Apicoectomy

The teeth are anchored in the jawbone by strong roots, which can vary in number depending on the type of tooth. Molars and premolars typically have multiple roots, while front incisors have a single root. At the tip of each root is the apex, through which nerves and blood vessels enter the tooth to supply blood to the visible crown.

A root canal treatment involves the cleaning of the tooth’s canals and removal of infected or inflamed tissue within the root. In cases where inflammation or infection persists after a root canal treatment, an apicoectomy may be necessary. An apicoectomy involves the removal of the root tip (apex) followed by a filling procedure to seal the root and prevent further infection. Untreated infected roots can cause damage to neighboring teeth, spread infection, and lead to jawbone deterioration.

Reasons for an apicoectomy:

1. Small Adjoining Root Branches: Roots can have intricate branching patterns that may not be thoroughly cleaned and sealed during a root canal procedure, allowing inflammation to persist.

2. Blocked Root Canal: Sometimes, a root canal cannot be effectively cleaned due to a blockage caused by a fractured file left behind from a previous root canal treatment. This can lead to infection and affect adjacent teeth.

3. Narrow or Curved Root Canals: Poorly shaped root canals may prevent endodontic files from reaching the root tip, leading to ongoing or recurrent infection.

What to expect during an apicoectomy:

Before the surgery, the dentist may prescribe antibiotics or anti-inflammatory medications to address the underlying infection. Panoramic x-rays will be taken to assist in planning the apicoectomy, which will be performed under local anesthesia.

The dentist will make a small incision in the gum, lifting it to expose the root. In some cases, a small portion of the jawbone may be removed to fully access the root. Using ultrasonic instruments, the infected tissue and the edge of the root tip will be removed. The root will then be sealed with a filling material, and the gum will be sutured with stitches.

This procedure does not require an overnight stay, and the dentist will provide aftercare instructions and any necessary pain medications. After a few days, the stitches will be removed, and the gum tissues will fully heal over several months.

If you are experiencing any symptoms such as pain or swelling associated with a tooth that has undergone a root canal, we strongly recommend contacting our office immediately to schedule an appointment.

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