Apicoectomy

Apicoectomy is not an often needed procedure as root canals rarely fail. Apicoectomy (apical surgery) literally means the removal of the apex of the root of the tooth. In this procedure the bony area surrounding the end of your tooth is treated, which has become inflamed or infected, following a root canal. This is normally where abnormal root anatomy and extra canals are present. This procedure is also known as a root-end resection. When a root canal fails it is usually due to one of the following reasons :

  • When there is unusual and undetectable tooth anatomy
  • Small accessory and lateral nerve canals that can not be instrumented
  • Cyst formation
  • Cracked tooth

Most of the “failures” can be saved in Apicoectomy procedure, by folding back the gum near the tooth, the dental doctor can access the underlying bone and extract the inflamed tissue. At the same time, the very tip of the root is removed and usually replaced with a small plug or filling. During the procedure, the area around the root tip is also cleaned (curettage) to remove any granulation (abnormal healing) tissue and cystic formations. The only exception is of a severely cracked tooth when an extraction is necessary.

Apicoectomy is an in office procedure performed by an Oral Surgeon or Endodontic specialist at India Dental Clinic. Apicoectomy is more difficult to perform in posterior teeth because of difficulty in vision, surgical access and the complexity of multi-rooted teeth. An endodontist (root canal specialist) or oral surgeon is typically most skilled in this type of procedure. The area is numbed with a local anesthetic and you may have IV sedation to relax you. Pain medication will be prescribed to keep you from experiencing any discomfort. The area may be sore for three to four days.

This is a problem that will not resolve or go away without some intervention. An oral antibiotic is never a satisfactory long term solution either, because the source of infection has not been removed. Apicoectomy surgery is an in-office procedure performed with either local anesthesia, i.v. sedation, or general anesthesia. While many patients prefer to have only a local anesthetic (the administration of numbing medicine to the area being worked on) more often patients/dental tourists choose to be asleep or sedated. That is a decision best left up to the doctor and patient and can be explored more fully during your dental treatment consultation visit to specialist of India Dental Clinic.

The gum is reflected (lifted) from an area adjacent to the root area of the tooth. By folding back the gum near the tooth, the doctor can access the underlying bone and extract the inflamed tissue. Access to the root tip is then made by removing the thin bone covering the end of the root. At the same time, the very tip of the root is removed and usually replaced with a small plug or filling. A small part of the root tip is then removed and the remaining root is checked to make sure it is sealed. Apical or Retrofilling (reverse filling) will be required to seal all canals that are found that are not properly sealed. Without proper sealing of all the canals present in a tooth the procedure will not be successful.