A root canal treatment refers to the cleaning of the canals and the removal of infected and inflamed tissue within the root. This is performed by a specialist called an Endodontist. When the inflammation or infection persists after the root canal treatment, an apicoectomy may be required. An apicoectomy is essentially the removal of the apex (or root tip), followed by a filling procedure to seal the root from further infection. When left untreated, infected roots can damage other teeth, spread infection, and cause pathology of the jawbone.

Reasons for an apicoectomy

Infected and inflamed soft tissue around the root of a tooth can be exceptionally painful and debilitating to the patient. The purpose of an apicoectomy is to eliminate the infection in the tissue and to ultimately preserve the function of the tooth and save it from extraction. An apicoectomy will rarely be considered unless a prior root canal treatment has failed.

There are several reasons why an apicoectomy may be necessary:

• Small Adjoining Root Branches – Roots are extremely complex and can contain many tiny branches. If these tiny branches cannot be cleaned and sealed when the root canal treatment is performed, inflammation can persist.
• Blocked Root Canal – In some cases, the dentist is unable to effectively clean a root canal because it is blocked by a fractured file left behind from prior root canal treatment. Infection and debris can quickly affect adjacent teeth.
• Narrow or Curved Root Canals – When the root canal is poorly shaped, the endodontic files cannot reach the root tip. Continuing infection or re-infection can then occur.

Prior to the surgery, Dr. Saxe will generally prescribe an antibiotic or anti-inflammatory medication to treat the underlying infection. Panoramic x-rays will then be taken to enable Dr. Saxe to plan the apicoectomy.

Dr. Saxe will make a small incision in the gum and expose the root by lifting away the gum. In some cases, a tiny fraction of the jawbone may be removed to properly expose the root. The edge of the root tip and any infected connective tissue will be removed using ultrasonic instruments. The root will be sealed using a retrofill (filling material) and Dr. Saxe will suture the gum with several stitches.  Recovery time for this procedure varies from person to person, but you can expect one to two days of discomfort.

If you are experiencing any signs or symptoms, such as pain or swelling associated with a tooth that has had a root canal, to schedule an appointment, please contact the office of Dr. Steven A. Saxe, D.M.D. in Las Vegas, NV via email or call (702)258-0085