An overview of endodontic surgery

Why would I need endodontic surgery?

Generally, a root canal or even a retreatment is all that is needed to prevent teeth with an injured pulp from being extracted. Occasionally, these non-surgical procedures will not be sufficient to heal the tooth and your endodontist may recommend surgery. Endodontic surgery can be used to locate fractures or hidden canal anatomy that did not appear on x-rays or did not appear under the microscope during root canal therapy or retreatment but may still manifest as pain in the tooth. Damaged root surfaces or the surrounding bone may also be treated during this procedure. The most common surgery used to save damaged teeth is an apicoectomy or root-end resection.

What is an apicoectomy?

The above video 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.

1. Infected Tissue

2. Tissue Removed

3. Suture Placed

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.

How long will it take?

Most endodontic procedures can be completed in one, sometimes two, visits.  The number of visits and the length of time required depends on your individual situation.  Your doctor may provide you with a better estimate of time after a thorough clinical and radiographic examination.

Will it hurt?

With the most up-to-date techniques, local anesthetic to numb the tooth and analgesics (pain medication), root canal therapy, retreatment and root end surgery is usually performed with minimal or no discomfort.  In fact, endodontic therapies are performed to remove diseased or damaged pulp thereby relieving pain.  Nitrous oxide sedation is not available at our office.