Apicoectomy

Apicoectomy, also known as root end surgery, is a surgical removal of a dental root apex.  It is an endodontic surgical procedure whereby a tooth's root tip is removed and a root end cavity is prepared and filled with a biocompatible material.  The endodontist will cut and lift the gum away from the tooth so the root is easily accessible.  The infected tissue will be removed along with the last few millimeters of the root tip.  He or she will use a dye that highlights cracks and fractures in the tooth.  If the tooth is cracked or fractured, it may have to be extracted, and the apicoectomy will not continue.

To complete the apicoectomy, 3 to 4 millimeters of the tooth's canal are cleaned and sealed. The cleaning usually is done under a microscope using ultrasonic instruments.  Use of a surgical microscope increases the chances for success because the light and magnification allow the endodontist to see the area better.  Your endodontist then will take an X-ray of the area before suturing the tissue back in place.  Most apicoectomies take between 30 to 90 minutes, depending on the location of the tooth and the complexity of the root structure.  Procedures on front teeth are generally the shortest.  Those on lower molars generally take the longest.

This is usually necessitated when a conventional root canal therapy had failed and a re-treatment was already unsuccessful or is not advised.  An apicoectomy is sometimes called endodontic microsurgery because the procedure is done under an operating microscope. During this procedure endodontist uses microsurgical techniques, such as a dental operating microscope, micro instruments, ultrasonic preparation tips and calcium-silicate based filling materials.

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