The teeth are held firmly in place by strong roots that extend into the jawbone. Molars and premolars tend to have several roots, whereas the front incisors only have a single root. The end or tip of each root is termed the apex. The apex is where the nerves and blood vessels enter the tooth and aids in the delivery of blood to the crown (the part of the tooth you can see in your mouth).
A root canal treatment refers to the cleaning of the canals and the removal of infected and inflamed tissue within the root. When the inflammation or infection persists after the root canal treatment, an apicoectomy may be required. An apicoectomy is essentially the removal of the apex (or root tip), followed by a filling procedure to seal the root from further infection. When left untreated, infected roots can damage other teeth, spread infection, and cause regression of the jawbone.
Reasons for an apicoectomy
Infected and inflamed soft tissue around the root of a tooth can be exceptionally painful and debilitating. The purpose of an apicoectomy is to eliminate the infection in the tissue and to ultimately preserve the function of the tooth and save it from extraction.
What does getting an apicoectomy involve?
Prior to the surgery, your dentist or Dr. Murphy will generally prescribe an antibiotic or anti-inflammatory medication to treat the underlying infection. Panoramic X-rays and, if necessary, a CT of the tooth, will then be taken to enable Dr. Murphy to plan the apicoectomy and rule out a fracture that would require extraction of the tooth instead.
Dr. Murphy will make a small incision in the gum and expose the root by lifting away the gum. In some cases, small opening in the jaw may be created to properly expose the root. The edge of the root tip and any infected connective tissue will be removed. The root will be sealed using a retrofill (filling material), and Dr. Murphy will suture the gum with several stitches.
After several days the stitches will dissolve, and the bone will fully heal several months after the procedure.