Apicoectomy

Why would I need endodontic surgery?

Generally, a root canal is all that is needed to save teeth with injured pulp from extraction. Occasionally, this non-surgical procedure will not be sufficient to heal the tooth and Drs. Azad or Vuong will recommend surgery. Endodontic surgery can be used to locate fractures or hidden canals that do not appear on x-rays but still manifest pain in the tooth. Damaged root surfaces or the surrounding bone may also be treated with this procedure. The most common surgery used to save damaged teeth is an apicoectomy or root-end resection.

What is an apicoectomy?

The video above illustrates this simple procedure. An incision is made in the gum tissue to expose the bone and surrounding inflamed tissue. The damaged tissue is removed along with the end of the root tip. A root-end filling is placed to prevent reinfection of the root and the gum is sutured. The bone naturally heals around the root over a period of months restoring full function.

A medical diagram showing a cross-section of a tooth with a previous root canal. An area of nfected Tissue (a periapical lesion or abscess) is visible in the bone at the very tip of the tooth root. Labels indicate the bone, ligament, gum tissue, and gutta-percha filling inside the tooth.
1. Infected Tissue
A diagram illustrating the surgical phase of an apicoectomy. A dental instrument is shown removing the Infected Tissue through an opening in the gum and bone. The very tip of the tooth root has been removed, labeled as
2. Tissue Removed
A diagram showing the Root-end Filling being placed at the tip of the shortened root to seal the canal. Small Sutures are shown closing the incision in the gum tissue, and the cavity in the bone is beginning to be managed.
3. Suture Placed
A diagram showing the final healed state of the tooth. The area where the infection was previously located is now labeled as Healed Bone, showing new bone growth filling the space around the sealed root tip.
4. Healing Complete

What should I expect after an apicoectomy?

Following the procedure, there may be some discomfort or slight swelling while the incision heals. This is normal for any surgical procedure. To alleviate any discomfort, an appropriate pain medication will be recommended. If you have pain that does not respond to medication, please call our office.