Apicoectomy is also known as a root end surgery. This is an endodontic surgery by which the professional removes the tip of the tooth root. This gives rise to a root end cavity. He then fills this root end cavity with a biocompatible material. Apicoectomy is performed when the infection and inflammation continue in the area around the root tip. Or, the root canal treatment failed and a re-treatment would not be feasible or had failed as well. Along with the tooth root tip, the surrounding infected tissue of the abscessed tooth is also removed. Before performing an apicoectomy, the first and second root canal treatments would have failed.
A general dentist with advanced training, an endodontist or an oral and maxillofacial surgeon could perform the treatment. Dental experts perform apicoectomy with the intention of preventing the need to extract a tooth. The procedure involves numbing the area first. Then, a cut is made on the gum, the gum over the tooth is lifted and the underlying bone and the root end of the tooth are accessed. A drill would be used by the dentist. This root tip and the other adjacent infected tissue are removed. A dye would be used by the dentist to highlight cracks and breaks in the tooth.
The end of the root canal is then cleaned and sealed with the help of a biocompatible material filling. Then the gum is placed in the normal position and sutures are applied to hold the gums in the correct position until the wound heals. The complete procedure of apicoectomy usually takes approximately 30 to 90 minutes.
The dental expert would prescribe the medicines which the patient would have to take after the surgery and would also advise what to eat and drink. Applying ice for approximately 20 minutes is very important because the treated area may swell after surgery. Brushing harshly and eating hard food items should be avoided. It is also important that the patient does not lift the lip in an attempt to check the surgery area because this may loosen and disturb the stitches.
The most significant risk involved in apicoectomy is that the surgery doesn’t work, and the tooth would then need to be extracted. Other risk factors depend upon the location of the tooth. For example, if the tooth exists on the back of the upper jaw, then the sinuses may be affected. Similarly, if the tooth exists on the back of the lower jaw, then some major nerves can be damaged as well.