Apicoectomy

The teeth are held firmly in place by strong roots that extend into the jawbone. Molars and premolars tend to have several roots, whereas the front incisors only have a single root. The end or tip of each root is termed the apex. The apex is where the nerves and blood vessels enter the tooth and aids in the delivery of blood to the crown (the part of the tooth you can see in your mouth).

A root canal treatment refers to the cleaning of the canals and the removal of infected and inflamed tissue within the root. When the inflammation or infection persists after the root canal treatment, an apicoectomy may be required. An apicoectomy is essentially the removal of the apex (or root tip), followed by a filling procedure to seal the root from further infection. When left untreated, infected roots can damage other teeth, spread infection, and cause regression of the jawbone.

Reasons for an apicoectomy

Infected and inflamed soft tissue around the root of a tooth can be exceptionally painful and debilitating. The purpose of an apicoectomy is to eliminate the infection in the tissue and to ultimately preserve the function of the tooth and save it from extraction. An apicoectomy will rarely be considered by the surgeon unless a prior root canal treatment has failed.

There are several reasons why an apicoectomy may be necessary:

  • Small Adjoining Root Branches – Roots are extremely complex and can contain many tiny branches. If these tiny branches cannot be cleaned and sealed when the root canal treatment is performed, inflammation can persist.
  • Blocked Root Canal – In some cases, the surgeon is unable to effectively clean a root canal because it is blocked by a fractured file left behind from prior root canal treatment. Infection and debris can quickly affect adjacent teeth.
  • Narrow or Curved Root Canals – When the root canal is poorly shaped, the endodontic files cannot reach the root tip. Continuing infection or re-infection can then occur.

What does getting an apicoectomy involve?

Prior to the surgery, the surgeon will generally prescribe an antibiotic or anti-inflammatory medication to treat the underlying infection. Panoramic X-rays will then be taken to enable the surgeon to plan the apicoectomy, which will be performed under local anesthesia.

The surgeon will make a small incision in the gum and expose the root by lifting away the gum. In some cases, a tiny fraction of the jawbone may be removed to properly expose the root. The edge of the root tip and any infected connective tissue will be removed using ultrasonic instruments. The root will be sealed using a retrofill (filling material), and the surgeon will suture the gum with several stitches.

This surgery does not require an overnight stay, and full aftercare instructions and pain medications will be provided as needed. After several days, the surgeon will remove the stitches, and the connective tissues will fully heal several months after the procedure.

If you are experiencing any symptoms, such as pain or swelling associated with a tooth that has had a root canal, we encourage you to contact our office immediately.

Testimonials.

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Testimonials

100% recommend this dentist! I am from out of town and was camping, and woke up with exploding pain in my jaw. Dr. Chisholm saw me on short notice on a Friday afternoon, did a thorough examination, and found out my problems were in my jaw, not in my teeth. He ground down an existing crown to make my bite even, And I experienced immediate relief. He could have charged an arm and a leg but was conscientious of my financial status and luckily didn’t even need to do x-rays. He recommended a chiropractic jaw adjustment, which I appreciate immensely. He’s very personable and it took time to sit and talk with me and make sure I understood everything. You will be in good hands with Dr. Chisholm!

Suzette S.

Great dentists. Worked well with my kids.

I had a crown. There were a few things that made it better than my last 3 crowns at 2 different dentists. First is that it was pain free. He did a good job at numbing. A few uncomfortable moments but no grip the chair in pain moments like I'd had with other crowns. The other was he used a dental dam. Kind of annoying for breathing and clamping on tooth not fun, but I have silver fillings and the dam prevented the silver (with mercury) from getting lodged in my mouth (one prior dentists i had to stop and fish a piece of filling from the back of my throat).

Cost is on par with other dentists I would have expected a bit cheaper due to the location but on par nonetheless.

Aaron S.

Very friendly and they do great work.

Jarom L.

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Contact Us. We encourage you to contact us with any questions or comments you may have. Please call our office or use the quick contact form below.

Contact Us

We encourage you to contact us with any questions or comments you may have. Please call our office or use the quick contact form below.