What is an Apicoectomy?

You should always take dental pain seriously. Dental professionals have training and treatments to relieve pain before losing a tooth. If you find your case requires an endodontic surgery called an apicoectomy, you should take the doctor’s advice and get the procedure. To ease your fears, at Innovative Endodontics, we’ve created this guide to help you answer questions such as, “What is an apicoectomy?”

What Is an Apicoectomy?

Several forms of endodontic surgery exist. However, the most common is called an apicoectomy. Although the name appears complex, it is based on what is actually done during the procedure. The name has two parts. The first is from “apical,” which is the descriptive form of the word apex, or the root end. The suffix “-ectomy” means to cut into. Therefore, apicoectomy means cutting into the end of the tooth. The procedure has several other names, including root-end surgery, root-end resection, or retrograde root canal treatment. The procedure involves removing the last few millimeters of the root and placing a filling at the root end. Although it sounds complex, it is all done with just local numbing and is painless.

An apicoectomy involves removing infected material from the root end instead of treating the tooth through the crown. In some cases, when patients have complex root anatomy, an endodontist may opt for apicoectomy to ensure they can completely remove all damaged pulp from the tooth. The majority of the bacteria in a tooth reside in the last few millimeters of the tooth’s root and that is where the surgery is performed.

Is an Apicoectomy the Same as a Root Canal?

An apicoectomy is not the same as a root canal. The former is a minor dental surgery that requires the endodontist to clean the root end. Root canal treatment is a non-surgical procedure that cleans the tooth through the top of the tooth. Both procedures have the same goal of ridding the tooth of harmful bacteria and enabling the body to heal.

Who Needs an Apicoectomy?

Which treatment is best for you takes into account a lot of factors. A thorough evaluation with three-dimensional imaging is the first step in the process. Sometimes, an endodontist may perform this minor surgery because the tooth is “heavily restored.” If the tooth with the infection has a post, core, and crown, it will make it very difficult to get through these materials and clean the canals in the tooth without potentially breaking the restorations or needing new ones. By treating the tooth from the root end, you can keep the existing crown and not disturb the upper part of the tooth. 

Another reason that this procedure may be performed may be due to the size of the bone loss or “lesion” of the tooth. If the size of the infection is big, the body cannot always heal from a traditional root canal. The surgery is able to physically debride the unhealthy tissue which is preventing the body from healing.

Are There Alternatives to an Apicoectomy?

In most cases, the only alternative to an apicoectomy is to have the tooth pulled, especially if you have an infection impacting the bone of the jaw. Getting a tooth pulled can result in surgery as well, depending on the location of the tooth and its orientation. Extracting a tooth may result in a longer recovery time and the risk of a dry socket.

What Is the Process of an Apicoectomy?

Though technically a surgery, an apicoectomy is a minor procedure that only requires local anesthesia, so you can drive home right after. As with all types of endodontic therapy, the doctor takes every step very seriously to minimize the chances of complications.

The area will be very thoroughly numbed. The gums will be gently reflected to see the area of infection which will be thoroughly cleaned. The last few millimeters of the root are removed and a filling is placed. The area is rinsed very well and the gum tissue is returned where it originally was found. A few sutures, or stitches, are placed. The whole procedure is typically completed within 45 minutes and is pain-free.

Do You Have to Go to an Endodontist for an Apicoectomy?

An endodontist is the best option for getting endodontic surgery because they spend years specializing in microsurgery and minimizing patient pain during and after the procedure. They are also trained on the best materials to use for the procedure.

How Long Does Recovery Take?

Recovery from the procedure is quite quick. There is mild to moderate discomfort for the first three days after the treatment. Proper pain management protocols will be emphasized and thorough post-operative guidance will be provided. Over-the-counter medications such as ibuprofen and Tylenol are what is recommended to manage the soreness. The gum tissue heals quickly and the sutures are typically removed approximately five days after the surgery. The bone healing will take about one year to complete, but of course, this is not something that you will feel or notice. A one-year follow-up to ensure healing is important.

Complications are very rare. However, if you were to notice any signs of infection after your operation, such as increasing discomfort, fever, or inflammation you would call your endodontist to get advice on what to do.

Contact Innovative Endodontics If You Need Endodontic Surgery

Now that you know the answer to your questions, such as “What is an apicoectomy?” you can feel more comfortable about the procedure. When choosing your endodontist for this type of surgery, you want to select someone who has extensive experience in endodontic surgery and other treatments. In the Charleston area, that doctor is Dr. Monica Estes at Innovative Endodontics.

Dr. Estes uses high-tech equipment to perform precise surgeries. Plus, she has an easy chairside manner that comforts her patients. If you need endodontic surgery, contact us today for an evaluation. Let us use innovation and old-fashioned caring to provide you with top endodontic surgery and other treatments.