If you damage the pulp inside your tooth, an infection is likely to develop. In this case, a dentist from a clinic like Nordel Dental will normally carry out a root canal treatment to clean out the infected material. Root canal treatments are generally successful, but you'll sometimes need follow-up treatment if the infection doesn't clear up. An apicoectomy is a surgical procedure that some patients with failed root canal treatments undergo. Learn more about the process of apicoectomy, and find out how this procedure can help your teeth.

The aim of an apicoectomy

Root canal treatments can fail for several reasons. A dentist may find it difficult to get access to the canal in your tooth, particularly if the space is narrow or curved. He or she may also not see smaller branched canals containing infected material. Unfortunately, in these (and other) cases, you will still experience pain and inflammation from the infection.

Persistent infections can also occur if you have a tiny crack in your tooth that allows bacteria to get into the root canal. Root canal treatments often fail around the root, which is difficult to reach from the crown (tip) of the tooth. An apicoectomy aims to save your teeth by getting access to the infection through the root tip or apex.         

Apicoectomy process

Apicoectomy (sometimes called endodontic microsurgery) takes place under an operating microscope. Before the surgery starts, your dentist will give you a strong local anaesthetic, so you shouldn't feel any pain or discomfort. Your dentist will then cut and lift the gum away from the tooth to expose the root.

From the root of the tooth, your dentist can then remove any inflamed or damaged tissue. Normally, he or she will also take away the root tip. Once complete, the dentist will then fill the root to seal the root canal. You'll also need a few tiny stitches to help the gum tissue heal again. After the procedure, the bone will then heal around the root.

Aftercare

For the first 10 to 12 hours after the surgery, your dentist will suggest you place ice against the affected area to reduce any swelling. The affected area is most likely to become sore and inflamed on the day after the surgery. Over-the-counter painkillers will normally ease the pain, but your dentist can also prescribe stronger medication, if required.

The healing process normally takes around 14 days. You'll need to avoid eating and brushing near the affected area during that time, and your dentist will also tell you not to lift your lip near the area because you can disrupt blood clot formation. The dentist will generally take the stitches out within 7 days of the surgery, and you shouldn't feel any soreness or discomfort after two weeks.

While you're healing, the affected area may feel a little numb. These symptoms will normally subside, but you should talk to your dentist if the problem persists.

Complications

Like any type of surgery, complications can arise from an apicoectomy.

During surgery, the dentist will normally apply a dye to the tooth, so he or she can see any cracks or fractures that aren't otherwise visible. If your tooth has a crack, the surgery is unlikely to succeed. In this instance, your dentist is likely to suggest that he or she extracts the tooth.

An apicoectomy can become more risky depending on where the tooth is. For example, if you have a problem in one of the rear teeth in your upper jaw, the infection can spread to your sinuses. As such, before the procedure, your dentist may recommend a course of antibiotics to help bring the infection under control.

If the infection is in the rear teeth on your lower jaw, the roots are closer to prominent facial nerves. In this case, root surgery could cause nerve damage, so your dentist will normally take an X-ray to help assess and control the risks.

An apicoectomy is a type of surgery that dentists use to treat infections after a failed root canal. Most people undergo the procedure without complications, but you should talk to your dentist if you have any concerns.