Clinical review: Dr. Samreen Ejaz, BDS, RDS ·
When it’s used
An apicoectomy treats the very end of a root by going in through the gum, rather than through the top of the tooth. It may be an option when a problem is still there after root canal treatment and the rest of the tooth is worth keeping. It isn’t a routine part of every root canal, and it’s not the same as taking the tooth out.
Planning first
We look at the existing root filling, the crown or filling on top, your symptoms and your X-rays. Where the root sits, and how close it is to nearby nerves, sinuses and teeth, affects how easily and safely it can be reached. Dr. Samreen will explain whether redoing the root canal is possible, and why surgery or a referral is being suggested instead.
What the surgery involves
The area is numbed first. A small opening is made in the gum to reach the root tip, the infected tissue and the end of the root are removed, and the root end is sealed if needed. The gum is then stitched closed. The exact steps depend on the tooth. Ask who will do the surgery and what the follow-up visits will be before you agree.
Healing at home
We’ll tell you how to keep the area clean, manage soreness, and when to come back for a wound check or stitch removal. If you take blood thinners or other regular medicines, tell us beforehand, and don’t stop any of them on your own. Call us if swelling keeps getting worse or bleeding won’t stop with pressure. If swelling spreads, or you have a fever or trouble swallowing or breathing, go to a hospital emergency. Later, an X-ray can show how the bone around the root is healing.
BEFORE YOUR APPOINTMENT
Questions about apicoectomy
Will surgery definitely save my tooth?
No. The crown or filling, the state of the root and how you heal all play a part. Ask us what your options would be if it doesn’t work.
Why not just redo the root canal?
For some teeth that’s the better choice. For others, a post or crown in the way, or the type of problem, makes surgery more sensible. Dr. Samreen will explain her reasoning for your tooth.
Does it hurt?
The area is numbed, so you should feel pressure rather than sharp pain during the surgery. Expect some soreness for a few days, and we’ll tell you how to manage it.
This is general information. What’s right for your tooth depends on what Dr. Samreen finds when she examines it.
Background reading: AAE: endodontic surgery. These are overseas sources, so their prices and rules don’t apply here.