Apical Surgery
in Lviv
Guaranteed Comfort
Comprehensive Approach
Personalized Treatment Plan
During the Appointment
Apical surgery (Apicoectomy) is a branch of surgical dentistry specializing in the elimination of inflammatory foci in the area of the tooth root apex (periapical tissues). These interventions are indicated for chronic periodontitis when traditional endodontic treatment is impossible or ineffective: presence of cysts, granulomas, foreign bodies (fragment of instruments, excess filling material) beyond the apex, as well as when quality root canal filling is impossible due to anatomical features or the presence of post-and-core restorations.
The doctor examines the tooth and oral mucosa, assesses the presence of a fistula, tenderness, mobility, the quality of previous endodontic treatment, and reviews the patient's medical history to determine the appropriateness of surgery.
A CBCT scan is performed to assess the size and location of the pathological lesion, bone condition, quality of root canal filling, and proximity to vital anatomical structures.
Based on the examination, the surgical approach is determined: root apex resection, cystectomy, cystotomy, retrograde filling, or other surgical techniques.
The surgical access, extent of resection, method of retrograde filling, and, if necessary, the use of osteoplastic materials are planned.
The patient is explained the plan and duration of the operation, an anesthesia method (local anesthesia or sedation) is selected, and psychological comfort is ensured.
Postoperative recommendations are provided, follow-up examinations and X-ray monitoring are scheduled to assess healing and prevent recurrence.
Apical Surgery: Modern Treatment
1
Modern Apical Surgery
Apical surgery is a branch of surgical dentistry aimed at eliminating chronic inflammatory foci in the area of the tooth root apex (periapical tissues) when traditional endodontic treatment is ineffective or impossible.
2
3D Diagnostics — The Foundation of Precise Planning
A key stage of apical surgery is precise preoperative planning. Before the intervention, we always perform a computed tomography scan. This allows us to virtually assess the size, shape, and exact location of the pathological lesion (cyst, granuloma), its relationship to the root apex, the condition of the surrounding bone tissue, as well as the quality of the root canal filling and the presence of foreign bodies.
3
Root Apex Resection (Apicoectomy)
The most common method of apical surgery is root apex resection — excision of the infected root tip together with the pathological lesion. Our surgeons use specialized microsurgical techniques and a surgical microscope, which allow them to work with jewel-like precision, preserving healthy tissue to the maximum extent.
4
Maximum Comfort During the Surgical Procedure
Understanding that surgical treatment can cause fear, we pay special attention to patient comfort. All interventions are performed under powerful local anesthesia (conduction and infiltration), which guarantees absolute painlessness.
5
Rehabilitation and Long-Term Monitoring
Apical surgery does not end in the operating room. We offer comprehensive patient support at all stages of recovery. After the intervention, detailed individual recommendations and medication therapy (antibiotics, anti-inflammatory drugs, painkillers, antiseptic rinses) are provided to prevent complications and ensure optimal healing.
Indications for Apical Surgery
As part of the surgical treatment of chronic periapical inflammations, the method of apical surgery is most often used when repeated endodontic treatment is ineffective.
The presence of large cysts (radicular, follicular, residual) or granulomas that do not respond to conservative treatment is a direct indication for apical surgery.
In some cases, apical surgery is used for perforations of the root wall in the area of the apex or bifurcation that occurred during endodontic treatment or as a result of a pathological process (caries, resorption).
Patients come to BIOCLINIC in Lviv when they face chronic inflammation at the root apex that does not respond to conservative treatment and wish to preserve their own tooth using the most effective method. During the consultation, the surgeon conducts a thorough examination and a mandatory computed tomography scan to assess the possibility of using apical surgery: the size and location of the pathological lesion, its connection to the root apex, the condition of the bone tissue, the anatomy of the root canals, as well as the proximity to the maxillary sinus or the inferior alveolar nerve.
Types of Surgical Interventions in Apical Surgery
Root Apex Resection (Apicoectomy)
This method is the most common in apical surgery and is used for chronic periapical inflammations when traditional endodontic treatment has proven ineffective. The operation consists of surgical access to the root apex through an opening in the bone tissue, excision of the infected apex (1-2 mm) together with the pathological lesion (cyst, granuloma), and retrograde filling of the root canal with modern biocompatible materials (MTA, composite, glass ionomer cement).
