Apicoectomies: The Basics

EVERYONE HAS HEARD of root canal therapy, even if there are a lot of misconceptions surrounding it, but are you familiar with apicoectomies? An apicoectomy is a type of endodontic surgery that involves removing the tip of a tooth’s root.

What Is an Apicoectomy?

To understand apicoectomy, we need to go over some dental anatomy. The center of each tooth is filled with soft tissue called dental pulp, which includes blood vessels and nerves that run from the inside of the crown of the tooth down through the root tip, where they connect to the circulatory and nervous systems. The tissue at the tip of the root can become infected (or even reinfected after prior endodontic treatment), at which point it may be necessary to remove it and the surrounding tissue.

When Is an Apicoectomy Necessary?

Apicoectomy is a minor surgery that can be done on children or adults to save at-risk teeth. One might be recommended for patients whose conventional root canal therapy has failed, particularly if there was already one unsuccessful retreatment or the retreatment is not advised. Performing this surgery may be the only option other than extracting the entire tooth.

Preparing for a Procedure

The days and hours leading up to an apicoectomy procedure will likely include:

• A consultation with your dentist regarding your condition
• Dental X-rays of the affected tooth and the surrounding bone
• Recommendations for pre-procedure care, such as antibiotics, antimicrobial mouthwash, or medicine for reducing inflammation.
• A review of your medical history, including a list of medications and any past and current medical problems.

The Apicoectomy Process

It’s perfectly normal to be nervous about any kind of surgical procedure, but we hope that knowing more about apicoectomy will help. These are the typical steps of an apicoectomy procedure, which is typically performed by an endodontist, an oral or maxillofacial surgeon, or a general dentist with advanced training:

1. We inject a local anesthetic to numb the area around the infected tissue.
2. We open the gum tissue around the affected tooth.
3. We remove any inflamed or infected tissue along with the root tip in question.
4. We seal the end of the root with a filling material.
5. We apply a few stitches or sutures to help the healing process.

To ensure accuracy, we might also take an X-ray during the procedure, and the length of the procedure will vary depending on which tooth it is, the complexity of the root structure, and your individual needs as a patient.

What Comes Next?

As with most procedures, there may be some pain or discomfort following an apicoectomy. We recommend avoiding eating while the area is still numb and avoiding chewing with the tooth while it’s healing. Application of a cold compress can help, as can over-the-counter pain relievers. Make sure to contact us if postoperative discomfort doesn’t fade or gets worse after the first few days.

Apicoectomies are an important tool for saving teeth!

Top image by Flickr user Cory Doctorow used under Creative Commons Attribution-Sharealike 4.0 license. Image cropped and modified from original.

The content on this blog is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of qualified health providers with questions you may have regarding medical conditions.