An apicoectomy is carried out to save a tooth from extraction. This procedure is used to clear up infections that occur after a patient has undergone a root canal treatment or re-treatment by taking out the apex, or root tip, of the tooth (which can be an entry point for infection) along with the infected materials. At this point, the end of the root is sealed up to prevent further infections in the future. Apicoectomy procedures are very useful because they allow the dentist to save a tooth that would otherwise have to be extracted, which is of course less than ideal for both patient and dentist.
There are several reasons why an apicoectomy may be necessary:
Although your regular dentist is qualified to perform an apicoectomy, oftentimes the best approach is to see an endodontist who specializes in these types of procedures. Prior to performing the surgery, the dentist may collect x-rays and/or give you an antimicrobial mouth rinse, antibiotics, and/or an anti-inflammatory medication to take before the procedure.
Once the information-gathering has concluded, the dentist will administer a local anesthetic. IMPORTANT: Please alert your dentist if you have any issues tolerating epinephrine or if you have hypertension (also known as high blood pressure). The local anesthetics employed in the apicoectomy procedure are highly concentrated in order to make your blood vessels constrict, which inhibits blood flow to the surgical site and allows the endodontist to get a better view of the tooth root. It is normal to feel as though your heart is racing while under the influence of the anesthetic. This feeling should subside relatively quickly.
After all of the preparatory work is complete, the endodontist or dentist will slice into the gum and peel it away so that the root is very visible. The infected material will be removed along with part of the root tip. At this point, the dentist will utilize a special dye that points out any fractures or cracks in the tooth — if the tooth is damaged or unhealthy in other ways, there is no point in trying to save it and the apicoectomy will be over as the tooth will need to be extracted.
Typically, an apicoectomy lasts somewhere between 30-90 minutes in length depending upon how complicated of a job it is.
Your dentist or endodontist will give you detailed post-surgical care instructions as you depart the office for your recovery. Bruising, swelling, and pain are all perfectly normal and can be alleviated using NSAID over-the-counter pain medications as well as the placement of ice packs on the face for the first 10-12 hours after the procedure. It will be very important to avoid eating crunchy or hard foods, smoking, rinsing vigorously, and/or brushing the area in the first few days after the procedure. Though the recovery period can last up to two weeks, many patients report that the apicoectomy recovery is milder than the root canal recovery process. Still, if you experience any weird symptoms like pain or swelling near a tooth that has never had a root canal, call our office as soon as possible so we can help you out.
No dental procedure comes without risks. The biggest danger with apicoectomy is that the procedure will fail, causing the dentist to have to extract the tooth rather than save it. There is also a minor risk of infections when apicoectomy procedures are done on teeth that are located close to the sinuses, such as the teeth in the back upper jaw. If this happens, your dentist is able to prescribe decongestants and/or antibiotics to fix the issue.