Why do I need endodontic surgery?
Surgery can help save your tooth in a variety of situations.
- 1. Surgery may be used in diagnosis. If you have persistent symptoms but no problems appear on your x-ray, your tooth may have a tiny fracture or canal that could not be detected during nonsurgical treatment. In such a case, surgery allows your endodontist to examine the entire root of your tooth, find the problem, and provide treatment.
- 2. Sometimes calcium deposits make a canal too narrow for the instruments used in nonsurgical root canal treatment to reach the end of the root. If your tooth has this “calcification,” your endodontist may perform endodontic surgery to clean and seal the remainder of the canal.
- 3. Usually, a tooth that has undergone a root canal can last the rest of your life and never need further endodontic treatment. However, in a few cases, a tooth may not heal or become infected. A tooth may become painful or diseased months or even years after successful treatment. If this is true for you, surgery may help save your tooth.
- 4. Surgery may also be performed to treat damaged root surfaces or surrounding bone.
The most common endodontic surgery is called apicoectomy or root-end resection. When inflammation or infection persists in the bony area around the end of your tooth after a root canal procedure, your endodontist may have to perform an apicoectomy.
Other types of endodontic surgery include root resection (amputation) and intentional replantation.
What is an apicoectomy?
The endodontist opens the gum tissue near the infected area to inspect the underlying bone and tooth root. The inflamed or infected tissues are removed together with the root tip.
A small biocompatible filling is placed to seal the end of the resected root and if there is an extensive bone loss, a collagen membrane may be placed to aid in healing and regeneration of the bone (guided tissue regeneration).
The prodecures are carried out under magnification using a dental operating microscope to enhance visualization of the diseased area.
Stitches are then placed to secure and stabilize the gums to allow for optimal healing.
Reviews are then done yearly and X-rays of the tooth taken to monitor bony healing.