Cystectomy and Cystotomy
Cystectomy is the radical removal of the cyst lining and contents, used for large radicular, follicular, or residual cysts that do not respond to conservative treatment. Cystotomy is the partial removal of the lining with the creation of a communication with the oral cavity, indicated for large cysts or when there is a risk of damage to vital structures.
Retrograde Root Canal Filling
This method is used as the final stage of root apex resection, when the main root canal cannot be qualitatively filled using the traditional method (presence of a post, instrument fragment, significant curvature, or canal obliteration). After excision of the apex, the surgeon forms a small cavity in the terminal part of the canal from the cut side and fills it with a special filling material.
Hemisetion and Crown-Root Separation (Radisection)
Hemisetion is the removal of one root of a multi-rooted tooth along with the adjacent part of the crown when it cannot be preserved. Crown-root separation is the division of the tooth into two parts at the level of the root bifurcation, followed by restoration with separate crowns.
Reviews
Користуюсь послугами клініки вже рік. Завжди дуже приємні лікарі, які готові обслуговувати тривожність перед лікування, та все чітко пояснити.Дуже гарний досвід видалення 8-к попри чутливість до багатьох препаратів та купу страхів.Чістки та лікування також завжди проходило максимально уважно та дбайливо. Лікарка Горбанюк Ірина прибрала чутливість зуба, коли інші стоматологи ,впродовж 2х років, пропонували видалити здоровий нерв.
Дуже дякую пародонтологу Горбанюк Ірині за професійний підхід і турботу! Лікар уважна, все пояснює зрозуміло, лікування пройшло безболісно. Тепер мої ясна в хорошому стані, немає кровоточивості і значно зменшилась чутливість! Рекомендую Bioclinic!
Вже четвертий місяць я регулярно відвідую стоматологію Bioclinic, готуючись до встановлення брекетів)За цей час мені видалили зуби мудрості, пролікували канали та виконали реставрацію передніх зубчиків. Кожен мій візит супроводжувався уважним і турботливим ставленням лікарів-стоматологів, детальним поясненням усіх етапів лікування та відмінною якістю виконаних процедур)Наразі я дуже задоволена сервісом і якістю обслуговування стоматології та можу її сміливо вам рекомендувати👍
Я видаляла зубки мудрості в цій клініці, по рекомендації сестри. І залишилася дуже задоволена, хоча так боялася, мене калатало, бо не люблю стоматологічні процедури. Ми розмовляли з лікарем про весь процес, як все проходитиме, що він робитиме, координував мене у всіх своїх діях, заспокоював своїм спокійним тембром голоса. За годинку у мене вже не стало 2 зубів і стресу, бо після першого зуба, я зрозуміла, що мені взагалі не боляче, і вже тоді заспокоїлася. Все пройшло дуже добре, тому дякую Гедеон Миколі за турботу, і команді асистентів за вашу прекрасну роботу ❤️
Приємно здивована підходом до лікування та спілкування . Лікарі чуйні та уважні до кожної деталі. Чітко все розповідають та розказують про етап лікування . Нічого зайвого ненав'язують .Протягом процедури дуже уважні до пацієнта, все чітко та поетапно розповідають в процесі лікування. Чудова клініка , на найвищому рівні .Дякую , що лікування проходить без стресу та страху ) 😊
Хочу написати слова вдячності всьому персоналу стоматології BIOCLINIC: дякую Вам за теплий прийом та професіоналізм, тут працюю справжні професіонали своєї справи!Якщо хтось так як і я боїться видаляти зуби мудрості ( я вже не боюсь ☺️) , варто звернутись до Тараса Богдановича - не встигнете порахувати до п'яти, як зуб мудрості вже буде видалено 💪довше доведеться чекати поки подіє анастезія, бо зуб він видаляє на раз-два-три 👌.Щиро вдячна за професіоналізм Любомиру Любомировичу , ох і натерпівся він з моїми каналами ...😅
Дякую клініці Bio clinic за професіоналізм і чудовий сервіс! Окрема подяка лікарю Тарасу Богдановичу за уважність і безболісне лікування, протезування .Сучасне обладнання,чистота та доброзичлива атмосферароблять візит комфортним. Щиро рекомендую всім !
