When it comes to root canal procedures, endodontic microsurgery is occasionally suggested if a non-surgical approach proves insufficient for repairing the tooth. This surgical intervention becomes necessary to save teeth that would otherwise require extraction.

Understanding Apicoectomy

Endodontic microsurgery serves various purposes, including the identification of fractures or concealed canals not visible on x-rays but responsible for tooth discomfort. Additionally, this method addresses issues such as damaged root surfaces or adjacent bones. The most common endodontic surgery used for salvaging compromised teeth is apicoectomy or periapical surgery. This treatment involves the removal of the tooth's root tip, known as the apex, and applies to both children and adults.

Distinguishing Apicoectomy from Root Canal Surgery

Apicoectomy is not the same as root canal surgery. In root canal surgery, the dentist opens your tooth to remove infected pulp. The pulp, composed of nerves, blood vessels, and cells crucial for maintaining the teeth’s health and functionality, is extracted when infected. Root canal surgery is necessary to eliminate the infection, clean the roots, and seal the tooth. On the other hand, an apicoectomy specifically targets the removal of the tooth's root tip. The procedure is often performed after a root canal treatment has been completed on the tooth.

Purpose and Indications for Apicoectomy

The primary purpose of an apicoectomy is to preserve a tooth and prevent the need for extraction. Various situations may prompt a dentist to recommend this procedure. The most common reason is when a previous root canal treatment has not led to proper healing of the surrounding tooth region, resulting in reinfection or damage to the tissue. Lingering inflammation or infection that the initial root canal failed to address may also necessitate an apicoectomy to remove the root tip and the diseased tissue, preventing further complications.

Additionally, apicoectomy may be recommended for the following reasons.

Locate Hidden Issues: In cases where the source of a problem, such as a fracture or a loose tooth, is not visible on an X-ray, an apicoectomy helps pinpoint and address the underlying concern.

Address Crowded Roots: The procedure may be advised to remove crowded roots and manage any damaged root surfaces effectively.

Step-by-Step Apicoectomy Procedure

Preparation: An apicoectomy typically takes 30 to 90 minutes, depending on the tooth’s location and accessibility. The procedure is designed to be painless. Prior to the procedure, your dentist may take an X-ray to visualize the infected root’s location and assess the need for removing surrounding tissue. A local anesthetic will be administered to ensure your mouth is fully numb before the operation.

Incision and Exposure: The dentist will make a tiny incision in your gums and gently push aside the gum tissue using microsurgical equipment to create a pathway to the affected tooth root. This approach enhances precision and minimizes tissue disruption.

Removal of Tissue and Contaminated Root Tips: The dentist carefully removes any inflammatory tissue and portions of contaminated root tips. Typically, only a few millimeters of the root and any diseased or inflammatory tissue need to be excised, preserving as much healthy structure as possible.

Cleansing and Sealing: After thoroughly cleansing the affected region, a root-end filling is applied to seal the root and prevent reinfection. This step ensures the long-term success of the procedure.

Closure with Stitches: A few stitches will be used to seal the gum incision. These stitches aid in proper healing and post-operative discomfort. Following the surgery, an additional X-ray may be taken to confirm the elimination of the infection and to assess the overall success of the procedure.

Postoperative Care and Recovery

The procedure is typically performed in the dentist's office, and it generally does not result in any significant discomfort. As no general anesthesia is required, you should be able to drive yourself home after the procedure.

After the surgery, some soreness or mild swelling in the treated region may occur during the recovery period. This is a normal response to any surgical procedure, and our South Shore Dental Care team will provide guidance on managing and recommending safe medications and measures to promote healing.

Recovery and Care Following Apicoectomy

It's advisable to rest with your head elevated to minimize blood flow, as there may be light bleeding for one to two hours post-treatment. Your dentist may suggest over-the-counter pain medication, and antibiotics could be prescribed to prevent postoperative infection.

While regular brushing and flossing are encouraged, extra caution should be exercised around the treated area to avoid disturbing the sutures. Rinsing your mouth gently with warm, saline water can help eliminate additional bacteria. Within a day or two, you should be able to resume your regular activities, and the sutures will be removed within a week.

Is persistent tooth pain disrupting your daily life? Discover the advanced solution you've been searching for at South Shore Dental Care. Our skilled team specializes in Apicoectomy, a precise and effective procedure designed to alleviate discomfort and preserve your natural tooth.