Apicoectomy (Endodontic Surgery)
If a root canal procedure was unsuccessful, an apicoectomy needs to be performed. When an infection will not go away or returns after a root canal has already been performed, this procedure is usually necessary. During a root canal, there are many nerves that may contain the infected tissue, so it is very difficult to ensure that all of the infection is removed during the procedure. During an apicoectomy, the tip of the root of the tooth needs to be removed and replaced with a filling.
In most cases, a second root canal is considered before an apicoectomy. A root canal is a simpler, less invasive procedure. Before the apicoectomy begins, a local anesthetic will be given to numb the area. The doctor will start the process by making a small incision in your gum to expose the root of your tooth. Any inflamed tissue will be removed in order to effectively clean out the area. The surgery takes place in a very small portion of your mouth and only a few millimeters are removed from the root. For this reason, the doctor will need to use magnification and small precision instruments to perform the surgery successfully. The precise nature of this dental surgery gives it a high success rate. After the root is finally removed, a filling is placed and the gums are sutured back together. Depending on the type of sutures used, you may have to return in a few days to have them removed. Sometimes dissolving sutures can be used instead. Over the course of the next few months, the jawbone will begin to naturally heal around the root.