Why Would I Need Endodontic Surgery?

Generally, a root canal is all that is needed to save teeth with injured pulp from extraction. Occasionally, this non-surgical procedure will not be sufficient to heal the tooth and your endodontist will recommend surgery.  The endodontist retreats non-healing root canal surgically from the root-end instead of retreating through the crown of the tooth.

The following are some of the reasons why surgical retreatment would be needed:

  1. Large recurring infections or cystic lesions,
  2. Infected canal spaces that are only accessible with surgery,
  3. Non healing (nonsurgical) retreatment
  4. Locate fractures or hidden canals that do not appear on radiographs (x-rays) but still manifest pain in the tooth
  5. Deep post, broken or fracture instruments
  6. Cases where retreatment could have undesirable consequences,
  7. Exploratory surgery for biopsy sample
  8.  Damaged root surfaces or the surrounding bone

The most common surgery used to save damaged teeth is an apicoectomy or root-end resection.


What Is An Apicoectomy?

During apical surgery, an incision is made in the gum tissue to expose the bone and surrounding inflamed tissue.  The damaged tissue is removed along with the end of the root tip, which usually contains the source of the problem.   If indicated, the infected tissue may be sent to a pathology laboratory for evaluation for oral pathology lesions that are not endodontic infections.  A small tunnel is carefully parepared in the root canal and a root-end filling is placed to prevent reinfection of the root.  The gum tissue is closed with sutures, which are removed in 3-6 days.  With the source of the infection removed, the bone naturally heals around the root over a period of months restoring to full function.

Following the procedure, there may be some discomfort or slight swelling while the incision heals. This is normal for any surgical procedure. To alleviate any discomfort, an appropriate pain medication will be recommended. If you have pain that does not respond to medication, please call our office.