Root Canal Surgery (Apicoectomy)

Online Dental Education Library

Our team of dental specialists and staff strive to improve the overall health of our patients by focusing on preventing, diagnosing and treating conditions associated with your teeth and gums. Please use our dental library to learn more about dental problems and treatments available. If you have questions or need to schedule an appointment, contact us.
The information listed below was provided by the American Dental Association and can be found on their website dedicated to oral health. See https://www.mouthhealthy.org for more information.

Implants

Dental implants are a popular and effective way to replace missing teeth and are designed to blend in with your other teeth. They are an excellent long-term option for restoring your smile. In fact, the development and use of implants is one of the biggest advances in dentistry in the past 40 years. Dental implants are made up of titanium and other materials that are compatible with the human body. They are posts that are surgically placed in the upper or lower jaw, where they function as a sturdy anchor for replacement teeth.

Veneers

Veneers are thin, custom-made shells crafted of tooth-colored materials designed to cover the front side of teeth. They are an option for correcting stained, chipped, decayed or crooked teeth. Veneers are made by a dental technician, usually in a dental lab, working from a model provided by your dentist. Placing veneers is usually an irreversible process, because it's necessary to remove a small amount of enamel from your tooth to accommodate the shell. Your dentist may recommend that you avoid some foods and beverages that may stain or discolor your veneers such as coffee, tea or red wine. Sometimes a veneer might chip or fracture. But for many people the results are more than worth it.

Crowns

A crown can help strengthen a tooth with a large filling when there isn’t enough tooth remaining to hold the filling. Crowns can also be used to attach bridges, protect a weak tooth from breaking or restore one that’s already broken. A crown is a good way to cover teeth that are discolored or badly shaped. It’s also used to cover a dental implant.

Diastema

A diastema is an area of extra space between two or more teeth. The two front teeth of the upper jaw area is where diastema is most frequently seen. Many children experience diastema as primary teeth fall out, though in most cases these spaces close when the permanent teeth erupt.

Diastemas may also be caused by a tooth size discrepancy, missing teeth or an oversized labial frenum, the tissue that extends from the inside of the lip to the gum tissue where the upper two front teeth are located. Secondary reasons involve oral alignment issues such as an overjet or protrusion of the teeth.

Whitening

Teeth whitening is a simple process. Whitening products contain one of two tooth bleaches (hydrogen peroxide or carbamide peroxide). These bleaches break stains into smaller pieces, which makes the color less concentrated and your teeth brighter.

Does Whitening Work on All Teeth?

No, which is why it’s important to talk to your dentist before deciding to whiten your teeth, as whiteners may not correct all types of discoloration. For example, yellow teeth will probably bleach well, brown teeth may not respond as well and teeth with gray tones may not bleach at all. Whitening will not work on veneers, crowns or fillings. It also won’t be effective if your tooth discoloration is caused by medications or a tooth injury.

 

Fracture

 

 

 

 

Oral Systemic Health

 

 

 

 

Root Canal

If you have a severely damaged, decaying tooth or a serious tooth infection (abscess), your dentist may recommend a root canal treatment. Root canals are used to repair and save your tooth instead of removing it.

 

 

 

 

 

Occasionally, root canal treatment proves unsuccessful at resolving an infection in the tissues near a tooth's roots. That's when a minor surgical procedure called an apicoectomy may be recommended. Because this procedure is often performed with the aid of a microscope and other small specialized tools, it's considered a type of endodontic microsurgery. Probably the most common type of root canal surgery, an apicoectomy involves removing a small portion of the apex (tip) of the tooth's root, along with any surrounding hard or soft tissue that may be infected.

What would cause you to need an apicoectomy? There could be several reasons, including a canal that is blocked or inaccessible, an anatomical irregularity, or a fracture or crack in the tooth's roots. The procedure is normally only recommended after one or more root canal treatments have been attempted, and have failed. Since this type of problem generally occurs near the apex of the root, the procedure is often an effective way to treat a persistent infection.

Root canal surgery apicoectomy.Before an apicoectomy procedure, diagnostic images (such as X-rays) of the affected tooth and surrounding bone, a careful review of your medical history including medications you take (both prescription and non-prescription), and other factors are reviewed. If an apicoectomy is recommended, the reasons for it will be explained to you.

The Apicoectomy Procedure

Root canal surgery is usually performed under local anesthesia such as a numbing shot, so you won't feel any pain. To begin the procedure, a small incision is made in the gum, and the infection at the end of the tooth's roots is exposed. The infected tissue is then removed, along with a few millimeters of the root tip itself. A dye may be used to help make cracks or fractures easy to see; if we discover that the tooth is fractured, it may be better to extract (remove) it at this time instead of completing the apicoectomy.

Next, a microscope and light are used to examine the tiny canals. They will be cleaned with an ultrasonic instrument, then filled with an inert material and sealed up with a small filling. To finish the procedure, a small bone graft may be placed at the affected site, and then the gum tissue covering the tooth's root will be sutured (sewn) closed. X-rays may also be taken as the procedure nears completion. Afterwards, instructions on postoperative care will be given, and you'll go home. Most apicoectomies take about 30 to 90 minutes to complete.

Following the procedure, you may experience some swelling and soreness in the area that was treated. Over-the-counter non-steroidal anti-inflammatory medications (such as ibuprofen) are usually all that's needed to control any discomfort. You can probably return to normal activities the following day, but you may want to avoid eating hard or crunchy foods or brushing vigorously for a few days afterwards. If your sutures aren't self-dissolving, you will be asked to return in about a week to have them removed.

The Goal: Saving Your Tooth

Although apicoectomy is typically a safe and effective procedure, there are slight risks with any type of minor surgery. That's why apicoectomies are not recommended unless further root canal treatment won't be effective. An alternative treatment in most cases would be extraction of the tooth. However, our goal as dentists is to help you preserve your natural teeth for as long as possible.

While there are excellent methods of tooth replacement (such as dental implants), these involve further and more complex treatments, and they can be costly. An apicoectomy is generally a permanent and cost-effective solution which can help the tooth last for the rest of your life.

Related Articles

Root Canal Retreatment - Dear Doctor Magazine

Root Canal Retreatment As occasionally happens with any dental or medical procedure, a tooth may not heal as anticipated after a root canal treatment. In these cases, it's often possible to save the tooth with a second root canal procedure... Read Article

Root Canal Treatment - Dear Doctor Magazine

Common Concerns About Root Canal Treatment The term “root canal” can send shivers down many a spine. However, preconceived notions that root canal treatment is filled with pain and discomfort are nothing more than outdated myths. In fact, root canal treatment doesn't cause pain but actually relieves it... Read Article


Contact Us