If you develop an infection deep in the root of a tooth, then you will probably be referred to a specialist for root canal therapy.

Despite a bad reputation, root canal therapy is a relatively straightforward procedure, which thanks to improvements in tools, techniques and anesthetic, is no more painful or complex than a regular cavity filling.

Each tooth may have one or more roots, and generally the larger the tooth, the more roots it may have. It is necessary to perform root canal on each root to ensure that the infection is completely removed.

However, sometimes inflammation or infection persists, even after a root canal therapy has been performed. If this happens, a procedure known as an apicoectomy may be required.

What is an apicoectomy?

An apicoectomy is a surgical procedure that removes the apex of the affected root.
The apex is is the very tip of the root, buried deep in your jaw, and the access point for the blood vessels, nerves and nutrients that your tooth needs to remain healthy.

In many cases where a root canal in not successful, it is because of remaining bacteria in the apex of the root.

After the apex is removed, the root is then sealed to prevent further infections from occurring. This helps preserve the health and function of the tooth.

Why might an apicoectomy be necessary?

There are several reasons why root canal treatment may fail. The most common reasons include:

  • A blocked root canal. This most often occurs in secondary root canal treatments. This is because the blockage most commonly occurs as a result of a previous root canal surgery. If the canal becomes blocked, your dentist may not be able to reach all infected parts of the root.

  • Narrow or curved root canals. If the root canal is particularly narrow or curved, the endodontic file used to clean them may not be able to access the tip.

  • Root branches. Roots are complex structures and may split into tiny branches, which are often too small for the endodontic file to access.

Apicoectomy procedure

Before your apicoectomy, you can expect to receive a course of antibiotics. These will help to treat the underlying infection, and you should make sure you take them as directed and for the full course.

Your apicoectomy will be performed under a local anesthetic and will begin with a small incision in the gum, which will allow your dental surgeon to lift away the exposed root underneath.

In some instances, it may also be necessary to remove a small part of the bone to gain sufficient access to the root. This will grow back and heal by itself.

The apex of the root and any infected tissue can then be removed using precision equipment. After sealing the root, the gum can then be closed and secured using sutures.

Apicoectomy aftercare

You will probably find that your gum and mouth is swollen and sore in the days after your surgery. Both of these will improve with time, but you will be given advice as to which pain medications are the right ones to alleviate your discomfort.

If you have not been given dissolvable sutures, you will need to return to our offices to have them removed several days after your procedure. Your surgeon will give you specific aftercare advice to follow, and this should be adhered to to minimize your risk of complications and give you the most efficient recovery from your apicoectomy surgery.

Our team of experienced and knowledgeable surgeons have the skill and expertise to provide high quality apicoectomy procedures to preserve your infected teeth. When it comes to saving an infected tooth after a failed root canal, time is of the essence. Call our office today to schedule a consultation.