Apicoectomy: Root-End Surgery

Tooth Anatomy And ModelWhen traditional root canal therapy isn’t enough to resolve persistent dental issues, endodontists may turn to apicoectomy (also known as root-end surgery) as an alternative treatment option. While less common than standard root canal procedures, apicoectomy is crucial in preserving natural teeth and restoring oral health.

What is an Apicoectomy?

Apicoectomy is a surgical procedure to address persistent issues associated with a tooth root’s tip or apex. The procedure becomes necessary when a previous root canal treatment fails to resolve the problem or when conventional root canal therapy is not feasible due to anatomical challenges or obstructions within the root canal system.

When is Apicoectomy Recommended?

Endodontists may recommend the procedure in the following situations:

  • Persistent Infection: Despite thorough root canal therapy, persistent infection or inflammation may remain in the periapical area (surrounding the tooth’s root tip).
  • Root Canal Anatomy: Complex root canal anatomy, such as curved or unusually shaped roots, may hinder complete cleaning and sealing during conventional root canal therapy.
  • Residual Lesions: Radiographic evidence of a persistent lesion or cyst near the root tip may signal the need for surgical intervention to remove the affected tissue.

The Apicoectomy Procedure

We access the root tip through a small incision in the gums made near the affected tooth. The surrounding bone may be gently reshaped to expose the apex of the tooth’s root. The endodontist then removes the infected or damaged tissue at the root tip and seals the end of the root with a biocompatible material to prevent further infection.

With the procedure complete, the gum tissue is sutured into place, and the healing process begins. Over time, the bone around the treated tooth will regenerate, restoring stability and function to the area.

What to Expect Afterwards

After undergoing apicoectomy, patients may experience some mild discomfort and swelling, which is typically manageable with over-the-counter pain medication and a cold compress. To ensure proper healing, follow the post-operative instructions and attend follow-up appointments as scheduled.

Benefits of Apicoectomy

The procedure offers several benefits for patients, including:

  • Preservation of Natural Teeth: Apicoectomy addresses issues at the root tip, helping to preserve natural teeth and avoid extraction.
  • Improved Success Rate: Apicoectomy has a high success rate in resolving persistent infections and promoting healing in challenging cases.
  • Minimally Invasive: Compared to traditional surgery, apicoectomy is a minimally invasive procedure. It targets the area of concern without affecting surrounding teeth.

Contact Us Today!

Apicoectomy is a valuable treatment option in endodontics, offering another targeted approach to resolving infection and preserving natural teeth. If you’re experiencing persistent dental problems, please contact our office, and we can explore whether the procedure is the right solution for you!

About Tom Massarat, DDS, MS

Tom Massarat DDS, MS is a Diplomate of the American Board of Endodontics. Dr. Massarat received his Certificate in Endodontics from Northwestern University in 1992. He also received his Dental Degree and Advanced General Dentistry Degree from Northwestern University in Chicago, Ill. Dr. Massarat is a member of the American Dental Association (ADA), American Association of Endodontists (AAE), San Diego County Dental Society (SDCDS) and American Board of Endodontists (ABE). He is also an advisor for the Experdent and Summit Study Groups. He has lectured extensively on many aspect of endodontics.

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