An apicoectomy is a straightforward, minor surgical procedure that's done on children and adults as a way to save at-risk teeth and prevent potentially serious complications. An apicoectomy is also known as root end surgery. This is because it involves the removal of a tooth's root tip and surrounding tissue.
The procedure is usually recommended when a standard root canal treatment has already been performed on a tooth but isn’t sufficient to save the tooth and prevent further complications.
In cases where there’s an anatomical concern with the root tip, such as one root crowding into the space of the root next to it, an apicoectomy may be helpful in preventing problems that could affect multiple teeth later on.
If your dentist is recommending an apicoectomy, it’s because there’s no real alternative except removal of your entire tooth. In that event, you’d need an implant, bridge, or a removable partial denture to keep the nearby teeth from shifting.
Before any work is done, you’ll be given a local anesthetic to numb the area around the affected tooth.
During the procedure, your dentist or endodontist cuts through your gum and pushes the gum tissue aside in order to reach the root. Usually just a few millimeters of the root are removed, as is any infected tissue surrounding the root.
After the root tip is removed, the root canal inside the tooth is cleaned and sealed with a small filling to prevent future infection. Your dentist or endodontist may then take another X-ray to make sure your tooth and jaw look good and that there are no spaces where a new infection could take hold.
The tissue will then be sutured (stitched), so your gum can heal and grow back in place. Your jawbone will also eventually heal around the filling at the end of the root. You shouldn’t feel much, if any, pain or discomfort during the procedure.
An apicoectomy usually takes 30 to 90 minutes. The location of the tooth and the intricacy of the root structure can affect the time needed to complete the surgery.
