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Root canal treatment
The apicectomy is a way to preserve the tooth if the first root canal treatment has failed. With curved roots or a widely branched canal system, residual tissue sometimes remains in the tooth root, often at the tip of the root. These areas are difficult for the dentist to reach. Inflammations then form again there because bacteria multiply. During a root resection, the dentist or oral surgeon cuts the diseased root tip (s).
Procedure / duration of the apicectomy
The root tip resection is carried out in several steps:
- After a local anesthetic, the doctor cuts the gums and periosteum and exposes the bone above the tip of the root.
- It removes inflamed tissue and cleans the area around the root tip.
- With a milling cutter, he cuts the tip of the root by around three millimeters, sometimes more.
- He cleans and disinfects the lower area of the root with fine special instruments.
- From the tooth crown, the dentist expands the root canal, disinfects, dries and fills it. In this way, it seals the root canal from below. Sometimes he also brings in the filling from the tip of the root.
- He folds the soft tissue back, brings it back into the correct position and sutures it.
- With the help of an X-ray, he checks the result of the apicectomy and the filling
No precise statement can be made about the duration of the tip resection. If the procedure goes without complications, you should expect about half an hour. The duration of the root resection can also be shorter or longer - depending on the difficulty of the treatment.
Root resection: duration of healing
Immediately after the root resection, you must not eat anything until the anesthesia has subsided. Refrain from coffee, nicotine and alcohol for at least 24 hours after the operation. These stimulants interfere with wound healing and prolong the healing time of the root tip resection. Cool the affected area well to keep any swelling at bay. Under no circumstances should you exert yourself physically.
The dentist will pull the stitches once the wound has healed. Usually this is the case after seven to ten days. However, the bone takes several months to heal. Regular follow-up care is particularly important during this period. After three to six months at the latest, the dentist can use an X-ray to see whether the root tip resection was successful in the long term or whether new foci of inflammation have formed.
Pain after apicectomy
The apicectomy is a surgical procedure that dentists perform under local anesthesia. Otherwise the apicectomy would be painful. The pain after the apicectomy is part of the natural healing process. Tension pain after the apicectomy is also normal.
You can relieve the pain with pain relievers, such as the active ingredient ibuprofen. The drug has a pain-relieving and anti-inflammatory effect at the same time. An external cooling from the outside also helps.
Swelling make apicectomy
It is also normal for the apex resection to be accompanied by swelling. The best way to treat swelling is with a coolant. Use ice cubes or a cooling pad from the freezer. But be careful! Never put ice directly on your skin, wrap it in a towel. Otherwise the skin could freeze. Cooling after an apicectomy can shorten the duration of the swelling. It usually subsides within a short time.
If you experience severe pain and increasing swelling after the operation, be sure to visit your dentist!
Cost of apicectomy
The root tip resection with the removal of the root tip, the removal of the inflamed tissue and the bacteria-proof closure of the root canal is carried out by the statutory health insurance for the anterior and posterior region. As with normal root canal treatment, some special regulations apply to molars.
As part of the root canal treatment, the dentist completely removes the inflamed tooth pulp from the root canals. He then closes the cleaned and disinfected cavity with a root filling. It consists of a material that is well tolerated, the body cannot dissolve and that does not cause allergic reactions. The filling of the root treatment must be clearly visible on the X-ray. There are various filling materials for the root canals. One example is gutta-percha and a sealing cement for sealing (“sealer”).
If the root canal treatment takes place in several sessions, for example because the tooth is highly inflamed, the dentist uses a temporary filling for the root canal treatment. After the end of the root canal treatment, he closes the access to the occlusal surface with a stable plastic filling. Often a tooth crown follows to stabilize the tooth.
Procedure / duration of the root filling
The root canal filling is an essential part of the root canal treatment process. The dentist only brings in the root filling after he has prepared, thoroughly cleaned and disinfected the root canal. The root filling hermetically seals the tooth and ensures that bacteria can no longer penetrate.
