Apicoectomy
An apicoectomy is a surgical option for resolving infections at the root tip that cannot be treated with a typical root canal. By directly addressing the root tip and removing the source of infection, this procedure can help preserve the natural tooth and avoid extraction.
What is an apicoectomy?
An apicoectomy, also known as apical surgery or root-end surgery, is a minor surgical procedure performed to remove the tip (apex) of the tooth’s root along with any surrounding infected tissue. This procedure is typically performed when a root canal treatment or root canal retreatment has not fully resolved an infection or if reinfection occurs at the root tip.
The goal of an apicoectomy is to save the tooth by treating the infection or inflammation in the root tip and the surrounding bone without the need for tooth extraction.
Steps involved in an apicoectomy
1 Examination and diagnosis
Your dentist will take digital X-rays and, in some cases, 3D imaging (CBCT) to evaluate the area around the root tip and determine the extent of the infection or inflammation.
2 Anesthesia
Local anesthesia will be administered to completely numb the area around the affected tooth, ensuring that you remain totally comfortable throughout the procedure.
3 Removal of infected tissue and root tip
A small incision is made in the gum tissue near the tooth to expose the underlying bone. The infected or inflamed tissue around the root tip is carefully removed. The tip of the tooth’s root (usually a few millimeters) is also surgically removed.
4 Cleaning and sealing the root
The end of the root canal is cleaned and sealed. This helps to seal the root and prevent bacteria from re-entering the root canal system.
5 Closing the gum incision
The gum tissue is then sutured (stitched) back into place. Over time, the bone will heal around the root tip, and the tissue will regenerate.
6 Post-surgical care
After the surgery, you will receive instructions on how to care for the surgical site. This may include taking prescribed medications (antibiotics, pain relievers), using ice packs to reduce swelling, and maintaining oral hygiene. Follow-up visits are scheduled to monitor healing and ensure the infection has been resolved.
7 Post-operative recovery
The initial healing typically takes a few days to a week, but complete bone healing around the root tip may take several months. Some mild discomfort, swelling, and tenderness may occur after the surgery, but this is generally manageable with over-the-counter pain medications and ice packs. Stitches may need to be removed after about a week, depending on the type used.