Apicoectomy

An apicoectomy is a dental surgical procedure designed to treat infections or complications that persist after a root canal treatment. It is typically performed when a root canal has failed to resolve an infection at the tip of the tooth’s root or if there is a persistent infection or cyst that cannot be treated through conventional methods.

When is an Apicoectomy Needed?

Apicoectomy is usually recommended when:

• Infection persists: After a root canal treatment, infection remains at the tip of the tooth’s root.
• Root canal failure: If the root canal treatment does not completely remove the infection or if the tooth develops new issues.
• Apical periodontitis: This condition occurs when there’s inflammation or infection around the tip of the tooth’s root.
• Cysts or abscesses: If these form at the root tip and cannot be addressed with traditional root canal therapy.
• Anatomical issues: Some teeth have unusual root shapes or extra canals that are difficult to clean, requiring surgical intervention.

The Procedure

1. Preparation: The procedure is typically done under local anesthesia to ensure the area around the tooth is numbed. Sedation options may be offered for anxious patients.

2. Incision: The dentist or endodontist makes a small incision in the gum tissue near the affected tooth to expose the bone and root tip.

3. Root Tip Removal: The tip of the infected root (the apical portion) is removed, along with any infected tissue, such as an abscess or cyst, that may be present.

4. Cleaning and Sealing: Once the infected area is cleared, the root canal is cleaned thoroughly. The remaining root canal is sealed with a filling to prevent future infections.

5. Suturing: The gum tissue is then sutured back in place, and the area is allowed to heal.

Recovery

• Post-surgical care: After the procedure, you may experience some swelling, discomfort, or mild pain, which can be managed with pain medication and over-the-counter anti-inflammatory drugs.
• Follow-up: A follow-up visit is typically scheduled to ensure proper healing and that no complications arise.
• Healing time: Full recovery may take a few weeks, but the area should improve gradually within the first few days.

Success Rates and Considerations

• The success rate for apicoectomy is generally high, with many patients retaining their teeth for years after the procedure.
• The procedure is considered a last resort before extraction, as it aims to save the natural tooth and avoid the need for an implant or bridge.

Potential Risks

• Infection: Though rare, infections can occur after the procedure.
• Nerve injury: The procedure can sometimes cause damage to nearby nerves, though this is unusual.
• Tooth fracture: In rare cases, the tooth may become more fragile after surgery, requiring further treatment.