A root canal treatment is the first step of the process. This will remove any infected tissue from inside the tooth. The success rate for this procedure is around 80%. However, occasionally, root canal treatment alone is not sufficient as a stand-alone treatment. In such a situation either the root canal treatment can be redone, or the tooth is extracted, or Apicectomy microsurgery carried out.
Apicectomy is not an alternative to root canal treatment, and is usually indicated on occasions where redoing the root canal is not possible or not sufficient by itself. In these situations, the dentist and the patient may decide that apicectomy will be a better last resort alternative to removing the tooth altogether.
The procedure for Apicectomy
- First of all, an X-ray or 3D cone beam CT scan is taken to check the end of root anatomy thoroughly.
- Your tooth will be fully numbed to ensure that the procedure is completely pain-free.
- Intra-Venous sedation is also available for nervous or anxious patients.
- The gum tissue around the affected tooth is eased back.
- Any Infected and cystic bony and soft tissue around the apex of the tooth is removed.
- The tip of the root is then removed.
- Retrograde (end of root) root filling material is placed at the apex of the tooth to seal it.
- The gum is sutured back together to encourage healing.
- The site is reviewed after 7 days.
The Apicectomy procedure will take around 90 minutes to complete depending on complexity.
Surgery aftercare
Ibuprofen is the best painkiller after such surgery as it reduces inflammation.
Chlorhexidine mouthwash is also recommended to reduce localised gum inflammation.
Applying ice packs to the face near the surgical region will reduce postoperative inflammation and pain.
Associated risks with Apicectomy
Like many surgical procedures, there can be some pain, bruising, swelling, tenderness, gum scarring, and bleeding after surgery. The tooth can feel slightly looser.
The gum around the tooth and the neighbouring teeth can occasionally recede a little. Also the neighbouring teeth can become a little sensitive as a result of this gum recession.
What is the success rate with the treatment?
Success rate tends to be around 70%. The results will be dependent on the complexity of the initial problem.
Who carries out Apicectomy microsurgery?
Our Specialist Endodontist will usually carry out such procedures. Specialists have the skills and experience to perform complex surgical procedures such as Apicectomy microsurgery. At Pearl Dental Clinic, we use dental microscope magnification to ensure that we do not miss any small root anatomy which can cause future infection.