Стоматологія «Bioclinic» справляє враження сучасної клініки, де комфорт пацієнта є пріоритетом. Тут панує затишна атмосфера, а привітний персонал одразу викликає довіру. Лікарі – справжні професіонали, які детально пояснюють план лікування, відповідають на всі запитання та пропонують індивідуальний підхід. Особливо приємно, що використовуються сучасні технології та високоякісні матеріали, що гарантує чудовий результат.Відвідування «Bioclinic» залишає лише позитивні враження завдяки уважності, доброзичливості та професіоналізму команди. Рекомендується всім, хто шукає якісне стоматологічне обслуговування на найвищому рівні!
Велика подяка стоматології Bioclinic за професіоналізм і турботу! Лікарі дійсно турбуються про комфорт пацієнтів і детально пояснюють кожен етап лікування. Сучасне обладнання та комфортна атмосфера зробили лікування легким і безболісним.Рекомендую Bioclinic усім, хто цінує якість і хороший сервіс)
Before-and-After Examples
Stages of Apical Surgical Intervention
By contacting BIOCLINIC with a problem of chronic inflammation at the root apex, ineffective endodontic treatment, or the presence of a cyst, you will receive professional help and comprehensive surgical treatment aimed at preserving your own tooth with maximum use of modern microsurgical techniques.
1
3D Diagnostics and Assessment of the Pathological Lesion
The first and mandatory stage of apical surgery is computed tomography (3D scan). It allows obtaining comprehensive information about the size, shape, and exact location of the pathological lesion (cyst, granuloma, residual cyst), its relationship to the root apex, the condition of the surrounding bone tissue (presence of destruction, perforation of the cortical plate).
2
Planning of Surgical Access and Extent of Intervention
Based on the CT data, the surgeon develops a detailed operation plan. The optimal surgical access is determined: the shape and location of the incision (arcuate, trapezoidal, angular), the need for reflection of a mucoperiosteal flap, and the size of the bone window for access to the root apex and the pathological lesion.
3
Surgical Intervention: Access and Removal of the Pathological Lesion
The operation is performed under local anesthesia with modern drugs (in complex cases or with increased patient anxiety — with the use of sedation). The doctor makes an incision and reflects the mucoperiosteal flap, opening access to the bone. Using surgical handpieces with abundant cooling, a small bone window is created in the projection of the root apex.
4
Retrograde Filling and Wound Closure
After removal of the pathological lesion and resection of the apex, the surgeon forms a small cavity in the terminal part of the root canal from the cut side and fills it with a modern biocompatible material for retrograde filling (MTA, Biodentine, composite). This ensures hermetic obturation of the canal and prevents reinfection.
5
Rehabilitation and Long-Term Monitoring
After the operation, the patient receives detailed individual recommendations, including medication support (antibiotics to prevent infectious complications, anti-inflammatory drugs, painkillers, antiseptic mouth rinses, medications to improve microcirculation and accelerate healing).
Postoperative Care and Rehabilitation After Apical Surgery
Diagnostic Methods
By scheduling an appointment at the clinic, you can undergo the following examinations
Visual Examination
Dental Microscopy
Computed Tomography (CT)
Electromyography (EMG)
X-ray Imaging
Digital 3D Scanning
Creating a Traditional Dental Impression
Intraoral Photographs
Advantages of Apical Surgery at BIOCLINIC
Service Prices
- Primary tooth extraction 800 UAH
- Single-root tooth extraction 1,200 UAH
- Multi-root tooth extraction 1,700 UAH
- Complicated single-root tooth extraction 1,400 UAH
- Complicated multi-root tooth extraction 1,900 UAH
- Complexity level 1 (atypical wisdom tooth extraction) 2,400 UAH
- Complexity level 2 (atypical wisdom tooth extraction) 3,200 UAH
- Complexity level 3 (atypical wisdom tooth extraction) 4,800 UAH
- Root apex resection (one tooth) 4,500 UAH
- Hemostatic sponge 300 UAH
- Lip/tongue frenuloplasty 3,200 UAH
- PRF Membrane 900 UAH
- Bone grafting in the area of one tooth (materials not included) 300 EUR
- Sinus lift surgery 600 EUR
- Sinus lift surgery (open) 300 EUR
- Gingivoplasty in the area of 1 implant 100 EUR
- Gingivoplasty of 1-3 teeth in one area 150 EUR
- Gingivoplasty of 4-6 teeth 600 EUR
- Vestibuloplasty of 1 segment 300 EUR
- Bone augmentation using autogenous bone laminae 800 EUR
- Benign tumor removal 250 EUR
Our Doctors
Frequently Asked Questions (FAQ)
Заповніть форму і ми передзвонимо для запису на консультацію
What is apical surgery and in what cases is it used?
