apicoectomy

Apicoectomy

An apicoectomy is a surgical procedure that attempts to remove infection from the tip of the tooth root (apex) that is inside the jawbone. This infection may be present in the absence of pain. X-ray evidence usually shows an unresolved, black circle around the tooth long after the initial root canal therapy was performed. Sometimes a fistula, or pimple, might be present in the gum.

An apicoectomy is usually performed only after traditional root canal therapy has failed. It might be necessary even when root canal therapy objectively appears well done. It should not be attempted unless re-treatment of the root canal through traditional root canal therapy is inadvisable. A filling material like silver, IRM or MTA is usually placed in the root tip after removal of the infected area.

The long-term success rate or prognosis for a tooth is significantly reduced when an apicoectomy is needed. Apicoectomy is more difficult to perform in posterior teeth because of difficulty in vision, surgical access and the complexity of multi-rooted teeth. An endodontist (root canal specialist) or oral surgeon is typically most skilled in this type of procedure.

To see photographs of an apicoectomy click on 'Dental Photos' at the top of this page and then click on 'Apicoectomy' in the left margin. There are hundreds of photographs in this section.