Apicoectomy

Why would I need endodontic surgery?

Generally, a root canal is all that is needed to save teeth with injured pulp from extraction. Occasionally, this non-surgical procedure will not be sufficient to heal the tooth and Drs. Haglund, Coe, Kleitches, Hubbard, Hutcheson, Carpenter, Lynn or Rockett will recommend surgery. Endodontic surgery can be used to locate fractures or hidden canals that do not appear on x-rays but still manifest pain in the tooth. Damaged root surfaces or the surrounding bone may also be treated with this procedure. The most common surgery used to save damaged teeth is an apicoectomy or root-end resection.

What is an apicoectomy?

The video above illustrates this simple procedure. An incision is made in the gum tissue to expose the bone and surrounding inflamed tissue. The damaged tissue is removed along with the end of the root tip. A root-end filling is placed to prevent reinfection of the root and the gum is sutured. The bone naturally heals around the root over a period of months restoring full function.

A cross-section diagram of a tooth and its surrounding structures. An area of infected tissue is shown in the bone at the tip of the tooth root. Labels point to the infected tissue, gum tissue, gutta-percha inside the root canal, bone, ligament, and the dental filling.
1. Infected Tissue
A diagram showing the surgical removal of infected tissue. A dental instrument is extracting the infected mass from the bone. The tip of the tooth root is shown as removed, with a label indicating the Missing Root Tip.
2. Tissue Removed
A diagram illustrating the completion of the surgical procedure. A Root-end Filling has been placed at the tip of the shortened root. A suture is visible on the gum tissue where the incision was made, and the previously infected cavity in the bone is now empty.
3. Suture Placed
A diagram showing the final stage of healing after an apicoectomy. The area in the bone where the infection was located is now filled with Healed Bone. The tooth remains in place with the root-end filling, and the gum tissue is fully closed.
4. Healing Complete

What should I expect after an apicoectomy?

Following the procedure, there may be some discomfort or slight swelling while the incision heals. This is normal for any surgical procedure. To alleviate any discomfort, an appropriate pain medication will be recommended. If you have pain that does not respond to medication, please call our office.