Accessibility View Close toolbar

Root Canal Surgery (Apicoectomy)

Occasionally, root canal treatment proves unsuccessful at resolving an infection in the tissues near a tooth's roots. That's when a minor surgical procedure called an apicoectomy may be recommended. Because this procedure is often performed with the aid of a microscope and other small specialized tools, it's considered a type of endodontic microsurgery. Probably the most common type of root canal surgery, an apicoectomy involves removing a small portion of the apex (tip) of the tooth's root, along with any surrounding hard or soft tissue that may be infected.

What would cause you to need an apicoectomy? There could be several reasons, including a canal that is blocked or inaccessible, an anatomical irregularity, or a fracture or crack in the tooth's roots. The procedure is normally only recommended after one or more root canal treatments have been attempted, and have failed. Since this type of problem generally occurs near the apex of the root, the procedure is often an effective way to treat a persistent infection.

Root canal surgery apicoectomy.Before an apicoectomy procedure, diagnostic images (such as X-rays) of the affected tooth and surrounding bone, a careful review of your medical history including medications you take (both prescription and non-prescription), and other factors are reviewed. If an apicoectomy is recommended, the reasons for it will be explained to you.

The Apicoectomy Procedure

Root canal surgery is usually performed under local anesthesia such as a numbing shot, so you won't feel any pain. To begin the procedure, a small incision is made in the gum, and the infection at the end of the tooth's roots is exposed. The infected tissue is then removed, along with a few millimeters of the root tip itself. A dye may be used to help make cracks or fractures easy to see; if we discover that the tooth is fractured, it may be better to extract (remove) it at this time instead of completing the apicoectomy.

Next, a microscope and light are used to examine the tiny canals. They will be cleaned with an ultrasonic instrument, then filled with an inert material and sealed up with a small filling. To finish the procedure, a small bone graft may be placed at the affected site, and then the gum tissue covering the tooth's root will be sutured (sewn) closed. X-rays may also be taken as the procedure nears completion. Afterwards, instructions on postoperative care will be given, and you'll go home. Most apicoectomies take about 30 to 90 minutes to complete.

Following the procedure, you may experience some swelling and soreness in the area that was treated. Over-the-counter non-steroidal anti-inflammatory medications (such as ibuprofen) are usually all that's needed to control any discomfort. You can probably return to normal activities the following day, but you may want to avoid eating hard or crunchy foods or brushing vigorously for a few days afterwards. If your sutures aren't self-dissolving, you will be asked to return in about a week to have them removed.

The Goal: Saving Your Tooth

Although apicoectomy is typically a safe and effective procedure, there are slight risks with any type of minor surgery. That's why apicoectomies are not recommended unless further root canal treatment won't be effective. An alternative treatment in most cases would be extraction of the tooth. However, our goal as dentists is to help you preserve your natural teeth for as long as possible.

While there are excellent methods of tooth replacement (such as dental implants), these involve further and more complex treatments, and they can be costly. An apicoectomy is generally a permanent and cost-effective solution which can help the tooth last for the rest of your life.

Related Articles

Root Canal Retreatment - Dear Doctor Magazine

Root Canal Retreatment As occasionally happens with any dental or medical procedure, a tooth may not heal as anticipated after a root canal treatment. In these cases, it's often possible to save the tooth with a second root canal procedure... Read Article

Root Canal Treatment - Dear Doctor Magazine

Common Concerns About Root Canal Treatment The term “root canal” can send shivers down many a spine. However, preconceived notions that root canal treatment is filled with pain and discomfort are nothing more than outdated myths. In fact, root canal treatment doesn't cause pain but actually relieves it... Read Article

Our Location

Find us on the map

Hours of Operation

Our Regular Schedule

Monday:

7:45 am - 5:00 pm

Tuesday:

7:45 am - 5:00 pm

Wednesday:

7:45 am - 1:00 pm

Thursday:

7:45 am - 7:00 pm

Friday:

Closed

Saturday:

Closed

Sunday:

Closed

Testimonials

What Our Clients Say About Us

  • "Hands down the best dentist I’ve ever been to. Dr Damelio is a master of his trade and the dental hygienists were the nicest and most professional I’ve ever dealt with. I would recommend this place to anyone!"
    Alex O.
  • "I had a great experience at my first appointment with Dr. Damelio and my hygienist Cally. The office is clean, staff is friendly and you can tell they really care about their patients!"
    Kyle C.
  • "Dr. Damelio has been exceeding my expectations ever since we first met them. Everyone is wonderful to work with and have great communication."
    Mel P.
  • "Dr. Damelio has an awesome team working with him. They all work very well together to make your visit efficient and productive. They are great at making the experience painless and I have nothing but compliments for the entire practice."
    Matt A.
  • "My children and I are always treated very well at Dr. Damelio's. The care is excellent. The staff is the best. We all enjoy going there very much."
    Carla P.
  • "Dr Damelio is competent, courteous, friendly and he has trained his staff in that mode. Everybody know your name and greets you upon coming. They out of their way to schedule to meet your convenience. Everyone knows their role and they do it well. It is a pleasure, an an honor, to have Dr. Damelio as my dentist."
    Jerry M.
  • "I have always had a tremendous phobia of the dentist growing up but things changed after I went to Dr. Steve. I had a few bad experiences in the past but after going to Dr. Steven Damelio they have completely gone away. I have never had a minute of pain and the staff are really great they are the best."
    Jim S.
  • "I love the friendly staff at Steven G. Damelio, DMD. I always leave this dentist office with my teeth looking great."
    Jamiee L.
  • "I always have an excellent experience at Dr. Damelio's office. Everyone is so nice and they have a great staff, keep up the good work."
    Brett M.
  • "I recently had a dental issue that needed quick attention. Dr. Damelio's staff was excellent. They worked with me and got me right in to the office for an appointment. Dr. Damelio gave me his full time and attention and was able to take care of the problem quickly and painlessly. I think this is a great dental practice and recommend Dr. Damelio to all of my friends."
    Megan M.
  • "Everyone at Dr. Damelio's office always so professional and friendly. Dr. Damelio always takes the time to explain everything and puts me at ease. I know I'm receiving the best care at each of my visits."
    Bonnie T.
  • "My family has been patients of Steven Damelio for a few years. My children and I are always treated very well. The care is excellent and the staff is top-notch. We all enjoy going to see Dr. Damelio."
    Lana B.
  • "I love coming to see Dr. Damelio. Everyone is so welcoming and friendly, it totally eliminates the fear of of being at teh dentist. Dr Damelio also performs his work so well that I never feel pain and I am rarely in any discomfort. I highly recommend them for sure."
    Coleen M.