Apicoectomy

The teeth are held firmly in place by strong roots that extend into the jawbone. Molars and premolars tend to have several roots, whereas the front incisors only have a single root. The end or tip of each root is termed the apex. The apex is where the nerves and blood vessels enter the tooth and aids in the delivery of blood to the crown (the part of the tooth you can see in your mouth).

A root canal treatment refers to the cleaning of the canals and the removal of infected and inflamed tissue within the root. When the inflammation or infection persists after the root canal treatment, an apicoectomy may be required. An apicoectomy is essentially the removal of the apex (or root tip), followed by a filling procedure to seal the root from further infection. When left untreated, infected roots can damage other teeth, spread infection, and cause regression of the jawbone.

Reasons for an apicoectomy

Infected and inflamed soft tissue around the root of a tooth can be exceptionally painful and debilitating. The purpose of an apicoectomy is to eliminate the infection in the tissue and to ultimately preserve the function of the tooth and save it from extraction. An apicoectomy will rarely be considered by the surgeon unless a prior root canal treatment has failed.

There are several reasons why an apicoectomy may be necessary:

  • Small Adjoining Root Branches – Roots are extremely complex and can contain many tiny branches. If these tiny branches cannot be cleaned and sealed when the root canal treatment is performed, inflammation can persist.
  • Blocked Root Canal – In some cases, the surgeon is unable to effectively clean a root canal because it is blocked by a fractured file left behind from prior root canal treatment. Infection and debris can quickly affect adjacent teeth.
  • Narrow or Curved Root Canals – When the root canal is poorly shaped, the endodontic files cannot reach the root tip. Continuing infection or re-infection can then occur.

What does getting an apicoectomy involve?

Prior to the surgery, the surgeon will generally prescribe an antibiotic or anti-inflammatory medication to treat the underlying infection. Panoramic X-rays will then be taken to enable the surgeon to plan the apicoectomy, which will be performed under local anesthesia.

The surgeon will make a small incision in the gum and expose the root by lifting away the gum. In some cases, a tiny fraction of the jawbone may be removed to properly expose the root. The edge of the root tip and any infected connective tissue will be removed using ultrasonic instruments. The root will be sealed using a retrofill (filling material), and the surgeon will suture the gum with several stitches.

This surgery does not require an overnight stay, and full aftercare instructions and pain medications will be provided as needed. After several days, the surgeon will remove the stitches, and the connective tissues will fully heal several months after the procedure.

If you are experiencing any symptoms, such as pain or swelling associated with a tooth that has had a root canal, we encourage you to contact our office immediately.

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Testimonials

My entire family gives Dr. Schmidt 5 stars! He is skilled, experienced, trustworthy, and you can tell he enjoys his job. My two children love to go to the dentist, and I think that speaks volumes. He makes you feel comfortable and at ease, even during unpleasant procedures. I trust Dr. Schmidt completely and know that he would never recommend unnecessary dental work. Oh, and by the way you cannot feel a thing when he gives you a shot.
The office staff is fun and super helpful as well. If you are looking for a dentist you will not regret coming to Dr. Schmidt!

Christina H.

THE place to go if you're scared of dentists. Dr. Schmidt is funny and relaxes you immediately. He makes a real effort so you don't feel pain. I hadn't gone in years and was hyperventilating before I went. Dr Schmidt's whole team was great. Told them I was nervous and they were great. Now, I'm never afraid to go. I trust him to the point that I eventually got braces (his recommended orthodontist was fabulous too) and today I've got a great smile.
He has several chairs. They can take X-rays right in the chair, and you can see them yourself on a big screen.
The office is a bit hidden in the interior corner of the shopping center, so you won't notice it from the parking lot.
My embarrassing moment... Going to the fish and chip place a few spots away to buy British candy afterward. I don't eat it right away!

A G.

Dr. Schmidt is the best dentist around. I have experienced a few different approaches and Dr. Schmidt's is the most comforting and knowledgeable. You never leave feeling negative or like you got raked over the coals. I was referred to Dr. Schmidt years ago by a close family friend and have not turned back. My family sees him and I have referred everyone I know to him. Over the years his staff has changed a lot but everyone I have come across is great. Highly recommended!

Jonathan G.

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Contact Us.We encourage you to contact us with any questions or comments you may have. Please call our office or use the quick contact form.

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We encourage you to contact us with any questions or comments you may have. Please call our office or use the quick contact form below.