Deep tooth decay, dental trauma, or infections can eventually spread to the root of the tooth. Although root canal treatment is highly successful in most cases, the infection may not always be completely eliminated. If inflammation, a cyst, or bone loss persists at the root tip despite root canal treatment, a surgical procedure called apical resection (apicoectomy) may be performed to preserve the natural tooth instead of extracting it.
Apical resection is a microsurgical procedure performed to remove the infected tip of the tooth root along with the surrounding inflamed tissue. This technique allows many teeth to be preserved in the mouth, maintaining natural chewing function without the need for extraction.
What Is Apical Resection?
Also known as root-end surgery, apicoectomy, or retrograde root canal treatment, apical resection is a surgical endodontic procedure performed when conventional root canal treatment is unsuccessful or insufficient.
During the procedure, a small incision is made in the gum tissue to access the root tip. The infected tissue, cyst, or granulation tissue around the root tip is carefully removed. A few millimeters of the affected root tip are then resected, and the root end is sealed with special biocompatible filling materials. This helps prevent bacteria from re-entering the root tip area.
Why Is Apical Resection Performed?
Root-end resection is generally recommended when root canal treatment alone cannot resolve the problem. It is commonly performed in the following situations:
• Persistent root abscesses despite root canal treatment
• Detection of a cyst in the root area
• Infection or bone loss surrounding the tooth root
• Separation of an endodontic instrument inside the root canal during root canal treatment
• Inability to completely clean the root canal due to its anatomical complexity
• Previously performed root canal fillings that do not adequately seal the root tip
• Recurrent infections at the root apex
• Evaluation of certain root fractures
• Removal of foreign objects lodged at the root tip
In such cases, the primary objective is to preserve the natural tooth rather than extract it.
Is Root Canal Retreatment Necessary Before Apical Resection?
The primary goal in dentistry is to preserve the natural tooth whenever possible. Therefore, if a previously treated tooth has not healed successfully, retreatment of the root canal should be considered before proceeding with surgery.
In cases where retreatment successfully eliminates the infection, surgical intervention may no longer be necessary. However, if the infection persists or the root canal cannot be accessed due to anatomical limitations, apical resection becomes an appropriate treatment option.
Can Apical Resection Be Performed on Any Tooth?
As long as the patient's jaw anatomy and the position of the tooth are suitable, root-end resection can be performed on anterior teeth, canines, premolars, and many molars.
In certain cases, the anatomy of the tooth or the extent of the infection may make surgery more challenging. Under such circumstances, the dentist may consider alternative treatment options or recommend tooth extraction if necessary.
How Is Root-End Resection Performed?
Apical resection is generally performed under local anesthesia, allowing the patient to remain comfortable and pain-free throughout the procedure.
The treatment process consists of the following stages:
Examination and Imaging
The procedure begins with a panoramic X-ray for an overall assessment. If necessary, three-dimensional CBCT imaging is obtained. These images allow detailed evaluation of the infected area, root structure, and surrounding tissues.
Local Anesthesia
Before surgery, the treatment area is numbed with local anesthesia to ensure patient comfort.
Creating a Gum Flap
A small flap is made in the gum tissue to gain access to the root tip.
Removal of Infected Tissue
The cyst, granulation tissue, or infected tissue is carefully removed.
Resection of the Root Tip
A few millimeters of the infected root tip are surgically removed.
Retrograde Filling
The root canal is sealed from the root end using specialized filling materials. This helps prevent bacteria from re-entering the area.
Suturing
At the final stage of the procedure, the gum tissue is repositioned, sutures are placed, and the surgery is completed.
Depending on the complexity of the case, the procedure typically takes between 30 and 90 minutes.
Recovery After Apical Resection
Mild pain, swelling, and tenderness are considered normal after the procedure. Swelling generally reaches its peak within the first 48 hours and gradually subsides over the following days.
During the first few days, patients may experience:
• Mild aching pain
• Sensitivity while chewing
• Minor bruising around the surgical area
• A feeling of tightness in the gum tissue
Soft tissue healing usually occurs within one to two weeks, while complete bone healing may take several months.
What Should Be Considered After Apical Resection?
To ensure long-term treatment success, patients should carefully follow postoperative instructions:
• Take all prescribed medications regularly to reduce the risk of infection and promote healing.
• Avoid hot foods and beverages completely on the first day.
• Apply cold compresses to the surgical area as instructed by your dentist.
• Avoid hard, crunchy, and crusty foods during the healing period.
• Refrain from smoking and consuming alcohol.
• Avoid movements that may cause trauma to the surgical site.
• Maintain good oral hygiene.
• Do not miss scheduled follow-up appointments.
For most patients, sutures are removed within 5 to 7 days.
What Are the Advantages of Root-End Resection?
The primary advantage of apical resection is that it allows the natural tooth to be preserved without extraction. In addition, it may:
• Eliminate the source of infection.
• Reduce pain and swelling.
• Help prevent the progression of jawbone damage.
• Delay the need for more extensive treatments such as dental implants or bridges.
• Contribute to preserving the natural tooth structure.
Where Can You Get Root-End Resection in Adana?
In Adana, root-end resection is performed by dentists experienced in endodontics and oral surgery. Treatment planning can be carried out with greater precision in clinics equipped with advanced imaging systems and modern surgical technology. At Dentrum Adana Private Oral and Dental Health Polyclinic, the first step is to determine whether the tooth can be preserved through root canal retreatment. If retreatment is not appropriate, apical resection is planned to preserve the patient's natural tooth whenever possible.
Personalized treatment plans can be developed for patients visiting from Adana, Seyhan, Çukurova, Sarıçam, Yüreğir, and surrounding areas.
How Are Root-End Resection Costs Determined in Adana?
The cost of apical resection varies from patient to patient. Treatment fees depend on factors such as:
• The extent of the infection,
• The location of the affected tooth,
• The complexity of the surgical procedure,
• The surgical techniques required,
• Imaging requirements,
• The materials used,
• The dentist's experience and the clinic's technical facilities.
For this reason, an exact treatment cost can only be determined after a comprehensive clinical examination and radiographic evaluation.
Root Tip Resection Hakkında Sıkça Sorulan Sorular
No. Since the procedure is performed under local anesthesia, you will not feel any pain during the operation. Any mild pain or sensitivity that may occur after treatment can usually be easily managed with pain relievers recommended by your dentist.
Patients who undergo this treatment can return to their daily lives quickly. However, it is recommended to avoid strenuous physical activities for the first few days.
In appropriate cases, apical resection is an effective treatment method that can help teeth at risk of extraction remain in the mouth for many years.
Soft tissues generally heal within one or two weeks. Complete healing of the bone tissue, however, may take several months.
Yes. It is necessary to attend follow-up appointments scheduled by the dentist to monitor the healing of the treated area.