What is an Apicoectomy?
On the rare occasion that a root canal is not successful, it may be due to a difficulty in getting a good seal at the end of the root tip. A root canal is done through the tooth. Sometimes, canals can be very clogged with hard calcifications or very tortuous, making it difficult to get the root canal filling material to seal well. Therefore, an apicoectomy is performed. It is a surgical procedure where the end of the root is exposed from under the gum and a filling is placed in the end of the root.
Sometimes a previous infection in a tooth will extend to the outside of the tip of a root of a tooth and will reside in the bone surrounding the tip of the root. Usually, our own immune systems can beat the infection after a root canal is performed. Sometimes, the body is unable to beat the infection. In these common cases, the patient or dentist will notice an area in the bone that is not healing, or the patient will continue to have symptoms suggestive of an infection.
The most common endodontic surgery is an apicoectomy or root-end resection in which the tip of the root is cut off. This is performed when inflammation or infection persists near the root end after root canal therapy. An incision is made in the gums to expose the underlying bone surrounding the end of the root. Often there is already a window of bone missing around the root end from an abscess. More bone may need to be removed to allow access to the tip of the root. Inflamed and infected tissue is then removed. This tissue (biopsy) is sent to the University of Iowa Pathology Labs to be evaluated. The tip of the root is then removed and a small filling is placed to seal the end of the canal. Sutures will be placed in the gums to close the incision. You will need to return to our office for suture removal. Your return appointment will be scheduled the day of surgery.
