Apical surgery, which also goes by the term apicoectomy, is a specialized endodontic procedure that is specifically designed to remove the apex, or the tip of a tooth’s root and its surrounding infected tissue. This medical intervention is performed when infection occurs or a conventional root canal operation fails to heal in a timely manner.
Contemplating if the said procedure is for you or otherwise? Well, if you are having second thoughts, you would be happy to know that technological advancements have significantly revolutionized the way the said surgery is performed. These technologies have drastically improved precision, success rate, patient comfort, and so on.
Let’s take a look into the important role that technology plays in enhancing modern-day apical surgery.
Enhanced visualization
Cutting-edge medical equipment such as surgical microscopes have remarkably improved the said dental procedure. At present, surgical operating microscopes are backed by high magnification features–some up to 20x or more–and enhanced illumination. This dramatically boosts an endodontist’s ability to see body parts in clear detail and allows for precise identification of root anatomy, fractures, and infections, among others. Something that was extremely difficult to detect decades ago.
Technological advancements also paved the way for micro-cone beam computed tomography or micro-CT scans that are used to create a 3D view of the patient’s root apex. With this, an endodontist can have an idea of anatomical complexities, the extent of infection, and hidden canals. Consequently, he or she can plan an approach that centers on efficiency, safety, and everything in between.
In addition to all these, high-resolution intraoral cameras also allow endodontists to capture extensively detailed images of the surgical site evaluation. This aids treatment planning, outcome assessment, and so forth. The said cameras are used hand in hand with practice management software: radiograph integration, digital charting, and patient recording. All these play a key role in streamlining surgical procedures and, at the same time, improving data management.
Minimally invasive procedures
Cutting-edge equipment such as ultrasonic instruments have made apical surgery procedures less invasive. The said devices use high-frequency vibrations to effectively cut bone, expel pathological tissue, and remove unhealthy tissues with minimal incisions.
The exceptional precision of the said instruments is beneficial when it comes to safety because they allow endodontists to access the apical root region minus the damage in the bone as well as soft issues. Furthermore, ultrasonic instruments are valuable in the preparation and debridement of the root-end cavity for filling. This enhances the cleanliness of the surgical area.
As straightforward as it may seem, it should be noted that sanitation of the surgical site can make or break the success of the said surgery.
Regenerative methods
It is safe to say that regenerative endodontics, a biologically based procedure that is specifically designed to replace damaged structures, e.g., root structures, dentin, etc., has found its way into apical surgery. This is via the use of growth factors, guided tissue regeneration, stem cell therapy, and so forth.
The aforementioned methods are performed to regenerate periapical tissues as well as bone rather than just employing treatment to the existing pathology. In the process, medically approved techniques like the application of platelet-rich plasma (PRP) or platelet-rich fibrin (PRF) are performed in an effort to boost healing. How? By releasing growth factors that effectively and efficiently promote tissue regeneration.
Also, the utilization of bioresorbable membranes in guided tissue regeneration (GTR) methods isolates the surgical site and, in a way, provides some sort of a scaffold for new bone growth. This further advances the success rate of the said surgery.
Advanced biomaterials
The development of highly advanced biomaterials like Mineral Trioxide Aggregate (MTA) as well as bioceramics have drastically improved root-end filling because of their superior sealing ability and biocompatibility. These biomaterials not only deliver an exceptional barrier against bacterial penetration, they also enhance the healing process by encouraging tissue regeneration. Their use in conjunction with regenerative methods has paved the way for, say, new avenues for post endodontic surgery healing.
CAD/CAM for incision and osteotomy
Computer Aided Design (CAD) and Computer Aided Manufacturing (CAD) are technologies that are common in the industrial sector and they have found themselves in the restorative dentistry field. They are now used to create 3D models of the anatomy of patients and allow for precise planning as well as execution when it comes to surgical incision and osteotomy.
This level of precision cuts down or eliminates the risk of inflicting damage in the adjacent structures and, in the process, ensures optimal installment of root-end fillings. All these also heighten the level of safety and efficiency of apical surgeries.
Summing up
In the end, it can be said that cutting-edge technologies have drastically improved and redefined the apical surgery field. They have elevated standards of efficiency, care, safety, and basically everything in between.