Apicoectomy (Root End Surgery)
An Apicoectomy is a surgical dental procedure that we perform when a standard endodontic procedure, known as a root canal, has been unsuccessful. We frequently are sent patients with failed endodontic therapy from their referring dentists. At Manhattan Maxillofacial Surgery Group, we specialize in these more difficult cases, removing the infection and restoring the patient’s oral health. Dr. Del Valle and Dr. Shahgoli can gain access to the source of infection that was missed in the original root canal therapy procedure and remove it.
Standard Endodontic Treatment
The most common endodontic treatment, the Root Canal, is a procedure that can be performed by your family dentist. This procedure is needed when the root of the tooth has become infected, generally from a deep cavity or tiny hairline fractures in a tooth that allowed passage for bacteria. Your dentist will remove the infected material by gaining access inside of your tooth and removing the pulp. The canal is then cleaned and filled with a medicated material. The tooth is then topped with a protective crown, allowing you to retain the original tooth structure, which is best for your overall dental health.
An apicoectomy is often needed when a tooth continues to rage with infection following your root canal treatment. This generally does not mean that your family dentist made an error, it is most often due to where the source of the infection is coming from. What patients may not understand is that root canal treatments can be very complex, there are many situations where the simple cleaning out of the canal removes the source of infection. Your root system is comprised of many small branches that extend from the main canal. If the source of infection has traveled into these tiny branches, even after your endodontic therapy treatment, there can still be infected debris that was missed in these branches. To remove the infected material, Dr. Del Valle or Dr. Shahgoli will then need to surgically remove the tooth’s root tip and prepare the root end cavity for filling.
Apicoectomy or Root Canal
Apicoectomy is commonly referred to as Root End surgery. We begin with a local anesthetic to thoroughly numb the patient ensuring that that they feel no discomfort. Dr. Del Valle or Dr. Shahgoli will then make a small incision directly through the gum tissues where the infected root is located. With access, we can then remove the infected material found near or around the tip of the root by removing the entire root tip, using endo-surgical procedures with microsurgical techniques, this includes a dental operating microscope, a range of micro instruments, ultrasonic preparation tips such as those used in removing plaque. Once we feel confidant that the infected material is gone, a root end cavity is prepared and filled with a biocompatible material, usually calcium-silicate based.
Once filled, Dr. Del Valle or Dr. Shahgoli are then ready to close the surgical site with a few sutures, this will help the gum tissue stay closed and assist while healing is occurring. Following the procedure, the patient can take an over the counter pain relief medication to assist with any discomfort. The healing should be a simple one, the patient needs only to be cautious of their sutures.