Treatment
Endodontic microsurgery in Loughborough
Sometimes an infection at the tip of a root persists even after good root canal treatment, or the canal simply cannot be reached from inside the tooth. In those situations a small surgical procedure — an apicectomy — removes the infected root tip and seals the canal from the outside, giving the tooth another chance.
When surgery is the better option
- infection that has not healed after root canal treatment or retreatment;
- a tooth with a post and a sound crown that would be damaged by reopening it;
- a canal that is blocked or sharply curved near the tip and cannot be cleaned conventionally;
- a cyst or lesion at the root tip that needs to be removed;
- a broken instrument or excess filling material beyond the end of the root.
Surgery is not a substitute for retreatment where retreatment is possible. It is recommended when it offers the tooth a better chance, after careful assessment and the right X-rays.
How the procedure works
- Anaesthetic. The area is numbed with local anaesthetic, in the same way as for a filling.
- Access. A small flap of gum is lifted and a tiny window is made in the bone over the root tip.
- Removing the infection. The last few millimetres of the root, together with the infected tissue around it, are removed.
- Sealing the root end. A small cavity is prepared in the cut root and filled with a biocompatible sealing material.
- Closing. The gum is repositioned and held with a few fine stitches, removed about a week later.
The appointment takes around an hour. The procedure is not painful, although you will feel pressure and hear the instruments.
Recovery
Expect some swelling and perhaps bruising for a few days, controlled with cold packs and ordinary painkillers. Most people are back at work the next day. Keep the area clean with a gentle mouthwash rather than brushing it for the first week, avoid strenuous exercise for a day or two and return for stitch removal and a check. Bone healing is reviewed on an X-ray later in the year.
Success and alternatives
Modern root-end surgery, performed with magnification and current sealing materials, has good success rates. As with all endodontic treatment, the outlook depends on the tooth: its bone support, the quality of its crown and whether a crack is present. We compare it honestly with retreatment and with extraction and replacement before you decide.