In some cases, a tooth that has had a root canal, which did not sufficiently heal or has become re-infected, is not a candidate for re-treatment with a second root canal procedure. For these teeth, an oral and maxillofacial surgeon can perform a surgical procedure, which is known as an apicoectomy. This procedure effectively treats the infection at the root-end to preserve and save the tooth. An apicoectomy serves as an excellent next step procedure to save a previously treated natural tooth, eliminate a dental infection, and to restore the health of the surrounding tissues. It is most useful in cases where fractures or hidden canals still cause pain or infection around a treated tooth, as well as when a second root canal procedure is not recommended as it will further weaken and jeopardize the tooth.
An apicoectomy may be performed under local anesthesia along with sedation if it is selected or indicated. During this procedure an incision is made in teh gum tissue to access the tip of the involved root. Once uncovered, the damaged tissue in the area is removed along with a few millimeters of the tooth’s root end. A biocompatible filling material is then placed to seal the remaining portion of the root. The gum tissue flap is put back into place and sutured to complete the procedure.
With an apicoectomy, post-surgical discomfort is generally well controlled with over the counter pain medications. If additional stronger pain medication is required your oral surgeon will advise you accordingly depending on your case.