Vienna Endodontics, Dr. A Citron, Dr. W Citron, and Dr. T Nguyen, perform apicoectomies (endodontic surgery) for patients who have had root canal therapy in the past, but still have some infection present. This is not a painful procedure and is sometimes the treatment of choice for a tooth that has had previous endodontic treatment.
Your teeth are held in place by very strong roots that extend into your jawbone. Unlike the front incisors which only have a single root, molars and premolars have several roots. The tip of the root is called the apex. This is where the nerves and blood vessels enter the tooth, and help deliver blood to the crown (the portion of the tooth you see in your mouth).
During root canal treatment, we clean the canals and remove any infected pulp. When there is still some infection present after root canal therapy, you may require an apicoectomy. During an apicoectomy, we remove the apex (or root tip) and, if necessary fill the root tip to prevent any further infection. If left untreated, infected roots can cause damage to other teeth, spread infection, and cause resorption of the jawbone.
When the soft tissue surrounding the root of a tooth becomes infected or inflamed, it can be incredibly painful and debilitating. The apicoectomy eliminates the infection and allows the tooth to function normally without having to be extracted.
Some examples of circumstances when you may require an apicoectomy include:
Before your surgery, your endodontist will typically prescribe an antibiotic or anti-inflammatory medication in order to treat your underlying infection. Then we will take an X-Ray to allow the endodontist to properly plan for the apicoectomy.
The procedure will be performed under local anesthesia. An incision is made in the gum to expose the root. A small portion of bone may need to be removed in order to expose the root in some cases. We will then remove the root tip and any infected connective tissue. We may reseal the root tip by using an ultrasonic instrument and a special biocompatible material. Then we will suture the gum closed.
You will be provided with detailed post-care instructions, and given prescriptions for pain relief and antibiotic therapy as needed for your individual situation. We will schedule a follow up appointment to have the endodontist examine the healing process, and remove the sutures. After a few months, the area should heal completely.
If you start to experience any pain or other unusual symptoms with a tooth that has had an apicoectomy, please contact us as soon as possible at 703-938-5920.