Some patients present lesions in the maxillary bone or mandible around one or several roots that grow destroying the support bone of the tooth and are responsible of pain and infections. These lesions are called granulomas and periapical cysts and its origin it’s in a chronic dental infection.
These lesions have a small size, less than a centimeter, and the treatment is done by your odontostomatologist by a root canal of the causal tooth. Usually the root canal fixes the problem, although it doesn’t occur in all cases.
When the root canal doesn’t cure the lesion, it’s recommended to repeat the root canal. If this doesn’t control the evolution of the lesion, it would be indicated a periapical surgery.
The periapical surgery consists of the surgical extraction of the lesion that is at the end of the tooth root, next to the section of the end of the root (about 3mm). Usually is accompanied by a small preparation of the end of the cut off root and the sealing off it with an amalgam or special cement.
The ideal candidates for this procedure are people with a periapical lesion that hasn’t responded to two root canals of the tooth or anatomical anomalies in the root of the tooth that prevent the root canal to suitably seal the root tip. In these occasions the rebuilding of the tooth needs the collocation of a bolt or casting posts that can lift up to try a root canal again.
This procedure is done under local anesthetic. The dentist removes the localized lesion at the end of the root, removes the end of it (apicoectomy) and seals the remaining root. Finally the incisions are sutured and a control X-ray is made.