Apicoectomy

The teeth are held firmly in place by strong roots that extend into the jawbone. Molars and premolars tend to have several roots, whereas the front incisors only have a single root. The end or tip of each root is termed the apex. The apex is where the nerves and blood vessels enter the tooth, and aids in the delivery of blood to the crown (the part of the tooth you can see in your mouth).

A root canal treatment refers to the cleaning of the canals and the removal of infected and inflamed tissue within the root. 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 regression 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 by the dentist 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.

What does getting an apicoectomy involve?

Prior to the surgery, the dentist will generally prescribe an antibiotic or anti-inflammatory medication to treat the underlying infection. Panoramic x-rays will then be taken to enable the dentist to plan the apicoectomy, which will be performed under local anesthesia.

The dentist 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 the dentist will suture the gum with several stitches.

This surgery does not require an overnight stay, and full aftercare instructions and pain medications will be provided as needed. After several days, the dentist will remove the stitches, and the connective tissues will fully heal several months after the procedure.

If you are experiencing any signs or symptoms, such as pain or swelling associated with a tooth that has had a root canal, we encourage you to contact our office immediately to schedule an appointment.

Testimonials.

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Testimonials

I had an entire dental replacement procedure done over the last 18 months. All new crowns to replace my worn teeth. BridgeCreek Prosthetic Dentistry did an amazing job and it was life changing for me. I now feel excited to smile again after many years of hiding. Dr Butler and his staff are just fantastic! Caring, attentive and professional. The entire experience was positive and it has given me a new found confidence in my appearance.

Thank you BridgeCreek

Ed G.

Dr. Waguespack gave me the smile I always dreamed of which also gave me the confidence to truly enjoy it.
From my very first (tearful!) consultation, he brought compassion, expertise, and steady reassurance to every step of my journey, from recommending Invisalign to the final restoration. He answered every question with patience, listened with care, and never made me feel rushed. He was precise and detail-oriented with a sharp eye for fine-tuning every area of my dental work. That level of care and artistry made my new smile not just beautiful, but truly mine.
My process with Dr. W wasn’t just about misaligned teeth or a crooked smile - it was about helping me feel like myself again. I always felt respected, supported, and genuinely cared for and not just by Dr. Waguespack but by his entire office team. They were warm, professional, and made every visit a pleasure.
I’ll be recommending Dr. Waguespack to anyone in need of prosthodontic care or even a thorough consultation. I don’t just have a beautiful smile now, I have a renewed comfort in being myself that shows in every photo, every laugh, and every moment where I feel free to simply be me.
Gratitude to Dr. Waguespack and all the caring people at BridgeCreek Prosthetic Dentistry.

Barbara V.

I have been seeing Dr. Butler and his staff at BridgeCreek Prosthetic Dentistry for over five
years for regular dentistry and other oral health issues. Dr. Butler's approach to dentistry has
been perfect for my needs, as he understand and treats serious problems when they arise,
but also takes a conservative approach when it is warranted, and does not perform
unnecessary treatments or interventions. This has saved me not only significant sums of
money over what other care providers recommended for my oral health needs, but has also
saved me from a lot of unnecessary procedures and the pain and inconvenience related
thereto.

I would recommend Bridgecreek Prosthetic Dentistry to anyone, no matter what level of oral
health care you need.

Jeremy S.

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