Apical surgery is a branch of surgical dentistry that specializes in eliminating chronic inflammatory foci in the area of the tooth root apex (periapical tissues). The method is used when traditional endodontic treatment is impossible or ineffective: in the presence of cysts and granulomas that do not respond to conservative treatment, when quality root canal filling is impossible due to anatomical features (severe curvature, obliteration) or the presence of foreign bodies (instrument fragments, posts, excess filling material) beyond the apex. This is an effective way to save your own tooth that was considered hopeless.
Is it always possible to save a tooth using the method of apical surgery?
Unfortunately, not always. The success of apical surgery depends on many factors: the size and location of the pathological lesion, the condition of the bone tissue, the anatomy of the roots, the possibility of quality retrograde filling, as well as the patient's general health. During the consultation, we always perform 3D diagnostics to assess all these factors and determine the treatment prognosis. Contraindications may include significant destruction of the tooth's crown portion, vertical root fracture, impossibility of restoring the tooth after surgery, or severe systemic diseases. If apical surgery is impossible, we offer alternative methods — tooth extraction followed by implantation or prosthetics.
Is the operation painful and how long does it take?
Modern local anesthesia (conduction and infiltration) completely eliminates pain during the operation. You may feel slight vibration or pressure, but no pain. Considering the complexity of the procedure, for patients with increased anxiety we offer sedation (medically induced sleep), which allows you to undergo the surgical intervention absolutely comfortably, without stress or fear. The duration of apical surgery depends on the complexity of the case, the size of the pathological lesion, and the location of the tooth, and usually ranges from 30 to 60 minutes. After the operation, when the anesthesia wears off, moderate pain occurs, which is easily controlled with prescribed painkillers.
What are the chances of success and how long does the postoperative area take to heal?
With proper patient selection, high-quality procedure performance, and the use of modern materials (MTA, Biodentine), the success rate of apical surgery reaches 85-95%. The healing process occurs in several stages:
Primary soft tissue healing — 7-14 days, sutures are removed after 7-10 days.
Beginning of bone tissue regeneration — first 2-3 months.
Complete bone restoration in the resection area — from 6 to 12 months.
To monitor the healing process, long-term follow-up is necessary: X-ray monitoring (CT or panoramic X-ray) at 3, 6, and 12 months to confirm bone tissue restoration and rule out recurrence.
How to prepare for the operation and what can and cannot be done after apical surgery?
As with any surgical intervention, there are certain risks that depend on the anatomical area. In the lower jaw, the main risk is associated with the proximity of the root apices of molars and premolars to the mandibular canal with the nerve — possible temporary sensory disturbance (numbness) of the lip, chin, or gums on the side of the operation. In the upper jaw, the risk is associated with the proximity of the root apices to the maxillary sinus — possible accidental opening during surgery. To minimize these risks, we always use 3D planning, which allows us to accurately determine the location of all anatomical structures and choose the safest tactic. Our surgeons have extensive experience in performing such interventions and master techniques for eliminating possible complications.
How to prepare for the operation and what can and cannot be done after apical surgery?
Before the operation, it is necessary to perform professional oral hygiene and sanitation of all foci of infection. On the day of the operation, a light breakfast is recommended 2-3 hours before the intervention if sedation is not planned, and with sedation — do not eat for 4-6 hours. After the operation, strictly follow the doctor's recommendations: for the first 2-3 hours, do not eat or drink, do not rinse your mouth, do not touch the wound with your tongue or hands. For the first 2-3 days, apply cold to the cheek in cycles of 10-15 minutes, sleep with an elevated headboard, limit physical activity, avoid hot baths, sauna, solarium. During the first 2-3 weeks, exclude hard, hot, spicy, acidic food, chew on the opposite side, do not consume alcohol and do not smoke, as smoking significantly impairs healing. For hygiene, carefully brush your teeth with a soft brush, avoiding the surgical area, and take mouth baths with antiseptics (chlorhexidine, miramistin) after each meal. Be sure to come for a follow-up examination after 7-10 days for suture removal and adhere to the X-ray monitoring schedule to assess the healing process.