Apicoectomy, also known as root end surgery or endodontic surgery, is a surgical procedure which consists of the removal of the tooth’s root tip together with all damaged tissue in the area. Apicoectomy is usually done when the classical endodontic treatment was unsuccessful or when endodontic treatment cannot be performed for various other reasons. It is also used to expose hidden tooth canals which do not appear on X-rays. Apicoectomy is usually performed as an attempt to save the tooth from being extracted.
Preparations for Apicoectomy
If your dentist recommends that you should have a root end surgery, he might ask you to make a few preparations before the surgery. X-rays are necessary so that the dentist can plan the procedure.
Some dentists recommend some antibiotics and anti-inflammatory drugs before the surgery. If you are on medication for other conditions, let your dentist know. A light meal and drinking liquids are recommended before the intervention. If you have chosen sedatives, you will need to have an empty stomach. Appropriate oral cleaning is also strongly recommended before the procedure.
Apicoectomy Root End Surgical Procedure
Apicoectomy is a microsurgery procedure and it is done under local anesthesia. After the area is numbed, the doctor makes a small incision in the gum tissue so that he can reach the tip of the root and the infected tissue around it. Then, he removes all damaged tissue in the area together with the root end. If the tooth has not been previously treated using classical endodontic procedures, the dead nerve will also have to be removed during this procedure.
After the removal of the tip of the root and cleaning the area of all damaged tissue, the empty part of the root cavity is filled with a substance based on calcium silicate. This filling has the role to seal the area and prevent further infections or the gathering of bacteria and infectious agents.
At the end of the procedure, the gums are sutured to close and protect the area. The stitches are typically dissolvable, otherwise, these are usually removed within a week after surgery. Typically, the procedure takes 30 to 90 minutes. The length depends on where the problem tooth is located and on how complex its root structure is.
Apicoectomy Aftercare
Until the incision fully heals, you might experience pain and discomfort in the area. To prevent swelling, apply ice on the face, in the surgery area. You can keep up with ice treatment for about 24 hours.
Your doctor will also prescribe medication to help you with pain and the inflammation. The most commonly prescribed substances after an apicoectomy are ibuprofen, aspirin and acetaminophen, and even antibiotics to help treat or prevent possible infections. You should respect the dosage and intervals of the medication prescribed.
Be careful when brushing your teeth in the area so that you do not cause pain; choose a softer brush. Follow-up checkups and X-rays are necessary, so consult with your dentist to set the follow-up schedule.
