Alternatives to apicectomy
If the tooth causes severe pain and dental treatment no longer helps, the cause of the pain is usually one inflammation deep in the Root tips. A resection, i.e. removal of the root tips, is performed to remove deeply 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?
Resection of the root tips is the last option in most cases to preserve a tooth. Alternatively, the tooth is often extracted.
Since the molars have more roots than the front teeth and the dentist usually has a harder time accessing 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, the pain may persist despite a root filling and the foci of inflammation in the depths of the roots are greatly enlarged. In such cases it must be considered whether a successful apicectomy can be performed to preserve the tooth or whether the tooth needs to be extracted.
Alternatively, a tooth that has already been treated with a root canal could be revised, i.e. refilled, or the tooth that was treated with a tip resection could then be crowned. There are alternatives associated with extraction of the tooth 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 options can replace your own tooth. It must be decided individually for each patient which type of alternative treatment options and restorations are suitable for a denture.
An alternative to the conventional one Root canal treatment represents a treatment by means of laser. The light of the laser has a bacteria-killing and disinfecting effect due to the action of heat and, by being introduced directly into the inflamed root area, it can fight the inflammation locally. This makes it easier to eliminate bacteria deep down than with disinfecting rinsing solutions, as bacteria tend to sit in small joints that are difficult to reach using conventional methods.
Another advantage is the time saved through faster treatment. After cleaning with the laser, a normal root filling is carried out to seal the cleaned root against pathogens and to prevent further or new infections.
The implant is a common means of choice after a tooth could no longer be preserved and had to be extracted. The prerequisite for the successful insertion of an implant is, among other things a well-preserved bone. If the inflammation has existed for a long time and has already ingested and damaged a lot of the bone, an implant is often not an option.
However, if the jawbone meets the requirements and is stable enough in the affected area, a screw, usually made of titanium, is screwed in. This now represents the anchorage in the bone. This task is taken over by the root in a healthy tooth. Now a crown that matches 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 high and are not covered by health insurance companies. If the tooth has to be extracted because the inflammation is already too strong and too extensive to preserve the tooth, it is very important to wait some time before further treatment measures. Before an implant can be placed, for example, the inflammation must have completely disappeared. Otherwise, the risk of re-inflammation is enormous.
A bridge that is constructed across a tooth gap consists of two bridge abutments and a connecting link. If teeth can no longer be saved, fixed bridges often serve as a way to preserve the chewing function and aesthetics. The teeth are prepared and can serve as bridge abutments. Since, like the implants, they are part of the so-called fixed, non-removable dentures, they are usually the method of choice alongside the implants.
The function when chewing is as good as with healthy teeth. Compared to a bridge, a prosthesis does not guarantee this. The bridges can be made of white ceramic or metal veneered with plastic and therefore also meet the requirements aesthetic demands. Oral hygiene is very important here. Brushing your teeth several times a day and using interdental brushes is a prerequisite for maintaining the bridge in good condition for approx. 10 years.
There are different types of bridge constructions. It has to be decided individually for each patient which construction is suitable. The bridges can be constructed on natural teeth or on implants as artificial tooth roots for anchoring in the jawbone.
Root canal revision
Often there is severe inflammation in the area of the roots of teeth that have already received a root canal filling. The patients usually feel no pain or have other complaints. Nevertheless, the inflammation in the area of the root must be removed. The reasons for such a chronic inflammation in teeth that have been treated with root canals are often leaky or insufficient fillings of the root canals.
Read more on the topic: Root canal treatment process
In these cases, the filling must be removed and the root canal cleaned again and all inflammation removed. The remaining bacteria, which causes inflammation in most cases, are eliminated and the root canal is refilled. This process is known as root canal revision. The renewed adequate filling of the root canals is equivalent to a normal root canal filling. All previously existing cavities are sealed and the risk of re-ignition is minimized.
Read more on the topic: Treatment of root inflammation
Prostheses are removable dentures. Missing teeth are replaced by plastic teeth. On the one hand, they lie directly on the gums and, on the other hand, they gain hold from being supported on other teeth. There are also different types of prostheses here. If no more teeth can be preserved, e.g. by root syringe resection, and the jaw is completely toothless, it is called a full denture.
If there are still several natural and healthy teeth in the jaw, they are supported on them and this is called a partial denture. The gaps created by pulling the teeth are replaced by plastic teeth. So-called transitional prostheses are often created as a further option. These are worn for a maximum of 6 months and are used to cover and protect a wound caused by a tooth extraction. The advantages of prostheses, especially for older patients, are above all that they are easy to clean and that they are easy to use thanks to their targeted insertion and removal.
But many patients fear the idea of seeing their own gaps in their teeth. Fixed dentures with implants, bridges and crowns are always advisable for individual gaps or young patients, provided the conditions in the jaw and oral cavity permit.
Read more on the topic: Denture