Typically, to save a tooth with extraction-related injured pulp, all you need is a root canal. Sometimes, however, a root canal isn’t sufficient enough to heal your tooth. In this case, our endodontist, Dr. Robert McBride DDS, would recommend surgery.
Endodontic surgery may be used for locating hidden canals or fractures not appearing on X-rays, but still causing pain in your tooth. He might also treat your surrounding bone or damaged root surfaces with endodontic surgery. A common type of endodontic surgery for saving damaged teeth is known as a root-end resection or apicoectomy.
What is an Apicoectomy?
An apicoectomy is a minor surgical procedure that removes the very tip, or apex of the tooth’s root.
There are many parts that make up your teeth, the primary three being your:
Root canals (these are long and skinny and extend into your jaw from your crown)
Crown (you can see this part)
Root tip (also referred to as the “apex”, meaning “point” or “tip”)
If you’re experiencing pain or infection in your tooth that had root canal treatment previously, it is most likely because there’s an issue in your apex area. Therefore, during an apicoectomy, Dr. McBride will remove the apex along with other infected tissue he finds.
Why You Would Need an Apicoectomy
An apicoectomy is often performed when you have a standard root canal that fails to remove all the infected tissues or dead nerves. This could cause a re-infection of your tooth and frequently signals an issue near your apex, where the roots of your tooth come to a point.
An apicoectomy repairs the issue by removing the apex as well as your nearby damaged tissue. Since it’s a complicated procedure, it’s often only suggested as a last resort after Dr. McBride attempts one or more root canal procedures. An apicoectomy allows you to preserve your natural tooth, which likely would have needed to be extracted as your last potential treatment option.
A surgical root canal could help save your tooth in various situations, such as:
1. Diagnosis. Dr. McBride might use surgery in diagnosis. If you’re experiencing persistent symptoms, but Dr. McBride can’t find the issues on your X-ray, your tooth might have a tiny canal or fracture that can’t be detected by Dr. McBride during nonsurgical treatment. In this case, surgery will allow him to:
Examine your entire tooth root
Identify the issue
Offer you treatment
2. Continued Infection or reinfections. Typically, your tooth that’s undergone root canal treatment, can last for a lifetime and never require further treatment. But, sometimes, a tooth might become infected or might not heal. Your tooth might become diseased or painful months or even years after your nonsurgical root canal. If this is the case, apicoectomy might help save your tooth.
3. Narrow canal due to calcium deposits. In some cases, calcium deposits cause the canal to become too narrow for nonsurgical root canal treatment tools to reach the end of your root. If you’re experiencing this “calcification” in your tooth, Dr. McBride might perform a surgical root canal to clean and seal the remainder of your canal.
4. Treat surrounding areas. Dr. McBride might also perform surgery to treat the surrounding bone or damaged root surfaces.
Preparing for your Surgical Root Canal
Before your treatment, you’ll have a consultation with Dr. McBride. Since he’s an endodontist, he has advanced training to perform an apicoectomy.
Before your procedure, Dr. McBride might take more X-rays of your surrounding bone and tooth. He may provide you with an antimicrobial mouth rinse, antibiotics and/or medicine for reducing inflammation.
He will also go over your medical history. Be sure you inform Dr. McBride of all medications you’re currently taking, including over-the-counter medications, supplements, and vitamins. Dr. McBride might consult with your primary care physician prior to the procedure, depending on other existing health conditions you may have.
How it Surgical Root Canal Works
Dr. McBride makes an incision in your gum tissue, exposing your surrounding inflamed tissue and bone. He’ll remove the damaged tissue as well as the end of your root tip. He’ll place a root-end filling for preventing reinfection of your root and will suture your gum. Your bone will heal naturally around your root over a several month period, restoring full function.
Does Surgical Root Canal Hurt?
To make your procedure more comfortable, Dr. McBride will provide you with local anesthetics. Of course, you might experience slight swelling and some discomfort while your incision heals. This is normal regardless of what surgical procedure you undergo. Dr. McBride will suggest appropriate pain medicine to ease your discomfort.
He’ll provide you with certain postoperative instructions that you’ll need to follow. After your procedure, if you have any questions or if you’re experiencing pain that isn’t responding to medicine, be sure to give Dr. McBride a call.
Recovering After Apicoectomy
Many individuals can continue on with their regular activities the following day. You might experience swelling and pain as you heal. Following the postoperative instructions provided to you by Dr. McBride, including brushing and diet advice, can help.
It can be a long journey of treatments for people that have undergone standard root canal treatment that has failed, but an apicoectomy procedure can help save your teeth that would have otherwise needed to be extracted. Once Dr. McBride performs the procedure, your bone, tooth and gum tissues that were infected previously will return to better functional use and health for many years.
To talk to our Colorado Root Canal Specialist about an apicoectomy surgical root canal, call us at 303-920-9145 or complete our online form.
Say goodbye to tooth pain and get back to enjoying your life
13762 Colorado Blvd #154, Thornton, CO 80602