Why would I need endodontic surgery?
- To find a hidden problem. If symptoms continue but x-rays show nothing, a tiny crack or missed canal may be the cause. Surgery lets us examine the whole root and treat what we find.
- Calcified canals. Calcium deposits can make a canal too narrow for instruments to reach the end of the root. Surgery cleans and seals the rest of the canal.
- A treated tooth that has not healed. Most teeth heal well after a root canal. If one does not, or becomes painful months or years later, surgery may save it.
- Damaged root surfaces or surrounding bone.
What is an apicoectomy?
An apicoectomy, or root-end resection, is the most common endodontic surgery. It is done when inflammation or infection continues in the bone around the root tip after a root canal.
- OpeningThe gum near the tooth is gently opened to reach the bone, and inflamed or infected tissue is removed.
- Treating the root tipThe very end of the root is removed, and a small filling may be placed to seal the end of the canal.
- ClosingA few stitches help the gum heal properly.
- HealingOver the next few months, the bone heals around the end of the root.
Because every surgery is done under the surgical operating microscope, the opening can be kept small, which means less discomfort and faster healing.
Other types of endodontic surgery
Other procedures include dividing a tooth in half, repairing an injured root, or removing one or more roots. In some cases a tooth is gently removed, treated outside the mouth and put back in its socket. This is called intentional replantation. Dr. Warren will explain which, if any, your tooth needs.
Common questions
Will it hurt?
Local anesthetic keeps you comfortable during the procedure. Some discomfort or slight swelling while the area heals is normal for any surgery. We will recommend medicine for discomfort and give you written aftercare instructions. Call us if you have pain that medicine does not control.
Can I drive myself home?
Often you can, but ask us before your appointment so you can arrange a ride if needed. If you choose IV or oral sedation, an adult must drive you home.
When can I get back to normal activities?
Most patients return to work and routine activities the next day.
Does insurance cover it?
Every plan is different. Check with your employer or insurance company before treatment, and we will help with the paperwork.
How do I know it will work?
Surgery is recommended when it is the best option for saving your natural tooth. No surgery comes with a guarantee, so we will talk about your chances of success before you decide.
What are the alternatives?
Usually the only alternative is removing the tooth and replacing it with an implant, bridge or partial denture. These involve more surgery or work on neighboring healthy teeth, so endodontic surgery is often the most natural and cost-effective way to keep your tooth.
Scheduled for surgery? Read how to prepare for IV sedation and what to do afterward.
Adapted from patient information by the American Association of Endodontists. Every tooth is different; Dr. Warren will explain what applies to yours at your exam.