Traditional root canal treatment involves removing the infected or inflamed “pulp” tissue that fills the root canal space of the tooth. Once space is filled and sealed, a final restoration is placed to protect and restore the tooth to full function. For the majority of patients, a root canal procedure is successful in protecting the tooth from subsequent re-infection, but in some cases, infected debris may remain in the canal, which prevents healing. If this happens, your dentist may recommend an apicoectomy.
Why might my endodontist perform an apicoectomy?
An apicoectomy, a type of endodontic surgery, is typically performed when a traditional root canal fails to remove all the dead nerves and infected tissues. This can lead to re-infection of the tooth and often signals a problem near the apex — where a tooth’s roots come to a point.
An apicoectomy corrects the problem by removing the apex along with the surrounding damaged tissue. Because it is a complex procedure, an apicoectomy is often only recommended as a last resort after attempting one or more root canal treatments. This surgical procedure allows patients to preserve their natural tooth, which otherwise may have required extraction as the last possible treatment option.
What does an apicoectomy procedure involve?
During an apicoectomy, a very small incision is made to open the gum tissue near the troublesome tooth. With the underlying bone exposed, the endodontist uses a special microscope and advanced equipment to remove the infected tissue along with the end of the root tips. Once this process is complete, the end of the tooth canal is cleaned and sealed. To finish the procedure, a small fitting is placed to seal the end of the root canal and prevent re-infection, and the gum tissue is sutured to help the tissue heal properly. Once surgery is complete, the bone will naturally heal around the end of the root and restore the tooth’s full function.
What is the recovery like following an apicoectomy?
Following an apicoectomy, an endodontist will provide special instructions on postoperative care. This may include which medications to take and any foods that should be avoided. Swelling and numbness are normal in the first couple of weeks following the procedure, and for this reason, ice should be applied for the first 12 hours after surgery.
Rest is especially important following an apicoectomy. Patients should also avoid vigorous rinsing, brushing and pulling or lifting the lips to allow for quick and complete healing.