In some cases, root canal therapy alone cannot save a tooth, and our doctors may suggest surgery.
While there are many endodontic surgeries, the most common is an apicoectomy. Also known as a root-end resection, an apicoectomy literally means the removal of the apex of the root of the tooth. This procedure, done following a root canal, treats the bony area surrounding the end of your tooth, which has become inflamed or infected. By folding back the gum near the tooth, our doctors can access the underlying bone and extract the inflamed tissue. At the same time, the very tip of the root is removed and usually replaced with a small plug or filling. At this time, your doctor may treat the area with antibiotics and will then close the area with a small suture. Eventually, the jaw surrounding the tooth will fill in with bone, supporting the tooth as before. This procedure helps ensure the lasting result of your endodontic treatment.
Other endodontic surgeries include:
- removing one or more roots
- dividing a tooth in half
- repairing an injured root
In addition, an intentional replantation may be performed. During this procedure, which is reserved for complex cases, the tooth is extracted. Endodontic treatment is then performed on the tooth while it is outside the mouth. After treatment, the tooth is placed back in the socket.
Reasons for Endodontic Surgery
Endodontic surgery can help save a tooth in several instances:
- Surrounding bone root surfaces are damaged.
- To diagnose problems, such as small fractures or root canals that do not appear on an X-ray, and are not recognized during root canal therapy.
- Used alone or in conjunction with endodontic retreatment.
Alternatives to Endodontic Surgery
In general, the only alternative is tooth extraction. The extracted tooth must be replaced with a crown or other restoration, and thus this alternative will be much more expensive and time consuming.