Why would I need Endodontic Surgery?

Generally, a root canal is all that is needed to save teeth with injured pulp from extraction. Occasionally, this non-surgical procedure will not be sufficient to heal the tooth and your endodontist will recommend surgery. Endodontic surgery can be used to locate fractures or hidden canals that do not appear on x-rays but still manifest pain in the tooth. Damaged root surfaces or the surrounding bone may also be treated with this procedure. The most common surgery used to save damaged teeth is an apicoectomy or root-end resection.

What is an Apicoectomy?

The video on the right illustrates this simple procedure. An incision is made in the gum tissue to expose the bone and surrounding inflamed tissue. The damaged tissue is removed along with the end of the root tip. A root-end filling is placed to prevent reinfection of the root and the gum is sutured. The bone naturally heals around the root over a period of months restoring full function.

Following the procedure, there may be some discomfort or slight swelling while the incision heals. This is normal for any surgical procedure. To alleviate any discomfort, an appropriate pain medication will be recommended. If you have pain that does not respond to medication, please call our office.

We routinely see our surgery patients within two days for suture removal and a tissue check, in one month for a comprehensive soft tissue evaluation of healing and then in six months to do a radiographic evaluation of bone healing.

Other surgical procedures are occasionally used to facilitate complete healing of your endodontically challenged tooth.

  • Hemisection can be used to remove half of a tooth that has multiple roots. If one of the roots has fractured, it can be removed, leaving the healthy root behind to support the existing crown, or be the site of a new crown.
  • Root Amputation is a similar procedure used on multi-rooted teeth. It can be characterized as leaving a larger portion of the natural crown intact. Only the root is removed from underneath the crown of the tooth.