During root canal treatment, the canals are cleaned and any inflamed or infected tissue is removed. An apicectomy is necessary when infection develops and refuses to go away after a root canal treatment. Root canals are very complex and they have several small branches off the main canal. There are times where even after root canal treatment; there will still be infected debris in the branches. This will prevent healing and may even cause more infections later on. In an apicectomy, the root tip or the apex is removed along with the infected tissue. A filling is placed afterwards so that the end of the root is sealed. Apicoectomies are usually referred to as endodontic microsurgery since it is usually done under an operating microscope.
What is an apicectomy used for?
If a root canal procedure was done in the past and your tooth still becomes infected then the problem may be near the apex of the root. In several cases, another root canal treatment is done before an apicectomy. With the advances in technology, dentists will be able to detect other canals that were not treated properly. In this situation, the infection can be cleared up by doing a second root canal. When this is done, an apicectomy is avoided.
An apicectomy can be done in order to fix the problem so that tooth extraction is avoided. apicectomy is only done after two root canal treatments that are unsuccessful. For instance, retreatment is not a good option if a tooth has a crown or if it has a bridge. Retreatment of the root canal will require cutting through the crown or through the bridge and may weaken or even destroy it. Apicoectomies are considered in this situation. Apicoectomies are not the same as root resectioning because root resectioning removes the entire root whilst apicoectomies merely remove the tip.
How is apicectomy done?
endodontist will cut and lift the gum away from the tooth so that there will be access to the root. The infected tissue will be removed and then the last few millimtres of the root tip will be removed as well. The endodontist will use a dye to highlight the cracks and the breaks in the tooth in order to determine whether extraction or apicectomy will be performed. If there are too many cracks and breaks then extraction will be done.
In order to accomplish an apicectomy, the endodontist will cleanse and close the end of the tooth’s canal. The cleaning will be performed using a microscope that has ultrasonic instruments. The light and the magnification will allow the endodontist to clearly see the area. This will increase the chances of the procedure succeeding. The endodontist will take an x-ray of the area before the tissues are stitched back into place.
An apicectomy will take around thirty minutes to one and a half hours. The length of the operation depends on the complexity of the root structure and the location of the tooth. Procedures that are done on the front teeth are the shortest whilst procedures on the lower molars take the longest.
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