Apical surgery

Indications for apical microsurgery include apical periodontitis (a cyst) that does not respond to conventional endodontic treatment, or cases where classical endodontic therapy is not possible (for example, due to complex tooth anatomy or the presence of a crown).

There are many reasons why conventional treatment may be ineffective, but there is only one solution to save your tooth — apical microsurgery.

Apical microsurgery is often confused with root apex resection.

So what is the difference between apical microsurgery and the old “soviet-era” method of root apex resection?

Apical microsurgery is a complex technique that requires the doctor’s experience, knowledge, and skills in both surgery and endodontics, as well as the use of a specialized surgical microscope, without which it is impossible to perform this procedure properly. The surgeon-endodontist creates a micro-access to the inflamed area through the soft tissues (gums) and the bone tissue.

The inflamed cyst-like lesion is excised together with the tip of the tooth root (about 3 mm). After resection of the affected root apex, the doctor performs diagnostic staining of the cut surface with methylene blue. Under high magnification using a microscope, the stained area is examined to detect missed anatomy, unfilled lateral canals, or microcracks. A key feature of apical microsurgery is mandatory retrograde preparation (from the root apex side) and sealing of the apical portion of the root canal with MTA material, which creates a dense, hermetic plug and seals the infection inside the root canal. As a result, bacteria can no longer infect the surrounding bone tissue, which explains the positive therapeutic outcome of the procedure.

When it comes to “classic” root apex resection, this method involves only the removal of the cyst-like lesion along with the root tip. This approach does not include retrograde preparation or sealing of the root canals and, therefore, does not eliminate the infection in the area. As a result, a recurrence may occur, which can eventually lead to tooth loss.

Advantages of apical microsurgery at Masych Clinic:

1. A highly qualified surgeon-endodontist with invaluable experience in successfully performing such procedures.
2. Advanced surgical microscope and all required micro-instruments for precise treatment.
3. The treatment can be carried out under medical sedation or nitrous oxide anesthesia.

Our clinic’s philosophy is based on caring for your health, as well as the professionalism and experience of our doctors. That’s why you should choose us — because you are in the hands of the best specialists in Ivano-Frankivsk.