Apicoectomy / Endodontic Surgery

Apicoectomy / Endodontic Surgery Information

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.

Helpful Endodontic Surgery Video from the American Association of Endodontists

Root Canal Surgery Explained

Sometimes, a tooth that has had root canal treatment may not heal properly or may become re-infected. If this is the case, endodontic surgery may be recommended to help save your tooth. Watch this video for information on endodontic surgery and to learn more about endodontists—the dentists who specialize in this procedure.

Miami's Endodontic Specialists

Miami's Endodontic Specialists

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Frequently Asked Questions About Root Canal Surgery

Will I be able to return to work / school after endodontic surgery?

Patients are asked to refrain from strenuous activity immediately following endodontic surgery. If your job involves physical activity or if you partake in sports, it may be best to schedule recovery time following your treatment.

How soon after my treatment can I eat?

Numbness can last for 1-2 hours after your appointment. Trying to eat while numb could result in you accidentally biting your cheek, lips, or tongue. For this reason, we recommend that you wait until the numbness has completely gone away before trying to eat. Following surgery, you will be advised not to eat in the area of your treatment. Eating in the area of the surgery can cause damage to your sutures and could disrupt the healing process of the gum tissue over the surgical site.

How many visits will my root canal surgery take?

Root canal surgeries are performed in one appointment. Patients are required to return to the office for post-surgical followup 3-5 days after the treatment. At this visit, we remove your sutures and evaluate the overall healing of the gum tissue in the surgical area. You will be asked to return to the office for a third appointment several months later to verify that the area has healed completely.

Will I feel any pain during my endodontic surgery?

Endodontists are specialists in anesthetizing (numbing) teeth. We do not move forward with surgical treatment until we are sure that you have been completely anesthetized. At our office, the vast majority of patients experience no discomfort during their Endodontic Surgery.

Will I feel any pain after my endodontic surgery?

Patients can expect to experience soreness in the area of surgery for a few days following the procedure. This soreness can generally be managed with over-the-counter medications. A small percentage of patients may experience swelling or bruising in the area of the procedure. Patients who experience anything more than slight discomfort are asked to contact the office so that their symptoms can be addressed promptly.

Will my tooth need a new crown after endodontic surgery?

In most cases, no. One of the main benefits of endodontic surgery is that the procedure is performed through a small incision in the gum tissue. The crown of the tooth is left undisturbed. If the crown was found to be in good shape prior to the surgical procedure, it will not need to be replaced afterward.

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