Apicoectomy
A tooth’s root system is complex, with many small canals and branches. Sometimes, pain and swelling in a tooth can return months or even years after root canal treatment. This occurs due to bacteria hiding in these areas, and it’s especially common near the root tip, called the apex.
This situation doesn’t always mean the tooth needs to be removed. We may be able to save it with a procedure called an apicoectomy.
What Is an Apicoectomy?
An apicoectomy is a minor surgical procedure meant to save a tooth by removing the root tip. It is also called root-end surgery or root resection.
Our endodontists typically recommend an apicoectomy when a tooth has already had root canal treatment, and the source of infection cannot be predictably addressed from inside the tooth. In some cases, retreatment may not be effective or feasible due to the complexity of the root structure or prior restorations.
In these situations, a surgical approach allows us to directly access and treat the area at the tip of the root while preserving the natural tooth.
What to Expect with Apicoectomy
We begin by evaluating the tooth using advanced imaging technology that provides a detailed view of the root and surrounding bone. We’ll then explain what we find and what we recommend.
Next, we numb the area so you won’t feel any pain during the procedure. We also offer nitrous oxide and oral sedation if you prefer a more relaxing experience. You’ll also appreciate our added comfort measures, such as noise-canceling headphones and a weighted blanket, to help you relax.
During the procedure, you can expect the following steps:
- Accessing the root tip — We make a small opening in the gum tissue to access the root tip.
- Removing the root tip — Next, we remove a small portion of the root tip and any infected tissue around it.
- Sealing the root — Then we place a small filling to seal the root tip.
- Graft the area — In some cases, regenerative materials such as a bone graft or guided tissue regeneration may be used to support healing and help restore the surrounding bone.
- Closing the area — Finally, the gum tissue is closed with small sutures.
We use a surgical microscope throughout the procedure, giving our specialists a precise,
detailed view not possible with the naked eye.
Apicoectomy Recovery
Before you leave our office, we will give you clear post-procedure instructions. Some mild swelling and discomfort for a few days after is typical, but many patients return to their usual activities the next day. Taking an over-the-counter pain medication is typically all that’s needed for relief.
Call Our Specialists for Skilled Care
If you have pain or swelling in a tooth that already had a root canal, don’t wait to reach out. Advanced Root Canal Specialists in Columbia, MD, at (410) 772-9600. We offer early morning and evening hours Monday through Friday and keep same-day appointments available for dental emergencies.
We welcome patients from all over Maryland, including Columbia, Baltimore, Rockville, Laurel, and beyond.