What Is a Dental Apico?

Specially trained dentists, endodontists and oral surgeons perform dental apicoectomy procedures. This form of endodontic microsurgery treats a tooth that has had at least one root canal, but continues to cause pain and have recurrent infections. An apicoectomy uses specialized dental tools to remove the apex of a tooth’s root along with infected tissue. An apicoectomy prevents extraction of a troubled tooth and preserves the integrity of crowns and bridges.

Reason for Procedure

• The root of a tooth attaches it to the jaw bone and holds it in place. The tip of the root, called the apex, allows nerves and blood vessels to enter the canals and travel to the crown of the tooth. Infections and inflammation can occur within the canals when nerves and tissue become exposed from cracks or damage. A root canal procedure cleans the canal of infected tissue; however, sometimes the area of infection recurs or does not get treated properly. An apicoectomy resolves recurrent infections in teeth previously treated with a root canal.

Scope of Procedure

• During the procedure, a endodontist cuts and lifts the gum away from the tooth to allow access to the root. With the use of a high-powered microscope, the endodontist locates and removes infected tissue and a few millimeters of the apex of the tooth’s root.


• Ultrasonic cleaning instruments thoroughly clean the end of the tooth’s canal, and then it is sealed. An X-ray records the final repair before stitches secure the gum tissue back into place.


• Depending on the complexity and location, the procedure takes 30 to 90 minutes. Lower molars require the most time. Recovery requires following specific care, eating and drinking instructions provided by the endodontist. Ice and over-the-counter pain relievers reduce pain and swelling.


• A followup appointment within 7 days of the procedure allows the endodontist to check the area for proper healing and remove the stitches. Soreness and inflammation typically resolve within 14 days. Numbness surrounding the treatment area may occur and goes away with time.


• An apicoectomy offers a permanent solution to recurrent canal infections within a treated tooth and lasts the life of the tooth.

Risks

• All surgical procedures come with risks. The primary risk with an apicoectomy includes unsuccessful treatment requiring complete extraction of the tooth.


• Long-term, untreated infections in upper molars can migrate into the sinuses and require additional treatment.


• A small risk of serious nerve damage in the jawbone exists. Your endodontist avoids nerve damage by taking multiple X-rays to locate nerves near the surgical site.