Tooth preservation
Root tip resection (WSR)
Treatment of inflamed or
infected root tips
Root canal treatment with maximum precision
We treat tooth root inflammation with state-of-the-art procedures
An apicoectomy is a special dental procedure to treat inflamed or infected root tips and preserve the tooth. This precise and effective method offers a solution when conventional root canal treatments are not enough. Find out more about the process, the benefits and how it can help you here.
Everything at a glance
Table of contents
Treatment of inflammation
What is an apicoectomy?
Root tip resection (WSR) is characterized by the fact that the treating dentist removes both the inflamed root tip and the inflamed tissue under (local) anaesthetic. Before or during the operation, the diseased tooth is filled with a root canal filling, followed by a bacteria-proof seal using a filling.
As a proven surgical procedure, apicoectomy is often the last option for preserving a tooth that is inflamed at the root tip. Depending on the problem, we perform retrograde or orthograde apicoectomy on teeth that are worth preserving. Health insurance companies generally cover the treatment for front and side teeth.
Retrograde or orthograde apicoectomy
When is apicoectomy useful?
Caries as the main cause
Cause of an inflamed root tip
An inflamed root tip is almost always preceded by caries, which successively penetrates the inside of the tooth and causes damage there. Bacteria enter the root tip and provoke pain. If a root tip becomes inflamed, in the worst case the infection can even spread to the surrounding bones, soft tissues of the face or even enter the bloodstream. In some patients, the fact that the root tip is inflamed is preceded by one or more unsuccessful root canal fillings. The WSR then offers the last chance to "save" the affected tooth.
Before an apicoectomy, technical aids such as a 3D X-ray (DVT) are used to determine whether the surgical procedure is at all sensible and feasible. The prerequisite is that the identified tooth with the inflamed root tip is worth preserving. Preservable means that the bones are not too badly affected by the inflammation and thus irreparably damaged.
We provide you with professional advice:
Diagnostics and determination of suitability for conservation
Only with a remaining basic stability can the tooth fulfill its function when eating and chewing for several more years. If the jawbone no longer provides sufficient support due to the consequences of severe inflammation, it makes more sense to extract the tooth. We carefully and transparently communicate the individually recommended treatment approach to our patients on the basis of precise dental diagnostics.
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Painless implementation
WSR under local anesthesia
Hardly any patient forgoes the opportunity to have the procedure performed with as little pain as possible. As part of the usually outpatient treatment, a local anesthetic is administered to ensure that there is no pain during the apicoectomy. Alternatives are additional nitrous oxide sedation or general anesthesia with intubation.
In local anesthesia, the anesthetic is usually injected with a syringe in the immediate vicinity of the tooth region to be treated. However, quite a few people feel discomfort when the anesthetic injection is given. The reason for this is the comparatively high pressure with which the anesthetic is injected into the tissue. The individual reactions range from neutral to a feeling of pressure to a slight sensation of pain.
Instead, we use an ultra-modern and very gentle procedure that makes anesthesia for apicoectomy as patient-friendly as it is efficient: computer-controlled single tooth anesthesia (STA). The microprocessor ensures both gentle and precise dosing. There is no unpleasant sensation of pressure or numbness in the nearby regions. We therefore offer all patients who are afraid of injections the opportunity to be anesthetized without any problems.
If a root tip resection (WSR) is indicated, the surgical procedure is performed from the side through the gum in the following steps:
Treatment procedure
How does apicoectomy work?
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1. local anesthesia, in rare cases general anesthesia is recommended.
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2. separation of the gums and periosteum of the affected tooth.
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3 To ensure visibility of the root apex, the dentist folds back the nearer tissue.
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4 The jawbone is then removed until the root tip is clearly visible.
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5. shorten the root of the tooth by two to three millimeters.
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6. removal/ablation of all inflamed tissue.
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7. disinfection of the tooth.
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8 The treated tooth is provided with an appropriate filling.
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9. folding back the tissue and suturing the wound.
With regard to WSR, a distinction must be made between retrograde and orthograde root filling procedures.
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Orthograde root filling for root tip resection
No root canal treatment was carried out prior to the procedure in the case of WSR with orthograde root filling. The root canal of the aching tooth therefore has no filling. In addition to the described lateral access to the root of the tooth and its removal, the root canal is also treated from above via the crown of the tooth as part of the treatment. To ensure that the canal expanded by the dentist is subsequently germ-free, it is dried and disinfected in accordance with current hygiene standards. The final step is the complete closure of the duct. This seal ensures that bacteria can no longer penetrate the tooth and cause problems or inflammation.
A root canal restoration with retrograde root filling is characterized by the fact that one or more root canal treatments have already been performed on the diseased tooth in the previous period. The patient's root canal therefore has a filling, but this has not led to the symptoms subsiding. Rather, a focus of inflammation has manifested itself under the canal: The root tip is inflamed and causes tooth and/or jaw pain. During retrograde apicoectomy, the root canal is widened from the shortened end. The dentist then places bioactive filling material in the canal and removes the focus of inflammation and root during the procedure.
We provide you with professional advice:
Retrograde root filling during apicoectomy
Root tip resection
Questions on the topic
Normally, you should assume that an apicoectomy will take about 30 minutes. Of course, we will inform you if the required treatment time differs from this. Both the degree of difficulty of the treatment and the length of the tooth play a role here - both factors can increase the amount of work required. The time information thus serves as an initial orientation so that you can better plan the procedure and time window on the day of treatment.
Comparison:
Root canal treatment versus apicoectomy (WSR)
Root canal treatment
Root tip resection
Type of intervention
dental
Surgical
Access to the tooth / root
from the inside over the tooth crown
from the outside through the gums
Prerequisite
Tooth must be worth preserving
Tooth must be worth preserving
Tooth preservation
Yes
from the outside through the gums
With regard to the costs of apicoectomy, please note that the statutory health insurance only covers the costs if the tooth to be treated is worth preserving. In addition, health insurance companies will pay for this surgical treatment if the teeth are diseased in the anterior or posterior region. As a result, molar apicoectomy is generally only covered by health insurance in special situations. For example, in cases where the tooth is in a complete row of teeth without a gap. The costs are also covered if the WSR prevents a row of teeth from being shortened backwards on one side. Or if the apicoectomy ensures that an existing denture is retained. We will be happy to provide you with further information and an overview of costs and possible alternatives in a patient consultation.
Health insurance and co.
Root tip resection - costs and assumption of costs
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Please contact us if you have any questions
Toothache, visits to the dentist and the indicated methods of treatment are always a sensitive subject. We take your needs and your individual well-being very seriously. We are therefore happy to respond to our patients' questions and concerns. Please use the contact options listed for brief questions; we will be happy to clarify challenging issues together in a confidential patient consultation.
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Benefit from our additional services
In addition to high-quality dentistry, we offer a comprehensive range of services on request to make your visit to us as pleasant as possible.
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SMS notifications
for reminders about check-up and prophylaxis appointments
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Digital dental impression
for fast fabrication of precise dental prostheses in 2 hours.
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Own laboratory on site
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Long opening hours
for more flexibility when booking appointments
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