A tooth can have several roots and these in turn can accommodate several branched root canals. The duration of the root filling and the entire root treatment can take longer to complete.
Root canal filling: pain
It is rare that the root filling itself causes pain if the dentist has worked carefully and proceeded correctly. However, the root filling must neither be too short nor too long. In the first case, inflammation can develop, in the second, bones and nerves are irritated.
Temporary pain after a root canal is completely normal. Some bite bite pains after the root filling when you put pressure on the treated tooth, for example when biting on it. The irritated tooth has to calm down after the root canal treatment.
You can get the pain under control with mild pain relievers, for example the active ingredient ibuprofen. The pain usually subsides within a short time after the root canal is filled. Anyone who feels more severe toothache after the root filling should visit their dentist and have the complaints clarified. Inflammation could have developed again.
Cost of a root canal filling
Statutory health insurance will pay for the root canal treatment if the dentist has classified the affected tooth as worthy of preservation and certain requirements are met. In this way, you also cover the costs for the root filling. There are, however, some exceptions and special regulations, for example for molars.
Root revision is an alternative to apicectomy. A root revision means that dentists perform a new root treatment on a tooth that has already been treated with a root. Dentists carry out the root canal revision if the first root canal treatment has not been sufficiently successful. The revision of the root treatment is necessary, for example, if:
- the root canal system could not be adequately cleaned and disinfected
- the dentist missed root canals
- There are leaks in the filling, crown or tooth decay
Bacteria then remain in the root system or settle again, multiply and trigger further inflammation. During the revision of the root canal, the dentist removes the root filling from the affected tooth and carefully carries out a second root canal treatment with all steps. The root revision is one way of preserving the diseased tooth. It is considered a “second chance” for the tooth. The chances of success of the root revision are between 60 and 80 percent.
Root revision: pain
As with normal root canal treatment, pain can also occur after the root revision. They are normal and go away after a short time. You can treat the pain after the root revision with pain medication, for example ibuprofen.
Root revision costs
In most cases, patients bear the costs for the root revision themselves - it is not a normal health insurance benefit. Ask your dentist about the cost of the root canal before starting the revision. Let us give you a cost estimate that precisely quantifies the items for the root revision. The dentist bills you privately for his services.
Microscopic root canal treatment
Microscopic root canal treatment is a relatively new method. The dentist works with a special microscope that enables multiple magnifications. This enables him to see the finely branched root canals more precisely. Root canal treatment with the microscope makes it easier for the dentist to recognize, clean and disinfect all root canals and side branches of the branched canal system, no matter how fine they are. If no bacteria and inflamed tissue are left behind, the chances that the root canal will be successful in the long term increase.
Dentists use microscopic root canal treatment in problematic cases, such as when the tooth roots are narrow, strongly curved and difficult to access. This is often the case with molars in particular. Root canal treatment with a microscope is also an option for teeth that have already had a root canal treatment and are subject to a root revision.
Cost of a microscopic root canal treatment
The cost of microscopic root canal treatment is borne by the patient themselves. The dentist usually estimates the cost per root canal when working with special instruments and the microscope.
It should be noted that some teeth have multiple root canals that the dentist has to prepare. Then the price for the root canal treatment under the microscope increases accordingly. The costs can be several hundred euros - depending on the duration of the treatment and the time it takes. Discuss with your dentist what costs he will charge for the root canal treatment under the microscope.
Root canal treatment with laser
Some dentists now offer laser root canal treatment. The light has a germicidal effect.
The dentist uses laser light instead of the rinsing solution to clean and disinfect the root canals. With the help of a special instrument, he brings the laser light directly into the inflamed root area. It penetrates deep into very fine root canals, which are difficult to access with normal instruments, and kills bacteria there. A root canal treatment with laser is usually carried out once or twice.
Cost of a root canal treatment with laser
The statutory health insurances do not pay for the laser root canal treatment. The dental practice needs the necessary technical equipment as well as a lot of knowledge and experience with the method.
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