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Apicoectomy

The teeth are held firmly in place by strong roots that extend into the jawbone. Molars and premolars tend to have several roots, whereas the front incisors only have a single root. The end or tip of each root is termed the apex. The apex is where the nerves and blood vessels enter the tooth and aids in the delivery of blood to the crown (the part of the tooth you can see in your mouth). 

A root canal treatment refers to the cleaning of the canals and the removal of infected and inflamed tissue within the root. When the inflammation or infection persists after the root canal treatment, an apicoectomy may be required. An apicoectomy is essentially the removal of the apex (or root tip), followed by a filling procedure to seal the root from further infection. When left untreated, infected roots can damage other teeth, spread infection, and cause regression of the jawbone.

Reasons for an apicoectomy

Infected and inflamed soft tissue around the root of a tooth can be exceptionally painful and debilitating.  The purpose of an apicoectomy is to eliminate the infection in the tissue and to ultimately preserve the function of the tooth and save it from extraction. An apicoectomy will rarely be considered by the surgeon unless a prior root canal treatment has failed.

There are several reasons why an apicoectomy may be necessary:

  • Small Adjoining Root Branches – Roots are extremely complex and can contain many tiny branches. If these tiny branches cannot be cleaned and sealed when the root canal treatment is performed, inflammation can persist.
  • Blocked Root Canal – In some cases, the surgeon is unable to effectively clean a root canal because it is blocked by a fractured file left behind from prior root canal treatment. Infection and debris can quickly affect adjacent teeth.
  • Narrow or Curved Root Canals – When the root canal is poorly shaped, the endodontic files cannot reach the root tip. Continuing infection or re-infection can then occur.

What does getting an apicoectomy involve?

Prior to the surgery, the surgeon will generally prescribe an antibiotic or anti-inflammatory medication to treat the underlying infection. Panoramic X-rays will then be taken to enable the dentist to plan the apicoectomy, which will be performed under local anesthesia. 

The surgeon will make a small incision in the gum and expose the root by lifting away the gum. In some cases, a tiny fraction of the jawbone may be removed to properly expose the root. The edge of the root tip and any infected connective tissue will be removed using ultrasonic instruments. The root will be sealed using a retrofill (filling material), and the dentist will suture the gum with several stitches.

This surgery does not require an overnight stay, and full aftercare instructions and pain medications will be provided as needed. After several days, the surgeon will remove the stitches, and the connective tissues will fully heal several months after the procedure.

If you are experiencing any 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.

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Testimonials

Dr. Carpenter,



So many times in business and life in general, we are pummeled with the negative. I just wanted to drop a quick positive note to let you know how pleased I am with yourself and the entire staff at M Street Dental. My entire family have been patients with you for many years. I don’t believe anyone will tell you they enjoy going to the dentist and I will confess I am no exception. M Street Dental however has always maintained a genuinely positive and friendly atmosphere where I feel as though I am among friends. This includes your entire staff. On Thursday, January 17th, I went into your clinic expecting to have a what was left of a tooth that had broken off extracted. To my pleasant surprise you have put me on a treatment plan to basically “resurrect” this tooth. Keep up the great work & kudos to you all.

Brian Buckingham

When I asked for an evaluation of my mouth, I thought I would probably lose all my remaining teeth, and start over. Remarkably you immediately removed the remains of 2 teeth and set up time the next day to make impressions. Your assistant made very good impressions, and made time the next day for your lab people to add to and repair my existing partial plates. A great job by all of you! The fit is amazing, and they work almost as well as normal teeth. They have needed no adjusting and I can eat green salad again, and apples! And the teeth that show in a smile look very natural. Thank all of you for a good job, well done. It is much appreciated! All done in 4 days!! Unbelievable! Thank you very much.

June Cheek

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