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Apicoectomy

An apicoectomy is necessary when a tooth infection cannot be solved by root canal therapy. This surgical treatment is performed by an oral and maxillofacial surgeon and can be utilized on any teeth at any location in the mouth.

Whether the infection is located in a front tooth with a single root or in the back of the mouth where the premolars and molars are located with two or more roots, an apicoectomy may be a necessary form of treatment.

When the tooth becomes infected, and the oral surgeon is made aware of the condition before it increases in severity, the tooth may be treated through a root canal. A root canal is usually performed by a general dentist or endodontist. When an infection has developed in the tooth’s nerve or around the tip of the tooth root, a root canal can treat the tooth. The tooth root acts as a roadway for nerves and blood vessels between the tip of the root and the inside of the crown (also known as the pulp chamber). Root canal therapy can be extremely beneficial when the problem is identified early, but an infection may persist after treatment, and an additional surgical procedure will be necessary to solve the problem. An apicoectomy is usually recommended if problems persist. Apicoectomy treatment, also known as endodontic surgery, is typically done with magnification and additional efforts to ensure that the tooth does not develop other serious infections or complications.

What is the purpose of an apicoectomy?

An apicoectomy may be recommended if your teeth exhibit any of the following:

  • Root Canal Blockage. Sometimes, debris from root canal therapy can block the root canal; if the canal is too small, proper cleaning becomes extremely difficult. If either are the case, an apicoectomy may be necessary to clear the blockage. If a patient has already undergone root canal therapy once and develops a second infection, the patient should be referred to an oral surgeon.
  • Small Root Branches/Lateral Canals. Patients who have branches or lateral canals that are smaller than average are at a greater risk for persistent infection. The smaller branches and canals are more difficult to clean and seal.
  • Curved or Narrow Root Canals. When the tooth root is narrow or curved, this makes it difficult for a general dentist to clean the infected area properly. Narrow or curved root canals run a higher risk of persistent infection following root canal therapy and may need an apicoectomy.
  • When an infected tooth root is not properly treated, the infection may cause a complete loss of the tooth. An apicoectomy is meant to help the patient avoid tooth extraction.

What occurs during an apicoectomy?

To perform an apicoectomy, the oral surgeon magnifies the tooth before the procedure to get the most detailed image of the infection. They will utilize a 3D CT scan to determine the least invasive path and ensure optimal recovery. Next, after the proper anesthetic is administered, any remaining infected tissue will be removed from the tooth along with the tooth’s root tip. The root tip is especially prone to infection, and its removal ensures that no infection will spread to the rest of the mouth. Your oral surgeon will then clean and seal the end of the tooth canal. The entire procedure usually takes between 30 and 90 minutes.