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What to Know About an Apicoectomy

Medically Reviewed by Poonam Sachdev on November 11, 2021

An apicoectomy is considered a minor dental procedure. It’s often performed on both adults and children to save a tooth. Here’s what you need to know.

What Is an Apicoectomy?

An apicoectomy is a common dental procedure where inflamed gum tissue and the end of the root of your tooth is removed while the top of your tooth is left in place. It’s often called a root-end resection because it works on the end (or, tip) of your root called the apex. 

What’s the Difference Between a Root Canal and an Apicoectomy?

root canal is a procedure designed to treat inflammation and infection in the inner pulp tissue of your tooth. Inflammation in tooth pulp causes deep tooth decay and abscesses, which can spread to your bone if they're not removed. 

During a root canal, your dentist opens up your tooth, removes the pulp and cleans the root area, and then fills and seals it. This is done to manage disease and decay without pulling your tooth.

An apicoectomy, in contrast, only deals with the tip of the root and is usually performed after a root canal to fix the root or the tissues around the tooth. 

Why Do You Need an Apicoectomy?

Your dentist will do a root end surgery for a few reasons. The most common is to try to fix a tooth that’s already had a root canal

In most cases, root canals last a lifetime, but sometimes, the tooth doesn’t heal well and becomes reinfected. Your dentist will use an apicoectomy to remove damaged tissue to save the tooth and avoid pulling it out

You might also need a root end resection to:

  • Remove calcium deposits in the root canal 
  • Find and treat problems that aren’t showing up on an X-ray
  • Treat a fracture
  • Treat a tooth with extra roots that can’t be treated another way
  • Treat bone loss that causes loose teeth
  • Remove a root that has a hole

Apicoectomies are also commonly used for tooth injuries in children. If the tooth is fractured or cracked after an impact, this procedure can help save the tooth.

How Is an Apicoectomy Procedure Done?

You might have X -rays of your teeth and jaw before an apicoectomy. This helps your dentist see what’s happening with a root canal, the roots, and any surrounding bone and tissue. 

Before starting the procedure, you’ll get some cream and a needle in your mouth to numb the area. Then your dentist will make a small cut in your gums around the tooth. They will examine the bone and remove infected tissue. 

If necessary, they’ll remove the end of the root and refill the tip of the root canal to seal it up. Then they’ll put in a few stitches to help the gums heal. Over time, your bone will heal around the root.

How Painful Is an Apicoectomy?

A root end surgery causes very little discomfort. It is a minor procedure done in your dentist’s office, and it doesn’t require any general anesthetic. You can usually drive yourself home afterward and go back to your normal activities the next day. 

It’s normal to have some minor bleeding after your procedure since your gums are cut and stitched, but this should go away after 1 to 2 hours. Rest with your head raised to slow down blood flow and stop bleeding. 

You can manage pain and inflammation with anti-inflammatories like ibuprofen. If you have an infection, your dentist might give you antibiotics. Take them as directed.

You can brush and floss your teeth as normal, but avoid the stitched area. After 24 hours have passed, you can gently rinse your mouth with warm salt water. This will help keep the area clean. Add a half teaspoon of salt to a cup of warm water and rinse after eating and before bed.

What Are the Risks of an Apicoectomy?

Your dentist might not perform an apicoectomy if your root is fused or the tooth is beyond repair. In these cases, your tooth might need to be pulled instead. 

While no procedure is totally guaranteed, apicoectomies can last a long time. One 2020 study found that 97 percent of apicoectomies lasted 5 years, and 75 percent were still in good shape after 13 years. Another study shows that an apicoectomy on a child’s injured tooth had completely healed after 1 year.

A root end surgery is not the best choice for every situation, but your dentist might try it to save your tooth. Ask your doctor about whether this procedure could help you. 

Show Sources

SOURCES:

American Association of Endodontists: “Endodontic Surgery,” “Endodontic Surgery Explained,” “What is a Root Canal?”

Canadian Dental Association: “Care After Minor Oral Surgery.”

Harper College: “Reasons for root canal treatment.”

Journal of Endodontics: “Long-term Follow-up for Apical Microsurgery of Teeth with Core and Post Restorations.”

Ng,Y., Gulabivala, K. Endodontics, “Management of non-surgical root-canal treatment failure,” Elsevier, 2014.

Refuat Hapeh Vehashinayim: “[Apical root end resection (Apicoectomy) as treatment option in cases of dental trauma in young patient].”

Rutgers Health University Dental Associates School of Dental Medicine: “Apicoectomies.”

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