Apicoectomy

What is an Apicoectomy?
An apicoectomy is an endodontic procedure that is performed if a root canal or endodontic retreatment fails. An apicoectomy is carried out only after at least one root canal has been performed. It is usually the last resort. Sometimes doctors perform a second root canal to clear canals they were not able to locate earlier.

Why do I need an Apicoectomy?
You may need an apicoectomy because often a root canal is not able to remove all the dead nerves and infected tissue. Because the root canal is a complex structure, even a retreatment may not be able to clear the canal completely. This can cause re-infection. Usually the infection occurs at the narrow tips of the root and an apicoectomy fixes the problem by removing the root tips along with the infected tissue. The ends of the roots are then sealed. An apicoectomy allows you to keep the tooth which otherwise may have required extraction because of the infection.

What does the Apicoectomy procedure involve?
Before an apicoectomy you will be given an antimicrobial mouth rinse, an anesthetic, and medicine to counter inflammation. The anesthetic can increase your heart rate so let your endodontist know if you have high blood pressure. The endodontist will cut the gum to access the root. The root is cleaned and the root tip is removed. The root is cleaned using a surgical microscope and ultrasonic instruments. The dentist will take an X-ray of the cleaned area and check for any debris. The surgical area is then sutured back. If any cracks or fractures are found in the tooth, it will have to be removed and the apicoectomy will end.

An apicoectomy can take between 30-90 minutes. An apicoectomy on the lower molars takes the longest while the procedure for the front teeth takes less time.

After the procedure you should avoid hard and crunchy food. Apply ice to the area for around 12 hours after the surgery. Do not rinse vigorously or pull your lips as this may loosen the sutures. The sutures will be removed in around a weeks time. In around fourteen days the swelling and numbness will be gone completely.