Zubi se održavaju na mestu pomoću korena koji se nastavlja u viličnu kost. Prednji zubi obično imaju jedan koren. Ostali zubi, kao što su pretkutnjaci i kutnjaci, imaju dva ili više korena. Kraj ili vrh svakog korena naziva se apeks. Nervi i krvini sudovi preko njega ulaze u zub. One putuju kroz kanal unutar korena do pulpe. To je komora unutar krunice zuba (deo zuba koji možete videti u ustima).

Apikotomija predstavlja hirurški zahvat kojim se uklanja vrh korena nekog zuba, zajedno sa patološkim procesom (inficiranim tkivom) koji se nalazi na njemu.

Postupak apikotomije je siguran tretman i u najvećem broju slučajeva predstavlja potpuno uspešan postupak. Sam postupak podrazumeva i obavezno punjenje kanala korena biokompatibilnim materijalom.

Celokupni hirurški rad prolazi kroz nekoliko faza.

U prvoj se pravi rez na sluzokoži. Kako postoje različite metode izvođenja ove operacije, to će i lokalizacija ovog reza zavisiti od odabrane metode. Kada se načini rez, podigne se sluzokoža i periost (površinski deo kosti), koji se jednim imenom označava kao režanj.

Kada se podigne režanj, postepeno se uklanja kost, kako bi se omogućio pristup vrhu korena i procesu na njemu. Kada se omogući pristup, uklanja se proces (inficirano tkivo), sa naročitom pažnjom na to da se ukloni u potpunosti, jer bi ostaci doveli do ponovne pojave istog procesa (recidiva).

Nakon uklanjanja procesa, pristupa se skraćivanju korena zuba. Resekcija (skraćivanje) se obavlja pod uglom od 0° do 45° u odnosu na horizontalnu ravan.

Na kraju se vrši punjenje kanala, čime se omogućava potpuno hermetičko zatvaranje kanala korena. Punjenje se najčešće vrši kroz krunu zuba, dok se, u nekim slučajevima, to mora učiniti preko vrha skraćenog korena zuba. Posle obavljanja svih potrebnih postupaka za punjenje kanala korena i posle uklanjanja svih zaostalih čestica, pristupa se krajnjoj inspekciji, kao i vraćanju režnja na svoje mesto i njegovo ušivanje.

Ceo postupak traje od 30 do 90 minuta. Dužina zavisi od lokacije zuba i složenosti strukture korena. Procedure na prednjim zubima su obično najkraće, a one kutnjacima obično traju najduže. Po završetku Vaš stomatolog će Vam reći koje lekove treba da uzimate, i šta možete da jedete i pijete. Trebali bi stavljati led na to područje 10 do 12 sati nakon operacije, i odmarati se u istom razdoblju.

Pogledajte demonstracioni video na engleskom jeziku:

 

Izvori:

Consumer Guide to Dentistry

Simple Steps to Better Dental Health


 

Your teeth are held in place by roots that extend into your jawbone. Front teeth usually have one root. Other teeth, such as your premolars and molars, have two or more roots. The tip or end of each root is called the apex. Nerves and blood vessels enter the tooth through the apex. They travel through a canal inside the root, and into the pulp chamber. This chamber is inside the crown (the part of the tooth you can see in the mouth).

During root canal treatment, the canals are cleaned. Inflamed or infected tissue is removed. An apicoectomy may be needed when an infection develops or won’t go away after root canal treatment or retreatment.

A root end surgery, also known as apicoectomy (L. apex, apicis: a summit or a tip), is an endodontic surgical procedure whereby a tooth’s root tip is removed and a root end cavity is prepared and filled with a biocompatible material.

In an apicoectomy, the root tip, or apex, is removed along with the infected tissue. A filling is then placed to seal the end of the root. Before the procedure, you will have a consultation with your dentist. Your general dentist can do an apicoectomy. However, with the advances in endodontic microsurgery, it is best to be referred to an endodontist. Apicoectomies also are done by oral surgeons.

Before the surgery, your dentist may take more X-rays of the tooth and surrounding bone. You may be given an antimicrobial mouth rinse, a medicine to reduce inflammation, and/or antibiotics.

The endodontist will cut and lift the gum away from the tooth to gain access to the root. The infected tissue will be removed along with the last few millimeters of the root tip. The endodontist will use a dye to highlight cracks and breaks in the tooth. If the tooth has large cracks or breaks, it may have to be extracted. In this case, the apicoectomy will not continue.

To complete the apicoectomy, the endodontist will clean and seal the end of the tooth’s canal. The cleaning usually is done under a special microscope using ultrasonic instruments. The light and magnification allow the endodontist to see the area clearly. This increases the chance that the procedure will succeed. The endodontist then will take an X-ray of the area before stitching the tissue back in place.

Most apicoectomies take 30 to 90 minutes. The length will depend on the location of the tooth and the complexity of the root structure. Procedures on front teeth are generally the shortest. Those on lower molars generally take the longest.

Your endodontist will tell you which medicines to take and what you can eat or drink. You should apply ice to the area for 10 to 12 hours after the surgery, and rest during that time.

Demo video:

Sources:

Consumer Guide to Dentistry

Simple Steps to Better Dental Health