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. Norrington or Smithson 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.

Labeled illustration of a tooth in bone with infected tissue at the root tip, showing gum tissue, gutta-percha and a filling
1. Infected Tissue
Illustration of a surgical instrument removing infected tissue from the bone at the root tip, labeled 'Missing Root Tip'
2. Tissue Removed
Illustration of the apicoectomy closed with a suture, with a new root-end filling placed at the tip of the tooth's root
3. Suture Placed
Illustration of a tooth in bone after surgery, with a pale patch of healed bone at the root end labeled 'Healed Bone'
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.