When does one need an apicoectomy?

An apicoectomy is warranted on a tooth that already had a root canal, and that root canal has failed. Some signs of a failing root canal can be persistent pain, a pimple on the gums adjacent to the tooth, or tooth mobility. Not every tooth is a suitable candidate for an apicoectomy.

 

What is an apicoectomy?

An apicoectomy is essentially a reverse root canal. A tooth remains alive by its blood supply, which travels with the nerve that gives feeling to the tooth. When that blood supply is compromised, the tooth dies and an infection develops in the bone. A root canal is usually the the first option to care for this problem. If the root canal fails, an apicoectomy is an option.

A window in the bone is created to gain acccess to the bottom of the root. A small incision is made in the gum tissue and the infection is cleaned out. The offending root tip is identified and removed, while leaving the rest of the tooth alone. The canal of the root is prepared for a sterile seal to prevent another infection from recurring. We use the most advanced instruments and equipment, including ultrasonic instruments to prepare the canal and the finest filling materials to insure the best seal for success.

This procedure can be performed under local anesthesia, nitrous oxide, or intravenous sedation. After the procedure you will have some minor tenderness that may persist for a few days.

diagram_apico_pre_op
A tooth remains alive by its blood supply, which travels with the nerve that gives feeling to the tooth.
diagram_apico_infected_tooth
When that blood supply is compromised, the tooth dies and an infection develops in the bone. A root canal is usually the first option to care for this problem.
diagram_apico_infected_tooth
If the root canal fails, an apicoectomy is an option. A window in the bone is created to gain acccess to the bottom of the root.
diagram_apico_after
The bottom part of the root is removed, the infection cleaned out, and the tooth is sealed. The exposed area of the tooth is left unharmed.