(Root Canal Surgery)

What is Apicoectomy – Root Canal Surgery?

An apicoectomy is usually performed after an unsuccessful or failing root canal. When an infection does not go away or returns shortly after a root canal has been performed, an apicoectomy is usually necessary. When left untreated, infected roots can damage other teeth, spread infection, and cause regression of the jawbone.

An apicoectomy is an endodontic surgical procedure, where the surgeon removes the inflamed periapical tissue and bone as well as the tip of the roots followed by a filling procedure to seal the root from further infection. It is a common procedure in dentistry also known as a root-end treatment, root end surgery and root-end filling.

Reasons why an apicoectomy may be necessary:

  • Roots are extremely complex and have a multitude of tiny branches. In the event they cannot be successfully cleaned and sealed when the root canal treatment is performed, inflammation could persist.
  • If a root canal cannot be cleaned thoroughly because it is blocked from a prior root canal treatment.
  • In the event a root canal is poorly shaped, the endodontic files will not be able to reach the root tip leading to a persistent or recurring infection.

What are the reasons to undergo an apicoectomy?

If a root canal treatment is not successful at first, the apicoectomy might be a good way to go. Most dentists will do a re-treatment of the root canal and if the second attempt is still not successful, then the last option is an apicoectomy. Factors leading to an apicoectomy can also include broken or chipped teeth, teeth with abnormal shapes of the roots, cysts located on the roots’ tips, secondary canals and many others.

The purpose of an apicoectomy is to eliminate the infection in the tissue or bone and to ultimately preserve the function of the tooth and save it from extraction. The patient might or might not be having any symptoms but infected and inflamed soft tissue around the root of a tooth can become exceptionally painful and debilitating for a patient. If the infection surrounding the tip of the root is acute and active, the patient will feel severe pain and might even have significant swelling. Other common symptoms may include sensitivity to hot and cold foods and drinks as well as sensitivity to touch or chewing.

Before an apicoectomy procedure, diagnostic X-rays of the affected tooth and surrounding bone will be taken, a careful review of your medical history including the medications you take (both prescription and non-prescription) will be performed, and many other factors will be reviewed by Dr. El-Hakim, Dr. Makhoul or Dr. Gigliotti. If an apicoectomy is recommended, the reasons for it will be shared with you in detail along with an in-depth explanation of the procedure. Our M3L oral and maxillofacial surgeons will also take the time to answer all your questions and make sure you are comfortable with the steps ahead.

What does getting an apicoectomy involve?

Prior to the surgery, your M3L maxillofacial surgeon will normally prescribe you an antibiotic and an anti-inflammatory medication to treat the underlying infection. X-rays will then be taken to enable Dr. El-Hakim, Dr. Makhoul or Dr. Gigliotti to plan the procedure, which is usually performed under local anesthesia with or without sedation.

Your oral and maxillofacial surgeon will start by making a small incision in the gum in order to expose the root by carefully lifting away the gum. In some circumstances, a tiny fraction of the jawbone may also be removed to properly expose the root. Following exposure, the root tip and any infected tissue around it are removed, the root is then immediately sealed using a special filling material and your M3L surgeon finally suture the gum back in place.

This particular type of surgery does not require an overnight stay. There may be some discomfort or light swelling while the surgical area heals. This is normal for any surgical procedure, and to help you manage any discomfort, we will guide you on the best medications and precautions to follow while the healing process is actively taking place.

If you are experiencing any signs or symptoms, such as pain or swelling associated with a tooth that had a previous root canal, we encourage you to contact the Maxillo 3 Lacs office immediately to schedule your appointment. If Dr. El-Hakim, Dr. Makhoul or Dr. Gigliotti thinks an apicoectomy is a suitable procedure for you, he will discuss this particular treatment option at the time of consultation and take the time to answer all your questions about the procedure.

To find out more, or to book a consultation with our M3L surgical team, please don’t hesitate to call us today at (514) 395-9896 or contact us using our online form.

Implantology and Maxillofacial Surgery Center

We accept new patients without a referral