Dental Procedure: Orthograde Root Tip Resection

Grafik einer orthograden Wurzelspitzenresektionbelsky

orthograde Wurzelspitzenresektion

Root tip resection with orthograde filling refers to the surgical removal of a root tip and the cleaning of the tooth canal from working from the crown area.

A root tip resection is performed on the root tip when a patient is suffering from chronic bone inflammation. You can find out how this happens in the video entitled "Root Resection". In the film "orthograde root tip resection" you see a patient who fell years ago and injured the left frontal incisor. He did not visit the doctor and over the years he observed tooth movement away from the center line as well as dark discoloration. The tooth nerve was damaged during the fall and “died”.

The rotting tissue caused an inflammation in the bone, specifically on the root tip, and led to cyst formation. The tooth has already been opened from behind and next follows the gum edge cut and the mucosa lobe preparation. Using a rose grinder, the bone is removed above the root tip, exposing the cyst. The cyst and the cyst content is cleaned out with a special spoon.

Now the root tip is cut and removed. Next, you see another instrumental root canal cleaning. The area is repeatedly flushed with special solutions in order to remove tooth particles and tissue residue that were cut off during the grinding process. Lastly, the canal is dried with a paper tip and the cleaned canal is filled with sealing cement again.

However, since the cement contracts during the hardening process and potentially creates subsequent micro fissures (potential entry points for bacteria), the cement is kept as thin as possible with the help of a bar. A narrow cement gap means less contraction and smaller leakages.

Surpluses are removed after the hardening process and the opening is once again cleaned. At the end of surgery, bone substitute material is inserted because the defect was rather large. This should only be done if there are no inflammation symptoms present and the defect can be properly cleaned. Finally, the mucosa is sutured and the surplus is removed. The tooth is then sealed tightly from behind.

Seam removal is done after a week and x-ray control is every 6 months. If everything was successful, bone will rebuild around the root tip. This is a root tip resection with an orthograde filling.

An alternative to this surgery would be tooth extraction.

Risks associated with root tip resection are negligible if performed by an experienced surgeon. However, there can be complications in isolated cases that may require additional measures. Any additional measure required can then lead to further complications; these can eventually become life-threatening.

This post is also available in: German

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