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Epicoectomy
Services > Orthodontic Dentistry > Epicoectomy
A Surgical Option to Save a Previously Treated Tooth
An apicoectomy is a minor surgical procedure that removes the tip of a tooth root along with any infected tissue surrounding it. It is most often recommended when infection persists after a root canal and cannot be resolved by treating the tooth from the inside. By addressing the problem at the root end, an apicoectomy allows many patients to keep a natural tooth that would otherwise need to be extracted.
What Is
an Apicoectomy?
An apicoectomy, also called root-end surgery, is performed through a small opening in the gum tissue near the affected tooth. The infected tissue at the tip of the root is removed, a few millimeters of the root end are trimmed away, and a small filling is placed to seal the end of the canal. The gum is then closed with sutures and allowed to heal as bone rebuilds around the root. Because the tooth is accessed from the side rather than through the crown, any existing crown or restoration usually stays in place.
An apicoectomy may be recommended to treat:
- Infection that persists after a root canal
- A cyst or lesion at the tip of the root
- Narrow, curved, or calcified canals that cannot be fully cleaned
- A canal blocked by a post, crown, or previous filling material
- A small fracture or damage at the root tip
- Canals that were missed during the original treatment
- Infection that has not responded to root canal retreatment
Signs You May Benefit from an Apicoectomy
Benefits of an Apicoectomy
- Preserves a natural tooth that might otherwise be extracted
- Avoids the cost and time of an implant or bridge
- Reaches infection that cannot be treated from inside the tooth
- Existing crowns and restorations can usually remain in place
- Completed in a single appointment under local anesthetic
- Allows the surrounding bone to heal once the infection is removed
- High success rate when the tooth is otherwise healthy
Potential Risks of an Apicoectomy
- Swelling, bruising, and soreness during the first few days of healing
- Infection may persist in a small number of cases
- Extraction may still be necessary if healing does not occur
- Proximity to nerves or the sinus can limit which teeth are candidates
- Not appropriate for teeth with fractures or poor bone support
The Apicoectomy Process
Consultation and Imaging
X-rays or three-dimensional imaging are used to locate the infection, assess the root anatomy, and confirm that surgery is the right approach.
Anesthesia and Access
The area is fully numbed with local anesthetic and a small incision is made in the gum to expose the bone and the tip of the root.
Removal of Infected Tissue
The inflamed or infected tissue surrounding the root tip is removed, along with a few millimeters of the end of the root itself.
Root-End Filling
The end of the canal is cleaned and sealed with a small biocompatible filling to prevent bacteria from re-entering the root.
Closure and Healing
The gum tissue is repositioned and closed with sutures. Bone gradually regenerates around the root over the following months, and follow-up imaging confirms healing.
An Alternative to Losing the Tooth
Many patients choose clear aligners because they allow orthodontic treatment to fit into their lifestyle with minimal disruption. The removable design and discreet appearance make them especially popular among adults and older teens.
FAQs about Apicoectomy
The procedure itself is performed under local anesthetic, so you should not feel pain during treatment. Soreness and swelling afterward are typically managed with over-the-counter pain relievers and cold compresses.
Most patients return to normal activities within a day or two, with swelling and tenderness improving over the first week. Sutures are usually removed a few days to a week after surgery.
A root canal cleans the canal from inside the crown of the tooth. An apicoectomy treats the tooth from the outside at the root tip and is used when the infection cannot be reached or resolved from within.
In most cases the existing crown is left undisturbed, since the tooth is accessed through the gum rather than through the restoration.
Apicoectomy is successful in the large majority of appropriately selected cases, though outcomes depend on the tooth, the extent of infection, and the surrounding bone support.
Keep the Tooth You Already Have
A tooth that still hurts after a root canal does not always have to be removed. At Zaller Family Dentistry, we offer apicoectomy treatment in Reisterstown, MD, to clear persistent infection at the root tip and give your natural tooth the chance to heal. Contact us today to schedule a consultation and learn whether an apicoectomy is right for you.
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