When we perform an apicoectomy, it is often to correct complications after a standard root canal treatment. Or we may use it when the doctor sees that the standard treatment is not best for the tooth.
An apicoectomy has the same purpose as the standard root canal service, which is to clean the infection from the interior of the tooth—the root canal—and to save the walls and the rest of the structure of the tooth. But we accomplish these purposes in a different way.
What Happens in an Apicoectomy?
The name “apicoectomy” refers to the tip, or apex, of a tooth root. Each tooth root extends down into the jawbone and comes to a point. A tiny opening there lets blood vessels and nerves through.
“Ectomy” refers to the removal of a structure, so “apicoectomy” means that we remove the tip of a tooth root. Dr. Stubbs might ask you to take anti-inflammatory or antibiotic medication before the procedure.
Then, we will:
- Scan the tooth and jawbone with digital x-rays, creating an accurate map of the area and a plan to successfully perform the surgery.
- Make you comfortable with anesthesia and any other necessary sedation.
- Expose the apex of the root and remove any damaged tissue there.
- Take off the tip of the root.
- Use our GentleWave ultrasonic device to ensure that any infected tissue is cleaned out of the root canal.
- Fill the end of the root with a sanitary material to protect the root canal area.
- Close the tissue around the root, which will heal naturally at home.
After this procedure, you’ll be able to go home right away and get comfortable for your recovery time.
Why Is an Apicoectomy Performed?
In a standard root canal procedure, we enter the tooth from the top to clean it out. But in an apicoectomy, we enter from the opposite end—the tip of the root.
This is needed for:
- A blockage: There is an object stuck in the root canal that stops the dentist from accessing the whole root canal in the standard way. We need to ensure that we clean every part of the root canal, so we access it from the other end of the root canal.
- Complicated, small branches: A tooth may have an unusual number of miniscule branches of the root canal that are impossible to clean thoroughly with the standard treatment.
- Curved or narrow root canal: The shape and size of the root canal may not allow standard cleaning.
- Previous complications: Something went wrong with a previous root canal treatment, and the infection returned. Not every bit of infected tissue was removed. The apicoectomy will come at the problem from the other end to find the infection.
A standard root canal treatment usually removes an infection from the root canal. It is a very successful procedure. It’s rare that any infection is left over. When this happens, there’s a good chance that it involves the tip of the root and damaged tissues there. That’s why an apicoectomy is sometimes used as a follow up procedure, which is used in unusual cases.
Wonderful Pain Relief
Your endodontist will give you instructions after the procedure that will help in your recovery, such as the foods you can eat and the medications you should take. You can expect some numbness and swelling around the tooth for a week or so. You’ll need plenty of rest and some ice packs.
We often see patients who are extremely distracted from the discomfort of a root canal infection. We’re excited both to relieve that pain and to keep the walls and root of the tooth as intact as possible. This can save you money, compared to replacing the tooth with a bridge or implant.
If Dr. Stubbs recommends an apicoectomy for you, don’t be alarmed. It’s simply a different strategy for accomplishing the same goals as a root canal.