One procedure that most patients have heard of is a root canal. This procedure is usually performed by a general dentist or endodontist and is necessary when an infection has developed in the nerve canal or around the apex (tip) of the tooth root. This canal acts as a roadway for nerves and blood vessels between the apex of root and the inside of the crown, also known as the pulp chamber. Root canal therapy can be extremely beneficial when the problem is identified early; however, in some cases, the infection may persist after therapy, and an additional surgical procedure is necessary to solve the problem.
What is an apicoectomy?
An apicoectomy is a surgical treatment performed by oral and maxillofacial surgeons and is necessary when an infection of the tooth cannot be solved by root canal therapy. This treatment can be used on any teeth at any location in the mouth, whether the infection is located in a front tooth with a single root or the premolars and molars with two or more roots.
Infections around the tooth root cannot be easily seen from the outside because they occur deep within the bone. Many times, infections within the tooth can be solved with root canal therapy; however, if the tooth develops another infection after treatment, or if the problem persists, an apicoectomy is usually recommended. This treatment, also known as endodontic surgery, is usually done with magnification and attempts to ensure that the tooth does not develop additional infections or complications.
What is the purpose of an apicoectomy?
If an infection of the tooth root is not properly treated, the infection may result in complete loss of the tooth. By treating the damaged tooth with an apicoectomy procedure, an oral and maxillofacial surgeon can mitigate the problem and help the patient avoid tooth extraction. Every patient’s teeth are unique to their mouths, and the structure and shape of some teeth increase their risk for infection. If your teeth exhibit any of the following characteristics, an apicoectomy may be recommended following root canal therapy.
- Small Root Branches/Lateral Canals. An important part of the tooth root structure are the small branches of root or small canals that extend out from the root near the apex. Patients who have branches or lateral canals that are smaller than average are at a greater risk for persistent infection because they are more difficult to clean and seal during a root canal procedure.
- Curved or Narrow Root Canals. Patients whose teeth have narrow or curved root canals run a higher risk of persistent infection following root canal therapy and may need an apicoectomy to solve the problem. This narrow or curved shape makes it difficult for a general dentist to properly clean the infected area to prevent further infection.
- Root Canal Blockage. If a patient has already undergone root canal therapy once and develops a second infection at a later date, the dentist may experience difficulty completing a second procedure, known as a re-treatment. On occasion, debris from the first procedure blocks the root canal, or the canal is too small, and proper cleaning becomes extremely difficult. If this is the case, an apicoectomy may be necessary to take care of the problem.
If you are in need of an apicoectomy, Dr. Cohen will perform a thorough oral examination during your initial consultation. Additional X-rays or 3D scans may be needed for him to determine the least invasive path to solving the problem and ensure optimal recovery following the procedure. During an apicoectomy, a magnification is used to get the closest and clearest look at the root apex and ensure proper cleaning and sealing of the canal. This treatment can be performed in 30–90 minutes depending on the tooth being treated (front or back) and the severity of the problem.
If you are in need of an apicoectomy, we encourage you to contact our office in Houston, TX, for an initial consultation. Our friendly front office staff is happy to assist in scheduling your appointment promptly so that you can restore your oral health, function, and smile quickly and easily.
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