There are cases where surgery is required to remove a persistent lesion (abscess) that has developed over time around the end of the root of the tooth. This is generally advised only if the root canal treatment has been completed to a high standard or retreatment of the root canal is not posibble due to an obstruction in the tooth.
The procedure involves making the area numb with an anaesthetic, the gum will be raised to access the end of the root. The lesion (abscess or cyst) is then scraped out/ removed and an extra filling (medicament) is placed at the end of the root.
Any queries or concerns regarding this procedure will be answered at the consultation appointment and if needed, a sedation option can also be discussed.
Decompression- The lesion at the end of a tooth can sometimes be quite large due to compression of the fluid within it and potentially become a cyst. These teeth can usually be effectively treated with root canal treatment and a saline wash of the large cystic space. This space is often left open with a stent and is rinsed with saline every few hours is required to "decompress" this lesion.
This decompression technique allows the analysis of the internal fluid and the lining of the lesion. If there is any uncertainty about the diagnosis then a referral is made to the Oral Maxillofacial Specialist. If the fluid is clear or straw colored and histopathology of the lining is as expected then the decompression procedure is usually sufficient as long as a good root filling is in place.
A regular and thorough check of this is required to ensure the lesion is healing and there is no sign of infection.