Until recently, the most simple and effective method of combating brushes are tooth extraction. Today, modern dentistry has absorbed all the achievements of medicine, science and technology and is aimed primarily at conservative techniques. Fortunately, there was a procedure called resection of the tooth root, designed to save the tooth, and deal with various kinds of manifestations of periodontal disease and other infectious diseases. She is a gentle method of treatment.
Resection – what is it?
The main threat to the safety of the tooth are bacteria that penetrated to the very root. To combat infection foci applied apikoektomiya. To find out who shows this technique, it is important to define what radiectomy. This procedure is an operation aimed at fighting infection, penetrating to the bottom of the root in the form of cysts, granulomas, periodontitis. Apikoektomiya quite painful, so performed under local anesthesia. In the process of operation removed a layer of the gum in order to get to the site of infection. Then cut off the root apex, and then sutures which promote healing well soft tissues. Since infectious diseases is locked channel inflammatory lesions, further treatment is not possible. Therefore radiectomy in this case, is the only effective method that avoids the further development of infection.
Radiectomy carried out in the following cases:
- in the presence of periodontitis, which involves the presence in the upper part of the root of inflammatory processes, cysts, infections;
- side effects of treatment endontologicheskogo channel narrowed and deformed, resulting in a fracture occurred broach, boron in the root canal;
- apex injury as a result of exposure to boron;
- Treatment of osteomyelitis, which involves the removal of pus from the bone structures of boron.
Radiectomy contraindicated in the following cases:
- advanced stage of periodontal disease;
- acute infectious diseases and viral infections;
- root too agile;
- there are no prospects for the future of prosthetics;
- aggravation of periodontitis;
- destruction of the tooth crown;
- pathology roots;
- disruption of the heart;
- cracks at the root of the tooth.
Preparing for surgery
Before the surgery should be performed sanitizing procedures – to cure all the teeth in order to reduce the risk of complications. The tooth to be apikoektomii for one or two days prior to the proposed procedure, treat, open access to channels through the steel or titanium-boron or Dril pulpekstraktora. The channels are sealed using pins or Celler (phosphate cement). In the preparatory phase of the expansion is carried out using a file, disinfection and filling with liquid cement so that it penetrated to the top of the tooth root. Then establish a permanent fillings or crowns.
The operation is painless for the patient, as is done under local anesthesia. During the intervention in the maxilla as an analgesic infiltration anesthesia is used, which provides a stable and lasting effect, as well as penetrate deep enough soft tissue of the gums. As anesthetic drugs used means “lidocaine” or “articaine.” Anesthetic agents are administered by injection into the submucosa zone via syringe. Anaesthesia affects the nerve endings gum fibers, penetrating into the bone tissue. Furthermore, there exsanguinating effect whitening gum. During the operation in the lower jaw are used regional anesthesia that is administered near troynichkovym nerve.
The operation radiectomy starts with an arc-shaped incision in the gum. Available from the bone and the periosteum. At the base of the root sawing holes conducted using boron.
With the use of forceps through the channel formed by the apex is removed and a brush (if any), or the focus of inflammation.
The cavity was washed with a disinfectant solution.
To restore the regenerative processes in the case of formation of significant voids after removal of the cyst, the extra space is filled with a synthetic bone.
radiectomy ends suturing carrying mucous-membrane bone by suturing. To ensure outflow ichor between sutures mounted drainage made of a rubber glove. The final stage is a superimposition of a pressure bandage for 12 hours as the upper and lower lips. To reduce the risk of hematoma is recommended to apply ice.
Restoration and rehabilitation after resection of the apex
To reduce the pain during the rehabilitation period the patient is prescribed preparations containing analgesics, for ustarneniya discomfort. As the prevention of infectious diseases need to take antibiotics. The recovery care includes antiseptic mouthwash. To improve tissue zazhivlyaemosti recommended anti-inflammatory and pain medications. The recovery period is recommended to exclude physical exercise, steam baths, saunas, exposure to cold. Do not eat too hot or cold food, alcoholic beverages, garlic and spicy dishes. Also avoid overly aggressive toothpastes and mouthwashes. In the first 2 days may cause swelling and pain, which analgesics are removed. A few months after surgery recommended to undergo X-ray examination for the prevention of recurrence and evaluation of the effectiveness of the procedure. During the 10-15 weeks is not recommended to eat solid foods, including nuts, kozinaki, roasted nuts.
The effects and complications
Apikoektomiya – quite a complex operation that requires the knowledge and experience of the specialist. In case of violation of technological and hygienic rules and failure to comply with recommendations for follow-up care may be complications for the patient and side effects. If you have performed poorly radiectomy, the consequences may be as follows:
- infectious diseases of the wound, including purulent complications as a flux, abscess;
- bleeding arising from damage to the integrity of the blood vessels, so it is important in preparation for the operation to check the blood clotting to prevent a large loss of blood;
- Damage tool maxillary sinuses during surgery – often such a situation due to the peculiarities of the anatomical structure of bones and facial skeleton, in which the upper teeth are too high in relation to the maxillary sinus (a side effect can be prevented by more careful movements and conduct broad cuts );
- troynichkovogo nerve damage, which can cause pain, reduce the sensitivity, after being held radiectomy; complications are treated using physiotherapy – HLA, electrophoresis;
- re-formation of cysts in the event that the wound cavity was not completely sanitized.
The cost of resection of the tooth root and reviews of patients undergoing surgery