Apicaectomy

Apiceactomy also called as root resection or root amputation is the ablation of the apically infected portion of the tooth and curettage of all periapical necrotic and inflammatory tissue.

INDICATIONS
 
  • Maxillary or mandibular anterior teeth with periapical infection.
  • Teeth in which the destruction of the investing alveolar bone does not extend over one third the length of the root.
  • Teeth with apical resorption.
  • Teeth with well circumscribed periapical granular tissue.
  • Tooth in young patients which is an etiologic factor in the production of radicular cysts or    which has been devitalized by extension of cysts.
  • Teeth in which root have been fractured by trauma.
CONTRAINDICATIONS
  • When general health of the patient is below par especially those who have had    rheumatic fever or are suffering from rheumatism, nephritis, diabetes, cardiac disease,    thyrotoxicosis.
  • In teeth with deep periodontal pockets and excessive mobility.
  • In cases where tooth approximates important anatomic structures.
  • In inaccessible areas.
  • In cases where it is necessary to remove too much tooth structure.
  • When traumatic occlusion cannot be corrected.
REASONS FOR FAILURE
  • Improper selection of teeth.
  • Negligence of pre operative measures.
  • Operation of tooth with partial root filling without refilling the canal.
  • Faulty technique.
  • Lack of surgical asepsis.
  • Removal of tooth along with the cortical plates. This retards healing as there is an    opening created.
  • Traumatic occlusion.
  • Failure to incise properly, this prevents good visibility of the field.

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