Apicoectomy

Gentle Root Canal (Apicoectomy)

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Teeth stay in place because strong roots extend into the jawbone. In most cases, molars and premolars have multiple roots. Meanwhile, front teeth (incisors) usually have a single root.

In addition, the tip of each root is called the apex. This area allows nerves and blood vessels to enter the tooth. As a result, it supplies blood to the crown, which is the visible part of the tooth.

A root canal treatment cleans the inside of the tooth. Specifically, it removes infected or inflamed tissue within the root canals. This treatment helps save the tooth and prevent infection from spreading.

However, in some cases, infection or inflammation continues after a root canal. When this occurs, an apicoectomy may be recommended.

An apicoectomy is a minor surgical procedure. It removes the root tip (apex) and seals the end of the root. Therefore, it helps prevent further infection and preserves the natural tooth. In many cases, this procedure helps patients avoid tooth extraction.

If left untreated, an infected root can:

• Damage surrounding teeth
• Spread infection
• Cause bone loss in the jaw

Reasons for an apicoectomy

An apicoectomy is typically recommended when infection remains after a root canal. In these cases, the goal is to remove infection and save the tooth.

Usually, this procedure is only considered after a root canal treatment has not worked.

There are several reasons why an apicoectomy may be needed:

• Small adjoining root branches: Root systems are complex. Because of this, tiny branches may be difficult to clean during a root canal. As a result, infection can remain.
• Blocked root canal: Sometimes, a root canal becomes blocked by debris or a broken file. When this happens, the canal cannot be fully cleaned. Therefore, infection may persist.
• Narrow or curved root canals: If the canal is too narrow or curved, instruments may not reach the root tip. Consequently, infection can continue.

What does getting an apicoectomy involve?

Before the procedure, your surgeon may prescribe antibiotics or anti-inflammatory medication. This helps control infection and reduce inflammation.

Next, your surgeon will take X-rays, such as panoramic or Cone Beam CT scans. These images help plan the procedure and ensure precise treatment.

The apicoectomy is performed under local anesthesia. In some cases, sedation may also be used, depending on your needs.

During the procedure:

• First, the surgeon makes a small incision in the gum.
• Then, the gum is gently lifted to expose the root.
• In some cases, a small amount of bone is removed.
• Next, the infected root tip and surrounding tissue are removed.
• After that, the root end is sealed with a filling material (retrofill).
• Finally, the gum is closed with dissolvable stitches.

This procedure does not require an overnight stay.

After surgery, you will receive detailed aftercare instructions. In addition, your surgeon may prescribe medication to manage discomfort. A follow-up visit will also be scheduled to monitor healing.

If you are experiencing any signs or symptoms, such as pain or swelling associated with a tooth that has had a root canal, we encourage you to contact our office immediately to schedule an appointment.