APICOECTOMY (ENDODONTIC SURGERY)
An apicoectomy is performed after an unsuccessful root canal. When an infection will not go away or returns after a root canal has been performed this procedure is usually necessary. There are many nerves that may contain the infected tissue, so it is difficult to ensure that all of the infection is removed during a root canal. During an apicoectomy, the tip of the root of the tooth is removed and replaced with a filling.
In most cases a second root canal is considered before an apicoectomy since it is a simpler, less invasive procedure. Before the apicoectomy begins you will be given a local anesthetic to numb the area. The doctor will start by making an incision in your gum to expose the root of your tooth. Any inflamed tissue will be removed to clean out the area. The surgery takes place in a very small area, and only a few millimeters are removed from the root. For this reason, the doctor will use magnification and small precision instruments to perform the surgery. The precise nature of the surgery gives it a high rate of success. After the root is removed a filling is placed and the gums are sutured. Depending on the type of sutures you may have to return in a few days to have them removed, or dissolving sutures may be used instead. Over the course of the next few months the bone will heal around the root.
Although there are many surgical procedures that can be performed to save a tooth, the most common is called apicoetomy or root-end resection. When inflammation or infection persist in the bony area around the end of your tooth after a root canal procedure, your endodontist may have to perform an apicoetomy.
What is an apicoetomy?
In this procedure, the endodontist open the gum tissue near the tooth to see the underlying bone and to remove any inflamed or infected tissue. The very end of the root is also removed.
A small filling may be placed to seal the end of the root canal, and a few stitches are placed in the gum to help the tissue heal properly.
Over a period of months, the bone heals around the end of the root.