by Dr. Jacqueline S. Allen | Oct 3, 2016 | Apicoectomy, Blog, Root Canal
Even though contemporary root canal procedures have very high success rates, not every root canal treatment is permanently effective. Tooth root systems can be complex, and undiscovered and untreated canals can harbor infections that threaten the pulp of a tooth months, or even years, after the initial procedure.
If you’re experiencing pain and swelling around a tooth that’s received a root canal, visit your dentist or endodontist to have it examined. He or she may suggest that an endodontist perform an apicoectomy, which treats an infected tooth from its root end, rather than from the biting surface of the tooth.
Here’s a brief guide to how an apicoectomy can save a natural tooth that’s already received a root canal treatment.
Apicoectomy: A Step Beyond Root Canal Treatment
- Apicoectomies can be useful when a root canal retreatment won’t work. If the tooth has received a crown as part of its root canal process, or is part of a fixed dental bridge, those restorations will have to be disassembled and replaced to do another root canal. Accessing the infection through the root avoids this.
- An apicoectomy removes and seals the tip of the tooth root. During an apicoectomy, the endodontist will cut and lift the gum away from the tooth so the root is easily accessible. The infected tissue will be removed, along with the last few millimeters of the root tip. Then the endodontist cleans and seals the end of that root, removing a critical avenue where infection can manifest and cause problems.
- The preparation for an apicoectomy gives the endodontist an accurate picture of your natural tooth. Endodontists use state-of-the-art technology to perform apicoectomies, including fiber optic lights, operating microscopes and ultrasonic cleaning instruments that remove infection via high frequency vibration. Between this and the imaging technologies employed before the procedure, your endodontist will have an exceptionally clear picture of the health of your tooth, and what can be done to preserve it.
“If an infection threatens a tooth that’s had a root canal, and a retreatment isn’t an option, an apicoectomy can preserve it and keep it useful and functional for years to come,” says Dr. Allen of the Phoenix Endodontic Group.
by Dr. Jacqueline S. Allen | Jul 17, 2015 | Apicoectomy, Blog, Endodontics, Phoenix Endodontic Group
Root canal treatments have a high success rate when it comes to saving an infected tooth – close to 95 percent. However, sometimes a standard root canal will fail and a surgical procedure known as an apicoectomy will be necessary.
Why Root Canals Can Fail
Dr. Jaqueline S. Allen, an endodontist with the Phoenix Endodontic Group, explained that there are a number of reasons that a root canal treatment might not be successful.
“Sometimes there is simply not enough tooth left to place a functional restoration,” Dr. Allen explained. “Other reasons for root canal failures can include a vertical fracture in the root that cannot withstand chewing on the tooth, a poor crown to root ratio, or an unusual root anatomy that creates difficulty in cleaning the entire root structure.”
Two other reasons that a root canal treatment might not succeed include a significant delay in the final crown being placed on top of the treated tooth, and when a successfully treated tooth develops an infection later, perhaps due to new cracks or fractures in the tooth, or additional tooth decay.
How an Apicoectomy Differs From a Root Canal
There are several significant differences between a standard root canal treatment and an apicoectomy:
- In a root canal, the endodontist approaches the treatment by going through the crown of the tooth. In an apicoectomy, he or she will perform the treatment by starting at the root (or apex) end of the tooth. To do this, he or she must make an incision and move the gums out of the way.
- During a standard root canal, the focus is on cleaning all the root canals in the tooth. For an apicoectomy, since the other canals have already been filled and sealed, the focus is on removing the infected tooth root and placing a small filling to prevent further problems.
- Because an apicoectomy requires a gum incision, stitches will be necessary, and bone grafts may be used to encourage your jawbone to fill in the area around the tooth root that is removed.
As far as recovery from an apicoectomy is concerned, Dr. Allen advised that patients should be prepared for possible post-operative bruising or/and swelling (which can be taken care of with the application of ice packs), and should allow one to two hours for the procedure itself. They should avoid vigorous exercise for several days and should avoid brushing in the area for two to five days. A return appointment to remove the sutures will also be necessary.
by Dr. Jacqueline S. Allen | Jun 2, 2015 | Apicoectomy, Blog, Endodontics
Although modern dentistry offers amazing artificial tooth restoration options, nothing is as good as a functional natural tooth. Your endodontist may recommend you have a surgical procedure known as an apicoectomy to save your natural tooth if you’ve had a root canal treatment that hasn’t been entirely successful.
Since an apicoectomy differs from a standard root canal treatment, it helps to know what to expect. Here are a few quick facts about the surgery and its impact on your oral health.
Having an Apicoectomy: What You Need To Know
- What it is: An apicoectomy is surgery on the end of your tooth root (also known as the apex). The infected tooth root is removed and a small filling placed to prevent further problems. Dr. Allen of the Phoenix Endodontic Group explains that during an apicoectomy, “Your endodontist will make an incision on your gum tissue to move it out of the way temporarily. Then they will perform microsurgery on the end of the roots and put the gum tissue back into place.”
- Why it is needed: You may need an apicoectomy because the tooth that received a root canal treatment has complex roots. The surgery may also need to be performed because the tooth in question has a crown or a bridge and retreatment of the root would require the cutting through the restoration.
- Preparation for the procedure: Before your apicoectomy, your endodontist will take X-rays of the tooth and surrounding bone. You may be given an antimicrobial mouth rinse, a medicine to reduce inflammation, and/or antibiotics to get your mouth in the best possible condition for the surgery.
- Post-apicoectomy recovery: For the first 12 hours, you’ll want to apply ice packs to the side of the face near the affected area – 20 minutes on, 20 minutes off. Avoid eating crunchy or hard foods for the first few days. Dr. Allen advises, “There is minimal discomfort after apical surgery, but there can be some swelling. That can be minimized with ice packs.” You should recover from the procedure within two weeks. Eventually, the bone heals around the end of the root.
Dr. Allen concludes, “Apicoectomies give patients with tooth root infections another chance to save their tooth. It is the most biologic and cost-effective option for maintaining your oral health.”
