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What is an Apicoectomy?


tooth-diagram-apicoectomy-austin-oral-surgery-300x256Though it is certainly a feared and maligned dental procedure, root canal therapy is most often a very successful, with over a 95% success rate. Root canal therapy is an effective treatment against infection of the pulp of the tooth — most of the time. Unfortunately, because of the way percentages work, this means that 5% of the time root canal therapy treatments fail. Though this is a small minority, it poses big problems for those affected. However, there is one last effort that can often be performed to salvage the tooth: an Apicoectomy. But what is this mysterious savior of infected teeth? Read on to find out.

Apicoectomies: An Overview

For those who are unfamiliar, below the surface of the gums, teeth are held in place by structures called roots. These roots often contain a complex system of blood vessels, nerves and canals that run throughout the inner structure of the tooth. Though a root canal treatment is designed to flush out and disinfect the inner parts of the tooth, including these complex tunnel-like systems, sometimes some bacteria survives and re-infects the tooth. Often times, the source of the problem is attributed to the root of the tooth, and in these cases the root and any infected material might be removed without the necessity for complete removal of the tooth. In these cases, an oral surgeon will perform an apicoectomy, also called root-end surgery, in which just the tip of the root is removed to solve the problem, as well as any diseased or damaged tissue. At the conclusion of an apicoectomy, the oral surgeon will place a filling in the empty space previously occupied by the root tip. This helps to reduce the risk of a recurrence of infection in the root.

Your oral surgeon will use local anesthetic during the procedure, and patients may also choose some form of sedation for additional comfort. Your surgeon can discuss your various sedation options with you so that you can make the best choice for you.

When Should an Apicoectomy Be Considered?

So when should you consider an apicoectomy instead of a root canal therapy? Here are some reasons:

  • Prior Failure of Root Canal Treatment(s) — As we’ve already mentioned, most commonly, apicoectomies are performed when root canal therapy has been deemed unsuccessful. In many cases, dentists will actually suggest another root canal treatment before attempting an apicoectomy. Talk to your dental care provider in order to determine the best course of action for you. Also, remember that apicoectomies only treat one potential cause of pulp infection, so depending on your individual case, it may be an unnecessary procedure.

  • Unsafe to Perform a Root Canal — Sometimes it is unsafe or harmful to perform root canal treatment on a patient. In these cases, if the circumstances are sufficient, an apicoectomy may be a route suggested by your dentist or oral surgeon.

  • Desire to Avoid Extraction — Of course, the option to remove the tooth is always there, but not always desirable. If a root canal treatment has failed, you might have an option between having the tooth extracted or having an apicoectomy.

Apicoectomy Recovery

Most patients will be able to resume normal activities within a day or two of having an apicoectomy. You will get instructions to prevent postoperative complications, like infection, which can derail the healing process. You may be prescribed a preventive antibiotic as another precaution against infection. If so, you should complete the entire course of the antibiotic as prescribed.

Patients may experience some mild discomfort after an apicoectomy, but this can typically be managed with painkillers that can be prescribed for you. If you have severe, persistent pain or other problems like unexpected breathing or fever,you should contact your oral surgeon as soon as possible to be evaluated for complications.

If you have any questions about Apicoectomy procedures, or would like to talk to a member of our team about a consultation, contact Austin Oral Surgery today!