If Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants and our team recommend an “apicoectomy” to save your tooth, you probably have a few questions about the procedure. Here are some of the basics you might discuss when you visit our Worcester office:
- What is an apicoectomy?
The tip of a root is also called its “apex.” An apicoectomy means the removal (“ectomy”) of the apex (“apico”) of the tooth. This is a surgical procedure performed by a specialist in the treatment of the inner tooth.
- Who performs apicoectomies?
Your endodontist is a specialist in tooth-saving surgical procedures. Endodontists like Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants diagnose and treat problems of the inner tooth and its surrounding tissue. They have two or more additional years of study in the field of endodontics, and have the experience, knowledge, skill, and specialized equipment needed to perform delicate endodontic surgeries.
- Why choose this procedure?
Usually, a root canal is all that you need to treat any damage or infection in your inner tooth. But when inflammation or infection returns at the tip of the root, or in the bone surrounding the tip, or a tooth can’t be treated with a conventional root canal, Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants may recommend an apicoectomy both to save your natural tooth and to prevent further infection or damage to the surrounding bone and teeth.
- How does the procedure work?
Often local anesthesia is all that is needed. (But if you have concerns, talk to us about your anesthesia and sedation options. We will have suggestions for you.) After the area is numb, an incision is made in the gum tissue to allow access to the root and any affected bone tissue.
Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants will carefully remove a few millimeters from the tip of the tooth as well as any infected tissue from the area. Because the tip of the tooth is small, and cracks or extra canals in a root are often difficult to discover even with an X-ray, we might make use of microscopic technology to be sure there are no additional canals or large cracks or breaks in the root. Using specialized instruments, the end of the tooth will be cleaned and sealed.
Stitches or sutures will be used to close the incision, and will either dissolve on their own or might need to be removed on a follow-up visit. We will let you know just how to take care of the site after surgery.
In general, any pain or sensitivity after the procedure can be treated with over-the-counter anti-inflammatory pain relief such as ibuprofen. Follow post-op instructions carefully to reduce any swelling, and be sure to follow any dietary suggestions and restrictions. If pain or swelling are a problem, or if you have any other concerns, call our Worcester office.
Apicoectomies are a common procedure used by endodontists to save a compromised tooth. If you have recurring or new pain or infection after a root canal, if you have an undetected extra canal, if there is a crown and post in place that would make it impractical to reach the root or pulp chamber area with conventional treatment, and if you want to preserve your natural tooth, an apicoectomy is an option well worth discussing.