About Apicoectomies

What is an apicoectomy?

You may have been informed by your dentist or endodontist that you need an apicoectomy.  We usually will see you for a consultation to evaluate the tooth and review your options.  Statistically, 6-7% of teeth that are treated with conventional root canals go on to have a chronic or acute infection later. This does not mean that the root canal was improperly done but usually is caused by either multiple accessory canals at the root end or a possible or extra canal.

An apicoectomy is a procedure that allows the oral surgeon the ability to remove chronically or acutely infected tissue which may be inflamed or cystic and which originates from the root end area of a tooth that usually has been treated with a root canal. Occasionally teeth that have calcified canals that are unable to be treated with conventional root canals may need an apicectomy as well (apico=root end or apex, ectomy=removal).  In this procedure (either under a local anesthetic, sedation, or general anesthesia) the infected root end is accessed through a small incision in the gum.  The inflamed area is completely curetted free from the root end and the infected 1-2 mm's of root structure is then removed.  The root end is then instrumented with an ultrasonic instrument to allow for root end sealing with a sealing agent that has antibacterial qualities.  After sealing of the tooth and complete lavage of the site, the wound is usually closed with dissolvable sutures.  Occasionally, synthetic bone material is placed into the defect that was created by the original inflammation or cyst.

Following the procedure, there usually is some discomfort but this does not usually necessitate use of prescription pain medication which will be available to you should you need it.  Patients can return to work usually the same day or the following day at the latest.  Antibiotics usually are prescribed and specific instructions will be rendered during your office visit.