Root tip surgery (apex resection)
What is an apex treatment:
An apex resection or root tip surgery is a jaw surgical treatment in which the root tip is shortened and the inflamed tissue is removed. After shortening the root tip, the underside of the root canal will be cleaned and closed with a new filling. It is important that prior to an apex resection, a dentist (endodontologist) has performed a root canal treatment at least once.
The treatment:
• The treatment takes place under local anesthesia.
• Then a small incision is made in the gums at the site of the tooth to be treated.
• Then the gums are opened, after which the root tip and the inflammation are removed with a drill.
• The shortened root tip is ultrasonically cleaned and sealed with filling material.
• The wound is closed with a number of self-soluble sutures.
• After the treatment, a control photo is taken.
• After half a year, a check-up will take place including a X-ray.

Risks:
• Unfortunately, an apex resection does not have a complete certainty of success. In general, the success rate of the treatment is between 70 and 90% depending on the condition of the element.
• In the lower jaw it may be that the root tip is near the sensory nerve of the lip and chin. In exceptional cases, this nerve can be damaged,which leads to a (temporarily) numb tingling sensation of the lip and or chin on that side.
• In the upper jaw, it may be that the root tip is near the bottom of the nasal sinus (maxillary sinus).
During the treatment, there is a chance that there will be a connection to the nasal sinus. Afterwards, you will be asked not to blow your nose for the first two weeks. If the connection to the nasal sinus. Afterwards, you will be asked not to blow your nose for the first two weeks. If the connection to the nasal sinus is not closed, this can lead to nasal sinusitis.
After treatment:
Any complaints during the first week can be:
1. Pain.
2. Swallowing complaints and a limited mouth opening.
3. A general feeling of being sick with an elevated body temperature.
4. A swelling in and outside the mouth, especially in the morning this swelling can be significant.
Removal of gauze/bleeding:
After some treatments, a gauze pad is applied to the wound. The gauze should be kept on the wound area with some pressure for half an hour. If the wound bleeds again at home, you can fold a gauze, napkin or handkerchief and press it on the wound area for another half hour. It is normal that the first days there is a little (old) blood in the saliva. If the bleeding does not stop, record contact by telephone.
Anesthesia and painkillers:
The anesthetic slowly works out after two to four hours. Until the anesthetic has worn off, it is wise not to eat or drink anything to prevent fire and bite wounds.
Pain:
After working out the anesthetic, you may experience pain. This pain can last for a week. You have received a prescription with painkillers from the doctor, have it according to instruction. Good pain relief for adults consists of two components: firstly, a good paracetamol level should be built up by using 1000 mg paracetamol at least four times a day. This may also be reinforced with the prescribed painkiller (if applicable).
Wound healing:
For a good healing of the wound, it is very important that you:
1. does not rinse or spit for the first 24 hours.
2. brush the teeth normally, with the exception of the wound area.
3. does not smoke for the first week and uses alcohol moderately.
4. use any prescribed oral polynative from the day after the procedure.
When to contact Haaglanden Clinics: Root tip surgery (apex resection)
1. When swelling increases after five days.
2. With fever above 39 degrees.
3. In case of bleeding that does not respond to 60 minutes of pressure with a gauze, napkin or handkerchief.
4. in case of a permanent numb feeling in the chin, lip or tongue.
Call for contact with Haaglanden Clinics From Monday to Friday from 08:30-12:00 and from 13:00-16:30 with 070 221 21 21.
For contact outside these working hours and if there are urgent complaints, call the general number of the Haaglanden Medical Center: 088 979 79 00.
You clearly indicate that you have been treated by an oral surgeon from Haaglanden Clinics and that there are agreements that you will be assisted by the HMC for aftercare.