Treatment
Endodontic surgery (apicectomy) in Burton upon Trent
Occasionally infection persists at the very tip of a root and cannot be reached from inside the tooth. Endodontic surgery — the apicectomy — removes that tip and the infected tissue around it and seals the root from below. It is a short, carefully controlled procedure under local anaesthetic, and it often keeps a tooth that would otherwise be lost.
When surgery is chosen
Treating a tooth from the inside, by root canal treatment or retreatment, is the first choice in nearly every case. Surgery comes into the picture when that approach has not worked or cannot be used: a post whose removal would wreck the tooth, a sound new crown that should be left alone, a canal that has calcified or holds a fractured instrument, or a lesion at the root tip that has refused to heal despite good treatment. Now and then surgery is chosen because the tissue at the root tip needs to be seen directly to understand what is wrong.
What the procedure involves
- Planning. X-rays from several angles, and when necessary a three-dimensional scan arranged through your dentist, map the root, the lesion and the structures nearby.
- Anaesthetic. Local anaesthetic numbs the area fully. You will notice pressure and the sound of the instruments, not pain.
- Access. A small flap of gum is raised and a window opened in the bone over the root tip.
- Removing the infection. The inflamed tissue and the last few millimetres of the root are taken away, and the cut surface is examined under the microscope for cracks and untreated canals.
- Sealing the root end. A small cavity is prepared with ultrasonic tips and filled with a biocompatible cement that bone will heal against.
- Closing. The gum is laid back and held with fine stitches, removed a few days later.
Allow about an hour.
Recovery
Some swelling and bruising of the cheek is expected for a few days and responds to cold packs and ordinary painkillers; most people are back at work the following day. The stitches come out at a short review, and bone healing is followed on X-rays over the months that follow.
Results
Carried out with magnification, ultrasonic root-end preparation and modern biocompatible materials, endodontic surgery has far better outcomes than the older technique, and most teeth treated this way heal well. The prospects for your own tooth are discussed, together with the alternatives, before you decide anything.