel, mucous delamination occurs, and the bone is available to work with.

Using dental burs, a hole is sawed in a bone tissue to expose the top of the root. The opening of the gums is accompanied by profuse bleeding.


The first stage of the operation is finding the root; the second phase is clipping the top. Clipping is held using a drill, extraction – using a scalpel. The result of a successful operation is the removal of the upper root with the build-up or a cyst.

In some cases, after the operation, the empty cavity is formed in the gums. In order to fill the space and to accelerate the healing process, a synthetic bone is introduced into the gum.

Gums stitching

To restore the gum structure, it is sewn with sutures. For the outflow of sanious secretions after surgery in the gum between the superimposed stitches, a drainage is put. A sterile gauze bandage and a cold to relieve swelling is applied.

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Rehabilitation period

Postoperative recovery period lasts from several days to a week. On the day of surgery, a patient should not eat any food, soups are allowed for the following days. It is necessary to limit the use of spicy, salty and of solid food (nuts, hard fruit, and vegetables).

For prevention of inflammation, the physician prescribes a mouth rinse special facilities several times a day. Effectively is to rinse oral decoction of chamomile, St. John’s wort or oak bark. Natural ingredients in herbs relieve swelling, prevent the occurrence of purulent formations in place of resection.

Among the drugs, chlorhexidine is recommended. Doctors prescribe additional antibiotics, immunostimulants.

If after a week, the wound stands out blood or pus, you should always consult a specialist, do x-rays and eliminate complications.


In the case, when methods of nonsurgical interventions cannot be effectively applied (endodontic treatment), the procedure that is called resection is prescribed to the patient.


  • The presence of purulent cysts larger than one centimeter. Conservative treatment in such cases is ineffective, its main disadvantages: the length of the process, often relapse;
  • Sealed canals and crowns on a tooth. When conservative treatment, you first need to remove the crown, then unseal channels and start conducting therapeutic procedures. The cost of medical treatment is high;
  • The presence of metal pins in the root canal. In dentistry, it is not recommended to remove the pins, as during the procedure, often there is a fracture of the tooth root, which is a prerequisite for its removal. Performing a resection, in this case, is inevitable;
  • Poor filling of root canals provides the penetration of infections and, as a consequence leads to the development of cysts. Unsealing and resealing is not recommended, the consequence of such manipulations can be tooth loss.

Resection of the tooth is the difficult and painful operation, often requiring a long recovery period, but its main advantage is the preservation of the patient’s tooth.


Contraindications to operationIn certain cases, a surgery to remove the upper part of the tooth is not possible. The main contraindications include:

  • periodontitis second, third and fourth degree;
  • the presence of cardiovascular disease;
  • the presence of acute respiratory disease;
  • cracks in the tooth root.

Not on all of the teeth may such surgeries may by conducted. The operation is most conveniently carried out on incisors and canines, it is not recommended to perform the procedure on the chewing teeth.

Possible consequences

Resection of the upper part of the tooth root is a complex type of surgery. The dentist should have extensive experience of conducting such procedures, in order not to harm during the resection.

Possible injury during the operation:

  • damage to the blood vessels;
  • damage to the nerve endings;
  • damage to healthy teeth around;
  • infection.

There are often complications after resection of an apex. The main ones are:

  • profuse bleeding at the wound site;
  • pus in the gums at the site of resection;
  • an occurrence of edema and swelling of the jaw;
  • numbness of the lower part of the face;
  • relapse.

In the case of poor removal of cysts and root of the tooth, there is a relapse. This phenomenon is usually manifested in an acute form; it requires surgical intervention.

Before you choose a clinic for treatment it is recommended to study the basic information about it, read reviews to get an appointment with qualified personnel with sufficient experience in conducting such surgeries.

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The cost

 price tooth resectionThe price of the operation ranges from 900$ to 1350$ (without dental insurance), or 100$ to 500$ (with dental insurance coverage). The cost varies depending on the location of operation (in most major cities value is higher), the quality of the filling materials used, the quality of the narcosis, the degree of neglected disease.

It should be noted that there are a lot more health centers, conducting operations on resection, in the big cities. More detailed information can be obtained by visiting the dental clinic. The doctor will conduct an initial diagnosis, on the basis of which a treatment plan and the price will be determined.


Resection of root apex is a complicated and painful surgery. For other readers to be able to make an objective opinion about the procedure, you can share your personal experiences by leaving a review in the comments to this article.

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