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Apicoectomy: Everything you need to know about it.

What is an apicoectomy?


Apicoectomy is a kind of endodontic surgery offered by an endodontist. It is a root end surgery which involves the removal of root tip and preparation of a root end cavity which is finally filled with dental materials. 

Our teeth stand in their place because it's roots are firmly planted in the jawbone. Front tooth usually have a single root whereas molars and premolars have two or more roots. The root of the tooth is referred to as the apex. It is through this apex that the dental nerve and blood vessels enter the tooth. These nerves and blood vessels make the dental pulp. The dentist removes the dental pulp and disinfects the root canal during the root canal therapy. But sometimes the infected tissue can be attached to the root of the tooth, and this leads to failure of the root canal treatment. In an apicoectomy, the root tip of the infected tooth and the infected tissue are removed, and the end of the root is sealed.
What is an apicoectomy?


Why is apicoectomy regarded as endodontic microsurgery?


Apicoectomy is often regarded as endodontic microsurgery because of the use of a surgical operating microscope.

A tooth has a complex nerve and root system. A microscope provides a more magnified view of the roots which may go unseen under naked eyes.

When is an apicoectomy suggested?

An apicoectomy is suggested when the infection is not eliminated after a root canal treatment and even after a root canal retreatment. It is advised in cases where the infection keeps relapsing. If a root canal treatment fails then the doctor may suggest root canal retreatment before suggesting an apicoectomy because nowadays due to the usage of microscope a root canal retreatment can let the doctor see other hidden canals which were not treated earlier. If the root canal retreatment brings relief to the patient, then there is no need for an apicoectomy, but if it fails to deliver comfort, then an apicoectomy becomes necessary.

Who can do an apicoectomy?


A general dentist with a good experience can do an apicoectomy, but it is always better to get it done by an endodontist. Endodontists have a two-year degree in diagnosing and performing root canal treatment and are specially trained to do apicoectomy and endodontic microsurgery.

What are the preparations done before the apicoectomy?


The dentist has to collect the medical history of the patient, the medicines taken by the patient including the names of the health supplements. The doctor also needs current X-ray reports of the tooth and the bones surrounding it to see the extent of the damage. The doctor might suggest mild medicines and antibacterial mouthwash in case the patient has pain and inflammation in the teeth and gums.

What is done during the procedure of apicoectomy?


In this procedure, a small cut is made on the gums, and the doctor removes the gums to expose the tooth and the bone. Then the doctor uses a drill to reach the root of the tooth and removes the infected tissue and the tip of the root. The cleaning of the cavity is done under the microscope to allow better and magnified view. An X-ray is retaken to see if the apicoectomy was successful and the doctor stitches the tissue and gums back to its place.

Procedure of apicoectomy


How can we take care of the tooth after the treatment?


After the apicoectomy, the doctor may suggest medicines to control the post-surgery pain. He may also advise rest and application of ice pack on the swollen part of the face. Hard and chewy food and smoking should be avoided for some days after the surgery.

Related Article: Say No To Dental Issues, Visit Garland Dentist

It is advised not to brush the teeth and rinse the mouth rigorously as it may harm the new surgical wounds. The lifting of the lip to see the healing or surgical mark is also prohibited. 

The surgical stitches may take up to seven days to heal, and the pain and swelling may subside in two weeks.


According to Dr. Fay Mansouri, an Orange County Root Canal professional, we must go to an excellent endodontist for apicoectomy because many times due to improper drilling the tooth may become cracked or injured and then the apicoectomy has to be stopped and the tooth has to be extracted to bring relief to the patient. 


References: 

  1. https://en.m.wikipedia.org/wiki/Apicoectomy
  2. https://www.aae.org/patients/root-canal-treatment/endodontic-treatment-options/endodontic-surgery/endodontic-surgery-explained/
  3. http://irvineendodontist.com/

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