Apicoectomy | An Overview of Endodontic Surgery

Why would I need Endodontic Surgery? Generally, a root canal is all that is needed to save teeth with injured pulp from extraction. Occasionally, this non-surgical procedure will not be sufficient to heal the tooth and your endodontist will recommend surgery. Endodontic surgery can be used to locate fractures or hidden canals that do not appear on x-rays but still manifest pain in the tooth. Damaged root surfaces or the surrounding bone may also be treated. The most common surgery used to save damaged teeth is an apicoectomy or root-end resection.

What is an Apicoectomy? The above diagram illustrates this simple procedure. An incision is made in the gum tissue to expose the bone and surrounding inflamed tissue. The damaged tissue is removed along with the end of the root tip. A root-end filling is placed to prevent reinfection of the root and the gum is sutured. The bone naturally heals around the root over a period of months restoring full function.

Surgical Instructions

This procedure will be performed using local anesthesia (numbing the area). There are usually no restrictions after the procedure concerning driving. Time required for the procedure is usually one hour.

1. Continue all medications for blood pressure, diabetes, thyroid problems and any other conditions as recommended by your physician. Please advise us if you are taking any blood thinner prior to surgery. If there is any question, please call our office prior to your appointment.
2. Please eat a full breakfast or lunch as applicable.
3. If you have been advised by your physician or dentist to use antibiotic premedication because of mitral valve prolapse (MVP), heart murmur, hip, knee, cardiac or other prosthesis, or if you have rheumatic heart disease, please make sure you are on the appropriate antibiotic on the day of your appointment. If there is a question, please call our office prior to your appointment.
4. If you can take ibuprofen (Advil) or naproxen sodium (Aleve), it does help reduce inflammation when taken pre-operatively. We recommend 2 tablets of either medication 2-4 hours before endodontic therapy.

Post Operative Instructions:

We suggest that you take it easy for the first 12 hours after surgical treatment to allow time to recover. (If possible, take the day off of work). Take prescribed medications as directed. To ease discomfort and swelling, taking an anti-inflammatory medication (such as ibuprofen) and applying ice to the area are recommended. Swelling and discoloration in the surgical area is normal for 3-5 days following surgery. The sutures will resorb over time and will not need to be removed. We will see you in approximately one week after surgery to monitor healing. You are encouraged to contact us at any time after treatment if you have any questions or concerns.