An apisectomy is a surgical procedure that places a filling at the end of the root and removes any infected tissue from around the tip. Its aim is to contain any bacteria that may be remaining totally within the canal system.
It may be performed in the following circumstances:
- Root perforation- where during tooth preparation instruments have pierced the side of the root.
- Persistent inflammation and infection remains due to a cyst.
- The tip of the root has been fractured due to trauma and has become infected.
- Where a post crown is in place and the tooth is problematic– removing posts is very difficult and can often lead to fracture of the root and the tooth being lost. An apisectomy leaves it undisturbed.
- Fractured instruments in the canal that cannot be filled around adequately and appropriately.
- Difficulty in performing the conventional root treatment due to a closed or very curved canal.
What is the procedure for an apisectomy?
A flap is raised, and a bony window cut so the surgeon can see the tip of the root. All infected tissue around the tip of the root is then removed, the area cleaned and a filling known as a’ retrograde filling’ is placed to seal the end of the root before stitches are placed to replace the gum in its original position. The filling material is commonly amalgam or MDA.
