Modern root canal treatment can preserve many teeth whose inner tissue has become inflamed or infected. Sometimes, however, an inflammation around the tip of the root persists despite previous treatment.
In selected cases, an apicoectomy – surgical removal of the root tip – can then be a way of preserving the affected tooth.
What happens at the root tip?
The root canal system of a tooth is very fine and can have tiny branches. Bacteria can lodge in areas that are difficult to reach even with careful root canal treatment.
If an infection persists, the body may respond with a chronic inflammatory reaction in the bone around the root tip.
What happens during an apicoectomy?
After a local anaesthetic, the root tip is reached through a small surgical access.
The inflamed tissue is removed and the affected portion of the root tip is shortened. Depending on the situation, the root canal system can additionally be cleaned and sealed tightly from the root end.
The wound is then closed again.
The goal: preserving your natural tooth
An apicoectomy is not a standard solution for every root-treated tooth. Before the procedure, we need to establish why the inflammation persists and whether repeating conventional root canal treatment might be the better alternative.
The condition, stability and long-term restorability of the tooth also play a role in this decision.
Healing
After the operation, the area may be tender or swollen for a few days. The bone then needs considerably longer to remodel the resulting defect.
That is why we do not judge the success of treatment by the first few days after the procedure alone, but also monitor the further bony healing where needed.