Understanding the Role of Apicoectomy in Dental Care

An apicoectomy is a procedure in which the root tip is removed, damaged tissue is excavated, the root end cavity is prepared, and the cavity is filled with a biocompatible material. The procedure is also commonly known as:

• Apicectomy
• Root-end filling
• Root-end surgery
• Retrograde root canal treatment

Our Renovo endodontic specialists can perform this microsurgery procedure to help save your tooth.

Signs an Apicoectomy Is Necessary

There are several reasons why we might recommend an apicoectomy. Sometimes, the canals in the root of a tooth are calcified, and we can’t address a tooth infection as we usually would (with traditional root canal therapy). Another reason might be that someone’s had root canal treatment, but they have a persistent infection, pain, or abscess. While not common, this can occasionally happen, and the best way to address it while saving the tooth is with an apicoectomy.

Other reasons include:

• Root perforation
• Severely curved canals
• Foreign bodies in the canal
• Fracture of the apical third of the tooth (tip of the root fracture)
• Diagnostic purposes (the patient has persistent symptoms, but the X-rays don’t show any issues)

How Can an Endodontic Specialist Miss a Canal?

In short, root canal treatment is an intricate procedure. The diameter of a root canal is between one and three millimeters. The length of canals is between 20-23 millimeters. However, the length and diameter of the canals can vary by person and by tooth.

Some roots are straight, meaning their canals are straight, while others are curved. Additionally, some canals are hidden behind others and are difficult to see in X-rays or with the naked eye. Therefore, finding and treating them isn’t always easy.

Does that mean patients should forego the root canal therapy recommended by their Renovo team? Of course not! Overall, root canals have an up to 95% success rate, making them an extremely worthwhile procedure.

What Happens During an Apicoectomy Procedure?

If you need an apicoectomy, here’s what you can expect during your visit to Renovo Endodontic Studio:

Accessing the Tooth’s Root

First, your endodontist will numb the tooth to ensure comfort during the procedure. Then, they’ll create an incision in the gum tissue to expose the root tip. The gum tissue is retracted while a few millimeters of the root tip is surgically removed.

Removing the Infected or Damaged Tissue

In addition to removing the root tip, any pathological tissue surrounding the root tip is also removed. This can include surrounding bone tissue.

The root is then cleaned and disinfected and is prepared to be filled. Preparation includes smoothing the tooth structure and margins to ensure there’s less risk of bacterial microleakage.

Placement of a Biocompatible Filling Material

The next step is to fill the root tip with a biocompatible filling material. This means that the material has been tested and proven to be safe. It will not harm your tooth, jawbone, or gums.

The material is carefully packed into the preparation to avoid voids in the filling material. A void can, over time, cause weakness, which can result in the introduction of bacteria into the tooth.

Sutures and Post-Operative Instructions

After the apicoectomy, we’ll close the gum tissue with sutures and provide post-op instructions. These instructions will help ensure your comfort during recovery and reduce your risk of pain, swelling, and bruising.

Recovery and Post-Operative Care – What You Can Expect After an Apicoectomy

Post-operative care is just as crucial as the apicoectomy procedure itself. What happens during recovery will help ensure your comfort and the success of the procedure.

Post-Operative Instructions

Post-operative instructions are designed to help you heal as quickly and comfortably as possible and with minimal side effects. They include but aren’t limited to:

• Don’t spit for the remainder of the day
• Don’t use a straw to drink
• Don’t smoke
• Keep fingers and tongue away from the surgical site
• Keep gauze on the surgical site for 30-45 minutes (apply moderate pressure)
• Replace the gauze if you’re still bleeding (keep it on for another hour if needed)

Pain Management and Medications

It isn’t uncommon to have some soreness and swelling at the surgical site and surrounding tissues. Here are some ways to reduce swelling and discomfort:

• Use an ice pack on your cheek for 15-20 minutes, take it off for 10 minutes, and repeat
• Sleep with your head slightly elevated
• On the third day, apply moist heat to the cheek instead of ice

Oral Hygiene Instructions

Brushing and flossing are still important. For the first day, though, avoid the surgical area. When you start brushing this area again, be very gentle. Avoid spitting or rinsing forcefully.

Follow-Up Appointments

We will want to perform a follow-up examination within six months of an apicoectomy. During this appointment, we’ll evaluate the success of the treatment, check that you’ve regained normal function, and assess bone health.

A Precise Solution: Harnessing the Power of Apicoectomy for Tooth Root Care

With procedures like apicoectomies, we can help patients regain their oral health without requiring an extraction.

As you embark on your journey to better oral health, learn about all your treatment options. An extraction isn’t the only choice if you have a damaged tooth. Alternative treatments are available to help you maintain your oral health, your beautiful smile, and all your teeth for a lifetime.

Ask your Renovo endodontic team how they can help.

Ready to explore the benefits of tooth root surgery and its role in dental care? Schedule a consultation with one of the experienced endodontists of Renovo Endodontic Studio and experience the exceptional care provided by our diverse team.