The Basics:
An Apicoectomy is a surgical procedure performed when traditional Root Canal Retreatment is not possible. Instead of treating the tooth through the crown (the portion of the tooth you see above the gumline), a small incision is made in the gum tissue to gain direct access to the tip of the infected root. The area is cleaned and sealed with biocompatible materials that help to protect against future infection.
The Details:
Standard Root Canal Retreatment is performed through the crown of the tooth (the portion of the tooth you can see above the gumline). In certain cases, however, this is not possible and retreatment is better managed with a micro-surgical procedure called an Apicoectomy.
This procedure is often considered as the treatment of choice when part of the root canal system cannot be accessed and cleaned effectively through the crown of the tooth. This may be due to abnormal tooth anatomy, severely calcified (narrow) canals, or canals with sharp dilacerations (bends and curves). Surgery may also be preferred if the tooth has a complex restoration (crown or bridge) that cannot be removed without causing substantial damage to the tooth.
Endodontic Surgery starts with a small incision in the gingiva (gums) next to the infected tooth. The root of the tooth is exposed and the infected/inflamed tissue from around the tip of the root is removed. The tip of the root is then cleaned and sealed with a biocompatible bioceramic material that helps to guard against future infection.
The Good News:
Similar to Root Canal Therapy and Non-Surgical Root Canal Retreatment, Endodontic Surgery allows patients to retain and continue using their natural teeth. The added benefit of Endodontic Surgery over Non-Surgical Retreatment is that the restoration (filling or crown) in the tooth is not affected by the procedure. In other words, if the existing restoration is in good condition, no new crown or filling is required after the surgical procedure is completed.
