Dr. Chris H. Fleming, D.M.D.
Understanding Apicoectomy
Typically, a root canal is sufficient to save teeth with damaged pulp and prevent extraction. However, in some cases, this non-surgical approach may not fully heal the tooth, prompting your endodontist to suggest surgical intervention. Endodontic surgery is useful for identifying fractures or concealed canals that may not be visible on x-rays but still cause discomfort. This procedure can also address issues with damaged root surfaces or surrounding bone. The most common type of surgery performed to salvage compromised teeth is an apicoectomy, also known as root-end resection.
When an Apicoectomy is Necessary
When the soft tissue surrounding the tooth’s apex becomes inflamed or infected, it can lead to significant discomfort. At Fleming Endodontics, we perform apicoectomies to eliminate this infection and restore proper tooth function, potentially avoiding the need for extraction. It's important to note that we only recommend an apicoectomy if a root canal procedure has failed.
Understanding the factors that can cause infection and lead to root canal failure is crucial:
- Blocked Root Canal: If a root canal is obstructed by a fractured file from previous treatments, an apicoectomy may be necessary. Infection and debris can significantly impact nearby teeth, so our goal is to prevent any further damage.
- Root Branches: The roots of teeth contain numerous small branches, which can complicate root canal procedures. If these tiny branches aren't adequately cleaned and sealed, inflammation may persist, indicating the need for an apicoectomy to resolve the issue.
- Curved or Narrow Root Canals: Occasionally, the shape of the root canal can make it challenging for the dentist to access the apex during treatment. In such cases, an apicoectomy may be required to reduce the risk of ongoing infection or inflammation.
What Happens During an Apicoectomy?
Before proceeding with the apicoectomy, we typically prescribe antibiotics to address any existing infection. Our team takes panoramic X-rays to ensure the dentist is well-prepared for the procedure.
On the day of the treatment, we administer a local anesthetic to ensure your comfort. The dentist will then make a small incision in the gum to access the root. In certain situations, a small portion of the jawbone may need to be removed if the root’s apex isn’t visible.
Using ultrasonic instruments, the dentist carefully extracts the root tip along with any infected connective tissue. After this, the root is sealed with a filling, and the gum is sutured to facilitate healing. You’ll need to return in 7-10 days to have the stitches removed.
This outpatient procedure boasts a high success rate for all patients at Fleming Endodontics.
If you experience persistent swelling or pain after a root canal, please contact us right away. An apicoectomy may be necessary to restore your tooth to optimal health.
