Apicoectomy (Root Canal Surgery)

An APICOECTOMY is a surgical procedure to clean the root end.

Teeth that have abscessed or that have suffered pulp death are candidates for root canal (endodontic) therapy. Root canal therapy cleans the root space and seals the root with a sterile rubber material.  Sometimes, conventional root canal treatment cannot sufficiently clean and seal the root space.  This may be due to an excessively curved root or obliterated canals that are hard to find.

If conventional root canal therapy was unsuccessful, infection and bone damage (red arrow) will continue to be present at the tip of the root.  If the root is severely curved or is inaccessible due to a post (black arrow), your dentist may recommend an apicoectomy as a procedure to maintain the tooth.

An apicoectomy is done with local anesthesia (novocaine).  A small incision is made through the gum, at the root tip, and the dental drill is used to gain access to the root end.  The infected area around the root tip is thoroughly cleaned and the root end is shaped back to where the root canal filling is sound.  In some cases a (retrograde) filling is placed in the tip end of the root.  This procedure serves to create a good seal to prevent further infection.  The incision is then sutured closed.

Teeth with apicoectomies have a good prognosis although they are slightly debilitated because they have inherently less root structure than an intact, healthy tooth.

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