When a tooth has become damaged, decayed, or infected, a root canal procedure must be performed on it in order to save the tooth. Most root canal infections are successfully treated with just a root canal treatment. However, if the problem persists even after the root canal, an apicoectomy will be needed to fully clear the problem.
An apicoectomy is a microsurgical endodontic procedure in which the very end of the tooth’s root is removed along with the infected gum tissue that is attached to the root tip (“apico” means root tip and “-ectomy” means removal or resection).
The apicoectomy is performed after the root canal treatment is complete. Local anesthesia is administered to make the treatment more comfortable. The gum is cut and opened up in order to access the root tip. The infected tissue in the tooth is removed, and the root tip is resected. A small filling may be placed in the root to seal the end of the root canal, and the gums are sutured back into place. The procedure is performed using ultrasonic instruments under a microscope in a sterilized environment. It can be completed in one office visit, taking 90 to 120 minutes depending on the tooth location and the complexity of the roots.
Some slight discomfort may be experienced after the procedure is completed. This is normal for any surgical procedure. Your dentist can prescribe some pain medications to ease discomfort. You should be able to return to regular activities by the day after surgery.
If a patient is not willing to undergo surgery for this procedure, the tooth will have to be extracted and replaced with a dental prosthetic like a dental implant restoration or bridge.