Root-end Surgery

Occasionally, a nonsurgical root canal procedure alone cannot save your tooth and your endodontist may recommend surgery. Read on to learn why you might need endodontic surgery and view a step-by-step explanation of the most common surgical procedure, endodontic microsurgery or apicoectomy.

Why do I need endodontic surgery?

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.

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.

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 re-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.

When inflammation or infection persists in the bony area around the end of your tooth after a root canal procedure, your endodontist may recommend endodontic microsurgery. Surgery may also be performed to treat damaged root surfaces and/or surrounding bone.

Local anesthetics make the procedure comfortable. Of course, you may feel some discomfort or experience slight swelling while the incision heals. This is normal for any surgical procedure. Your endodontist will recommend appropriate pain medication to alleviate your discomfort.

Your endodontist will give you specific postoperative instructions to follow. If you have questions after your procedure, or if you have pain that does not respond to medication, call your endodontist.

What is endodontic microsurgery?

First

Removal

In this procedure, the endodontist opens the gum tissue near the tooth to see the underlying bone and to remove any inflamed or infected tissue.

Second

Filling

A small filling may be placed in the root to seal the end of the root canal, and a few stitches or sutures are placed in the gingiva to help the tissue heal properly.

Third

Healing

Over a period of months, the bone heals around the end of the root. Be sure to follow up if you have any concerns.