If you recently had a root canal, then you likely experienced a sense of relief once the treatment was over. Your dental pain probably disappeared, and you and your dentist likely worked together to decide on the best crown for the tooth. In some situations, though, a root canal is not the final treatment that needs to be completed on the tooth, even once a crown is added. According to studies, about 18% of all root canals fail. While some cases may result in an extraction, you may be able to receive an apicoectomy instead. Keep reading to find out why this treatment may be needed and also what will happen during the apicoectomy to keep your crown intact.
Why Is the Treatment Necessary?
Root canals are completed in cases where a tooth is cracked, where the tooth contains a large cavity, or where the pulp has been injured. Most of the time, though, root canals are scheduled when an infection forms inside a tooth. To treat the infection, your dentist will remove all of the dental pulp and clean out the tooth entirely. The tooth will then be filled in. Your dentist will have several goals during the treatment. These goals include removing infected tissues, saving the tooth, and preventing future issues. Cleaning the tooth while saving the majority of the natural material can be difficult. Only a relatively small access hole in the crown will be formed, and the dentist will need to reach all the way through the dental roots to clear out the tooth.
The dental roots are narrow, and your dentist will work to clear the openings without breaking off a piece of the root. Tools called files that are also quite narrow will be forced into the ends of the tooth. Gentle pressure is used with the files to minimize damage concerns. Sometimes this will cause the dentist to miss the very tip of the tooth. If the dentist feels that this is a concern, your tooth may be medicated for a period of time before it is filled. However, even medicine may be unable to reach the root tip. If bacteria become trapped in the tooth, then an infection can spread to the bone tissue near the tooth root. You will likely feel pain starting to build in the jaw when this happens.
How Is an Apicoectomy Performed?
While a typical root canal will involve treatment through the middle of the tooth, an apicoectomy will involve surgery through the gum tissues. This allows your dentist to directly access the dental root while also keeping your dental crown intact. The dentist will inspect the root itself as well as the bone and gum tissues that surround the root. A scalpel or drill is used to release damaged tissues around the tooth root, and the very tip of the root is removed too. Typically, only a few millimeters are removed to help retain as much of the natural tooth as possible. Once the root tip is cut away, your dentist will secure a filling in the end of the root tip to close the tooth off from microorganisms that may come into contact with the tooth.
If you need an apicoectomy, you may be concerned about going through a dental surgery. All incisions and cuts are extremely small, though. To make sure that the surgery is as exact and as minimally invasive as possible, your dentist will use fiber-optic technology, surgical microscopes, and sometimes lasers to complete the operation.
A few dissolvable stitches may be needed to close up the gum tissues, but healing is typically quick, and pain is minimal. You will likely need an x-ray several weeks to several months after the procedure is over to make sure the apicoectomy was successful. If for some reason the operation does not resolve the tooth-infection issue, then another apicoectomy treatment may need to be completed, or the tooth may need to be extracted. However, the root-tip removal is usually successful when it comes to saving your tooth and retaining an undisturbed dental crown.