Apicoectomy (Endodontic Surgery)
Did you know that your tooth is a living organ? Many of our patients are surprised to learn this, as they often think of teeth as hard, inert objects in their mouth. While the dental enamel is indeed the hardest material in your body, it serves a vital purpose: it protects the softer inner dentin and the tooth pulp. Your dental pulp is made up of a bundle of nerves and blood vessels that feed into your tooth. When the pulp is compromised by infection, that is when your tooth can die.
For many of our patients, a root canal can help save the tooth. However, we do occasionally have infection come back after a root canal, which is why we here at Summercrest Dental have to perform a procedure known as an apicoectomy to help save it.
What Happens During an Apicoectomy Procedure?
In addition to the enamel, the dentin, and the dental pulp, your teeth also have roots. Many of your teeth have just one root that leads to a point called an apex, but some teeth have two points. The apex is the portion of your tooth that connects to the blood vessels and the nerves that keep the pulp alive. When infection occurs after a root canal, it often occurs at the point of the apex.
When we perform an apicoectomy, we are surgically removing the very tip of the apex. This procedure is also known as endodontic microsurgery, as it requires extreme precision and the aid of an operating microscope. During the apicoectomy, we will remove not only all of the infected material but also the very tip of the tooth apex. Once this portion of your tooth is removed, we will seal it with a filling.
Before we proceed with your apicoectomy, we will first start by taking a series of X-rays to allow us to fully assess the affected site. We will then prepare your tooth with a local anesthetic to prevent you from experiencing any discomfort during the procedure. For our anxious patients, we can also offer IV sedation or nitrous oxide (laughing gas) to help keep you calm.
What Goes Into The Process
Once we are ready to begin, we will carefully surgically cut into the gum tissue to reveal the affected tooth. This will expose the tooth root to allow us to work on it. We will then thoroughly remove any evidence of infection. Once the infected area is gone, we will then also remove the very tip of your tooth. The amount of material we will remove is just a few millimeters in length, which is why we do need the operating microscope. If we find any signs of cracking during the procedure (which we will be able to identify with a special dye that highlights it), we will need to stop immediately. If there are no fractures, however, we will then clean and seal the site. Finally, we will use sutures to reattach the gums. From start to finish, this procedure can take up to an hour and a half.
Apicoectomies are entirely safe and routine and can help save a tooth from requiring extraction. To learn more about this procedure, or to set up an appointment with us, please give us here at Summercrest Dental a call today at (503) 649-7701!