Alternatives to a root tip resection


If the tooth causes severe pain and no dental treatment helps anymore, the cause of the pain is usually an inflammation deep down at the root tips. A resection, i.e. a removal of the root tips, is performed to remove deep-seated inflamed tissue in the area of the root tip. The aim is to keep the tooth functional and to seal the root canal against bacteria in order to prevent further spread of the inflammation.

What alternatives are there?

The resection of the root tips is in most cases the last option to preserve a tooth. Alternatively, the tooth is often extracted. Since the molars have several roots compared to the front teeth and the dentist usually has less access to the former, the chances of a successful treatment are higher with front teeth than with molars.

In many cases the affected teeth have already been treated in their root canals. Nevertheless, it is possible that the pain persists despite a root filling and the focus of inflammation in the depth of the roots is greatly increased. In such cases it must be considered whether a successful apicoectomy can be performed to preserve the tooth or whether the tooth must be extracted.

Alternatively, a tooth that has already been treated in the root canal could be revised, i.e. filled again, or the tooth treated with an apicoectomy could be crowned afterwards. Alternatives associated with an extraction of the tooth are implants, bridges or prostheses in the resulting gap area. The advantage of an extraction is that the inflammation can be completely removed.

However, none of the above mentioned options can replace the own tooth. It must be decided individually for each patient which type of alternative treatment and restoration options are suitable for a dental prosthesis. An alternative to conventional root canal treatment is laser treatment.

The light of the laser has a bactericidal and disinfectant effect due to the heat effect and can, by being applied directly into the inflamed root area, fight the inflammation locally. This makes it easier to eliminate the bacteria deep down than with disinfecting rinsing solutions, as bacteria like to sit in small joints that are difficult to reach using conventional methods. A further advantage is the time saved through more rapid treatment.

After cleaning by laser, a normal root filling is performed to seal the cleaned root against pathogens and prevent further or renewed infections. The implant is a frequent means of choice after a tooth could no longer be preserved and had to be extracted. One of the prerequisites for the successful insertion of an implant is a well preserved bone.

If the inflammation has persisted for a long period of time and has already taken up a lot of the bone and damaged it, an implant is often not an option. However, if the jawbone meets the requirements and is stable enough at the affected area, a screw, usually made of titanium, is inserted. This now represents the anchorage in the bone.

The root takes over this task in healthy teeth. Now a crown matching the remaining teeth can be selected and then screwed on to close the gap. An implant cannot completely replace a healthy tooth.

In most cases, however, it is the preferred treatment option, although the costs are comparatively very high and are not covered by health insurance. If the tooth has to be extracted because the inflammation is already too severe and too extensive to preserve the tooth, it is very important to wait some time before further treatment measures are taken. Before an implant can be placed, for example, the inflammation must have disappeared completely. Otherwise the risk of a new inflammation is enormously high.