What You Should Know About An Apicoectomy
Root canal treatments are a common way for patients to combat tooth decay without completely removing the affected teeth. Despite a success rate as high as 97 percent, however, there are a small number of cases where root canals must be corrected through an apicoectomy procedure. The following illustrates how this dental procedure works, why it's needed and what patients can expect afterwards.
Why Apicoectomies Become Necessary
Bacterial infection and incomplete treatment of the canal are two of the most common reasons for post-treatment complications following root canal treatment. Untreated and unfilled spaces within the canal can allow harmful bacteria to colonize the area, resulting in an abscess that could spread into the surrounding tissue and bone.
Apicoectomies are a common step for saving a tooth that's already been root canaled from extraction. Instead of removing the tooth altogether, the abscessed tissue is cut out of the bone along with the tip of the affected root. This completely removes the infection from the tooth altogether, allowing the surrounding bone and tissue to heal without the risk of reinfection.
Your endodontist may suggest undergoing an apicoectomy if the affected tooth is a part of a bridge or already has a crown installed. Since performing another root canal procedure could weaken or destroy the crown or bridge, an apicoectomy is often considered the next best step.
Understanding the Procedure
First, your endodontist will conduct x-rays or cone beam-computed tomography (CBCT) scans of the affected tooth to locate the source of the infection, as well as previously undetected canals and other issues that could impact the apicoectomy procedure.
After identifying the infected area, your endodontist will numb the area with local anesthesia. Next, your endodontist will make a small incision in the gum tissue at roughly the same level as the infection. This way, the gum tissue can be lifted upwards to expose the underlying bone.
Once the bone is exposed, your endodontist will remove the infected tissue along with a small portion of the root tip. Once the root tip is removed, a small filling is inserted into the exposed root canal end to seal the root and prevent bacteria from taking hold once more. The flap of gum tissue is brought back down to cover the new bone cavity created by the procedure.
At the end of the procedure, your endodontist will reattach the once-retracted gum tissue using dissolvable sutures, which will hold the gum in place until it fully heals. According to Cambridge University Hospitals, the sutures will vanish after approximately 2 weeks.
The procedure itself is relatively quick and straightforward. According to Colgate, the majority of apicoectomies take 30 to 90 minutes to successfully complete. You may experience some bruising and swelling after the apicoectomy procedure is complete. To reduce pain and hasten recovery, your endodontist may recommend over-the-counter anti-inflammatory drugs containing ibuprofen or prescription pain medicine. The soreness and swelling caused by the procedure should disappear within a couple of weeks.
The void left behind by the apicoectomy procedure will fill in with new bone growth on its own. Bone grafts may be needed in some cases to help spur bone growth in the newly-created cavity. It may take a few months for all of the bone near and around the root to completely return.
There are a few things you can do to make your post-procedure recovery much smoother. For instance, you should avoid eating foods that take a lot of effort to chew, including crunchy foods. You should also ignore the temptation to lift your lip just to examine where the surgery took place. Doing so can actually cause the sutures to loosen and jeopardize the healing process. For more information, contact a professional in endodontics.