Apicoectomy - Silver Spring, MD

The teeth are held firmly in place by strong roots that extend into the jawbone. Molars & premolars tend to have several roots, whereas the front incisors only have a single root. The end or tip of each root is termed the apex. The apex is where the nerves & blood vessels enter the tooth, & aids in the delivery of blood to the crown (the part of the tooth you can see in your mouth).

A root canal treatment refers to the cleaning of the canals & the removal of infected & inflamed tissue within the root. When the inflammation or infection persists after the root canal treatment, an apicoectomy may be required. An apicoectomy is essentially the removal of the apex (or root tip), followed by a filling procedure to seal the root from further infection. When left untreated, infected roots can damage other teeth, spread infection, & cause regression of the jawbone.

Reasons for an apicoectomy

Infectedinflamed soft tissue around the root of a tooth can be exceptionally painful & debilitating to the patient. The purpose of an apicoectomy is to eliminate the infection in the tissue & to ultimately preserve the function of the tooth & save it from extraction. An apicoectomy will rarely be considered by the dentist unless a prior root canal treatment has failed.

There are several reasons why an apicoectomy may be necessary:

  • Small Adjoining Root Branches – Roots are extremely complex & can contain many tiny branches. If these tiny branches cannot be cleaned & sealed when the root canal treatment is performed, inflammation can persist.
  • Blocked Root Canal – In some cases, the dentist is unable to effectively clean a root canal because it is blocked by a fractured file left behind from prior root canal treatment. Infectiondebris can quickly affect adjacent teeth.
  • Narrow or Curved Root Canals – When the root canal is poorly shaped, the endodontic files cannot reach the root tip. Continuing infection or re-infection can then occur.

What does getting an apicoectomy involve?

Prior to the surgery, the dentist will generally prescribe an antibiotic or anti-inflammatory medication to treat the underlying infection. Panoramic x-rays will then be taken to enable the dentist to plan the apicoectomy, which will be performed under local anesthesia.

The dentist will make a small incision in the gum & expose the root by lifting away the gum. In some cases, a tiny fraction of the jawbone may be removed to properly expose the root. The edge of the root tip & any infected connective tissue will be removed using ultrasonic instruments. The root will be sealed using a retro & fill (filling material)the dentist will suture the gum with several stitches.

This surgery does not require an overnight stay, & full aftercare instructions & pain medications will be provided as needed. After several days, the dentist will remove the stitches, & the connective tissues will fully heal several months after the procedure.

If you are experiencing any signs or symptoms, such as pain or swelling associated with a tooth that has had a root canal, we encourage you to contact our office immediately   Request Your Appointment or Call us today at  301-585-1515.