In some cases, a tooth that has had a root canal, which did not sufficiently heal or has become re-infected, is not a candidate for retreatment with a second root canal procedure. For these teeth, an oral and maxillofacial surgeon can perform a minor surgical procedure, which is known as an apicoectomy. This procedure effectively treats the infection at the root-end to preserve and save the tooth. An apicoectomy serves as an excellent next step procedure to save a previously treated natural tooth, eliminate a dental infection, and to restore the health of the surrounding tissues. It is most useful in cases where fractures or hidden canals still cause pain or infection around a treated tooth, as well as when a second root canal procedure is not recommended as it will further weaken and jeopardize the tooth.
An apicoectomy may be performed under local anesthesia along with dental sedation if it is selected or indicated. It is typically a straightforward procedure during which an incision is made in the gum tissue to access the tip of the involved root. Once uncovered, the damaged tissue in the area is removed along with a few millimeters of the tooth’s root end. A biocompatible filling material is then placed to seal the remaining portion of the root to prevent any possibility of reinfection. The gum tissue flap is put back into place and sutured to complete the procedure.
With an apicoectomy, post-surgical discomfort is generally mild. Our oral and maxillofacial surgeon will provide post-operative care instructions and follow-up care as indicated.