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.
Endodontic surgery can be used to locate fractures or hidden canals that do not appear on x-rays but still manifest pain in the tooth. Damaged root surfaces or the surrounding bone may also be treated with this procedure. The most common surgery used to save damaged teeth is an apicoectomy or root-end resection.
What is Apicoectomy?
The adjacent diagram illustrates this simple procedure. 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. A root-end filling is placed to prevent reinfection of the root and the gum is sutured. The bone naturally heals around the root over a period of months restoring 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.
What happens after treatment?
When your apicoectomy has been completed, a record of your treatment will be sent to your restorative dentist. You will return to our office for a post operative check and the removal of any sutures which may have been placed. This will take place approximately 5 to 7 days following the procedure. In most cases there is no need to follow up with your general dentist for the restoration of this tooth. Normal check ups to your general dentist should follow as usual.
How much will it cost?
The cost is generally similar to the cost of a retreatment of a previous root canal. Even though the procedure is surgical in nature it is similar to a conventional Retreatment and accordingly the cost is similar as well.
While dental insurance may cover part of the cost of the apicoectomy, some policies limit coverage to a single procedure on a tooth in a given period of time. Check with your employer or insurance company prior to retreatment to be sure of your coverage.