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What is an Apicoectomy?

Posted on 10/25/2015 by Jeffery Gerhardt
A diagram of the inside of a tooth.While root canal treatments are generally quite successful, these therapies sometimes fail to resolve an infection near the root of the tooth. In these situations, a minor oral surgery known as an apicoectomy may be required. This is arguably the most common root canal surgery, and it involves removing the tip of the root along with other tissues that surround the area that might also be infected. An apicoectomy differs from a root resection, in which the entire root is removed, as with this procedure, just the tip will be taken out.

Uses of an Apicoectomy

If you have had a root canal procedure in the past, but the tooth becomes infected again, there is often a problem close to the root apex. In many situations, a second root canal may be considered, but if this procedure still fails to clear up the infection, you may also need to have an apicoectomy.

In other situations, retreatment of a failed root canal won't be a possibility. For example, a tooth that is part of a bridge or has had a crown put into place might not be good options for a root canal since retreatment would require cutting into the restoration. This could weaken or destroy the appliance, so an apicoectomy may be used instead.

During the Procedure
You can expect this procedure to take anywhere from 30 minutes to 1.5 hours. The length of time needed for your specific procedure will depend on how complex your root structure is found to be. Procedures on the lower molars usually take the longest, while the front teeth can be completed in the fastest amount of time.

During the apicoectomy, your oral surgeon will make a small cut into the gums so that the tissue can be lifted off the tooth and surrounding bone. To gain access to the root, your surgeon may need to use a drill so that the tissue can be removed along with the end of the root tip. In some cases, dye will be used to highlight breaks and cracks in the tooth, and if it is determined that this damage is large, the tooth may need to be removed. In this case, the apicoectomy will be discontinued.

Next, your dentist or oral surgeon will clean out the canal and seal it. This is usually done with a specialized microscope and ultrasonic instruments. Finally, an X-ray will be taken of the area before your surgeon stitches the gum tissue back into its proper position.

After the Procedure
After your apicoectomy, you might experience some soreness and swelling in the affected area. You can take over-the-counter medications like ibuprofen in order to control swelling and discomfort, and most people will feel well enough to return to their normal activities the next day. However, it may be recommended that you avoid eating crunchy or hard foods for a few days following treatment so as to not disturb your sutures or the surgical site.

An Apicoectomy Can Save Your Tooth

An apicoectomy is an effective and safe procedure, although there are some slight risks with any type of surgery. For this reason, apicoectomies aren't recommended until it is determined that further root canal therapy won't be effective. An alternative to an apicoectomy would be to extract the teeth, but your oral surgeon's first goal will be to help you preserve your natural teeth. There are a variety of great tooth replacement options out there, but they will involve further, complex treatments and can be expensive. An apicoectomy is typically a cost-effective and permanent solution which can allow the tooth to remain in your mouth for the rest of your life.

Please contact us if you have any questions about Apicoectomy.

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