Root End Surgery/Apicoectomy
Apicoectomy is an endodontic surgical procedure where by a tooth’s root tip is removed and a root end cavity is prepared and filled with a biocompatible material. An apicoectomy is a surgical procedure for people who have an infection in the root of their tooth. Normally, infections in and around the root of the tooth are dealt with by root canal treatment. This basically means that we clean around the root of your tooth, ensuring that any plaque, decay and infection are removed so that the tooth and gum can become healthy once again. In some cases, however, root canal treatment is not sufficient to stave off infection, which can return. Therefore, we have a choice. To once again attempt root canal treatment and clean away the infection, even though this has failed already. Or, an alternative procedure can be attempted, which may hopefully yield more lasting results.
- An apicoectomy is sometimes called endodontic microsurgery because it is often done using an operating microscope.
- If a root canal procedure has been done in the past and it becomes infected again, it’s often because of a problem near the apex of the root. In many cases, a second Endodontic Therapy (root canal treatment) is considered before an apicoectomy. With advances in technology, endodontists often can detect other canals that were not adequately treated. In this case, they may be able to clear up the infection by doing a second root canal procedure. This will avoid the need for an apicoectomy.
- An apicoectomy can be done to fix the problem so the tooth doesn’t need to be extracted. An apicoectomy is done only after a tooth has had at least one root canal procedure and retreatment has not been successful or is not possible. For example, retreatment is often not a good option when a tooth has a crown or is part of a bridge. Retreatment of the root canal would require cutting through the crown or bridge. That might destroy or weaken the crown or bridge. An apicoectomy is often considered in a situation like this.
- An apicoectomy is not the same as a root resection. In a root resection, an entire root is removed, rather than just the tip.