Apicoectomy/
Endodontic Surgery

 

An Apicoectomy is a surgical procedure aimed at addressing infections at the tip of a tooth's root, particularly when previous root canal treatments have not been effective. This procedure may be necessary if you continue to experience symptoms such as pain or swelling, even when X-rays do not reveal any issues. In such cases, an apicoectomy allows the endodontist to directly access the root area, identify hidden problems, and provide treatment to eliminate infection. By addressing these persistent issues, this procedure can often preserve your natural tooth, allowing it to function properly for years to come.

An Apicoectomy

An apicoectomy, also known as a root-end resection, is a surgical procedure performed to treat infections at the tip of a tooth's root. This surgery is often necessary when a root canal treatment has failed or when persistent infections cannot be effectively addressed through conventional methods.

During the procedure, the endodontist will make a small incision in the gum tissue to expose the underlying bone and affected tooth root. The infected tissue and the tip of the root are then removed, and a biocompatible filling material is placed in the root tip to seal the area and prevent further infection.

Why You Need an Apicoectomy

There are several reasons why an apicoectomy may be necessary:

  • Persistent Infection: If bacteria remain in the tooth after a root canal treatment or if new bacteria enter through a crack or fracture, an infection can persist. An apicoectomy allows for the removal of the infected tissue and the chance for healing.
  • Symptoms without Radiographic Evidence: Sometimes, patients continue to experience symptoms such as pain or swelling even when X-rays show no apparent issues. An apicoectomy can help diagnose and treat the underlying problem by providing direct access to the root area.
  • Calcium Deposits: In certain cases, calcium deposits can narrow a canal, making it too difficult for instruments used in nonsurgical root canal treatment to reach the end of the root. An apicoectomy can clean and seal the remainder of the canal.
  • Tooth Anatomy: Some teeth have complex root structures that make it difficult to completely clean out the infection during a root canal. If conventional methods fail, an apicoectomy can target the specific area causing the problem.
  • Obstructions: In cases where there is a blockage, such as calcifications or extra roots that were not identified during the initial treatment, an apicoectomy can provide access to the affected area.

Other Surgical Options

In certain cases, your endodontist may perform additional surgical procedures, such as: 

  • Intentional Replanation: This involves extracting a tooth, treating it with an endodontic procedure while it is out of the mouth, and then replacing it in its socket.
  • Root Repair: Procedures may include dividing a tooth in half, repairing an injured root, or even removing one or more roots.

Your endodontist will discuss the specific type of surgery your tooth requires and the best options for your situation.

Recovery and Aftercare

After an apicoectomy , patients may experience some swelling, discomfort, or bruising, which can typically be managed with over-the-counter pain medications. Your dentist will provide specific aftercare instructions, including dietary recommendations and activity restrictions to promote healing.

Endodontic Surgery Alternatives

Often, the only alternative to endodontic surgery is the extraction of the tooth. If extraction is necessary, the missing tooth must then be replaced with an implant, bridge, or removable partial denture to restore chewing function and to prevent adjacent teeth from shifting. While modern artificial tooth replacements can be effective, nothing compares to the benefits of preserving your natural tooth.

An apicoectomy is a valuable option for treating persistent infections at the root of a tooth when other treatments have failed. If you are experiencing symptoms related to a previously treated tooth, consult your dentist to discuss whether an apicoectomy is the right choice for you. Early intervention can lead to successful outcomes and help save your natural tooth. 

Apicoectomy Post-Op Instructions