Sometimes, a non-surgical root canal may be sufficient for preserving a tooth. The infected inner pulp is removed, the tooth is fitted with a crown, and the natural tooth can be saved for many years, perhaps the rest of your life. However, when such a treatment is not enough, you may require root canal microsurgery, also known as an apicoectomy.
What Situations Call for Root Canal Microsurgery?
– When nonsurgical procedures alone cannot save the tooth
– Diagnostic purposes – sometimes problems persist with a tooth even when nothing appears on an x-ray. This may be the case with tiny fractures or if the infection is in a very small canal that cannot be reached with a nonsurgical procedure.
– Calcium deposits – Such deposits can constrict the canals of the roots. This may make it impossible to reach the end of an infected canal with a nonsurgical procedure.
– Root canal follow-up – While this is not a common occurrence, a tooth on which a successful root canal has been performed may get infected again months or even years later. Or the tooth may become diseased, fail to heal, or continue to be painful. If this is the case, an apicoectomy can help save the tooth.
– When bone or root surfaces are damaged
How is an Apicoectomy Performed?
This form of endoscopic microsurgery involves going in through the gums to remove the infected material and the root-tip. The end of the canal may be sealed with a filling. The gums will be stitched closed allowing for proper healing to take place. Eventually, the bone itself will heal and encase the end of the root once again. This may take several months.
Should You Be Concerned?
As far as surgical procedures go, an apicoectomy is very minor. The procedure should not hurt at all thanks to the local anesthetics that are administered. The pain the tooth is causing should be relieved by the procedure. Pain medication may be provided to help with any discomfort while the gums heal from the incision.
Is There Anything Else I can Do?
If your dentist recommends an apicoectomy, likely the only solutions are the procedure or extraction of the tooth. Since root canal microsurgery can preserve the tooth indefinitely, it is certainly a better option than losing the tooth. Especially since extraction usually means a bridge or implant, root canal surgery can often be a cost-effective solution as well.
In the end, there is nothing better than a natural tooth, even with the great advancements in modern replacements. Therefore, it just makes sense to opt for root canal surgery if there is reasonable hope of preserving the tooth.