You’ve already had a root canal, but months later your tooth is still causing problems. Your endodontist just mentioned something called an apicoectomy, and you’re wondering what that means. An apicoectomy is a minor surgical procedure where the tip of your tooth’s root is removed and sealed to eliminate persistent infection. Studies show success rates of 85-95% for surgical endodontic treatment using modern techniques, making it an effective option when standard root canal therapy alone cannot save your tooth.
At West Atlanta Endodontics, we perform apicoectomies using advanced technology including surgical microscopes and ultrasonic instruments. This procedure offers you a chance to keep your natural tooth instead of resorting to extraction.
Why Root Canals Sometimes Need Additional Treatment
Root canal treatment successfully saves millions of teeth each year. The procedure removes infected tissue from inside your tooth, cleans the root canal system, and seals it to prevent future infection. However, some situations prevent standard root canal treatment from completely resolving the problem.
The anatomy of tooth roots can be complex. Some teeth have tiny branches or curves at the root tip where bacteria can hide beyond the reach of standard root canal instruments. Calcium deposits can make a canal too narrow for the instruments used in nonsurgical root canal treatment to reach the end of the root. When infection persists in these hard-to-reach areas, the bone and tissue surrounding your root tip remain inflamed.
Other times, a tooth that healed well after initial treatment develops new problems years later. The restoration on top of the tooth might leak, allowing bacteria to reinfect the root canal system. In these cases, redoing the entire root canal from the top down might be impractical, especially if the tooth has a crown or post that would need to be removed and replaced.
When Your Endodontist Recommends an Apicoectomy
Several specific situations lead endodontists to recommend root-end surgery. The most common occurs when inflammation or infection continues in the bone around your root tip despite proper root canal treatment. X-rays or cone beam CT scans show a dark area at the end of your root, indicating bone loss from ongoing infection.
You might experience persistent symptoms even though X-rays look normal. Surgery allows your endodontist to examine the entire root of your tooth, find problems like tiny fractures or canals not detected during nonsurgical treatment, and provide treatment. Endodontic retreatment is often the first choice when a root canal fails, but an apicoectomy may be more practical if you have an expensive crown in good condition or complicated anatomy.
What Happens During the Procedure?
An apicoectomy typically takes 30 to 90 minutes, depending on which tooth is being treated and the complexity of its root structure. Here’s what you can expect during the procedure:
- We start by numbing the area with local anesthesia to ensure you feel comfortable throughout
- A small incision is made in your gum tissue near the affected tooth to access the bone and root tip
- We remove a small amount of bone to expose the very end of the root and any infected tissue
- The tip of the root is removed, typically just a few millimeters
- A small filling made with biocompatible material seals the end of the root canal to prevent reinfection
- The gum tissue is closed with a few stitches that either dissolve or are removed within a week
The endodontist removes the very end of the root, and a small filling is placed to seal the end of the root canal. We use surgical microscopes and ultrasonic instruments to ensure precise placement of this filling. Your bone naturally heals around the sealed root tip over the following months, eliminating the infection and restoring normal function.
Expert Endodontic Surgery at West Atlanta Endodontics
Dr. David Norrington and Dr. James Smithson II bring extensive training and precision to every apicoectomy procedure. Both doctors take an analytical approach to complex endodontic cases. We use the latest surgical microscopes, ultrasonic instruments, and cone beam CT technology to provide the most accurate and minimally invasive treatment possible.
We serve patients from throughout the West Atlanta area at our Marietta and Cartersville offices. If your dentist has recommended an apicoectomy or you’re experiencing problems with a previously treated tooth, we can evaluate your situation and discuss your options. Contact us today to schedule a consultation.