In most cases, root canal therapy can successfully repair an infected tooth and save it from extraction. But what happens if the tooth becomes re-infected after the treatment? In many cases, an apicoectomy can repair the damaged root and eliminate the bacteria that cause infection. At our Charlotte, NC dental practice, our doctors provide this treatment when and if it is necessary.
A type of endodontic surgery, an apicoectomy, or a root end resection, involves removing the very tip of an infected tooth root. This eradicates the source of infection and prevents bacteria from spreading to adjacent teeth. An apicoectomy is significantly different from a root amputation. In the latter procedure, the entire tooth root is removed.
Generally speaking, an apicoectomy is recommended if a root canal treated tooth becomes infected again. If there is evidence that necrotic tissue has been left behind, root canal therapy is often recommended a second time. However, if this is not indicated, your dentist may consider an apicoectomy.
In all cases, an apicoectomy will only be performed if there is a generally good prognosis as long as treatment is pursued. If the long-term predictability is poor, an extraction may be considered as a last-resort option.
During your consultation with your doctor, he or she will perform a comprehensive visual assessment and also take x-rays. Diagnostic imaging will help your dentist better understand where the source of infection is located, and how much of your natural tooth will need to be removed to eradicate it.
To begin the procedure, local anesthesia will be administered to numb the tooth and surrounding gums. A small incision will be created in the gum line so the doctor can access the jawbone and the tooth root.
At this point, a specialized dye will be used to detect any hard-to-see fractures or cracks. If the tooth is beyond repair, it will be removed at this juncture. If the doctor does not see a fracture, he or she will move forward with the apicoectomy.
To perform this, only the portion of the root that is affected will be removed. Any inflamed tissue that has developed around the tooth root will be removed as well. The remaining portion of the root canal will be cleaned and disinfected, and the end of the root will be sealed. A final x-ray will then be taken before the tissue is repositioned and the incision is closed.
Following the procedure, post-operative instructions will be given to you. These guidelines should be closely followed for a speedy and successful recovery.
Resting at home for the remainder of the day is recommended if possible, as bleeding and swelling are more likely if activity is not kept to a minimum. During the first 24 hours, apply a cold compress to the external jaw for 20 minutes at a time. To minimize swelling, over-the-counter ibuprofen or naproxen can be taken.
During the first few days, you will need to avoid brushing the area directly, keeping the site clean with an antibacterial rinse instead. Hard, crunchy foods should also be avoided, as they can irritate the surgical area. As a general rule, post-treatment soreness, swelling, and bruising should diminish within a few days, with full recovery taking place around the second week.
If you have a sore or tender tooth that has been previously treated with root canal therapy, talk to your doctor about an apicoectomy. Schedule an appointment at our practice to determine if this type of treatment could be beneficial for you. Call our office at (704) 543-1102 or contact us online anytime.