Apicoectomy: Why is it Performed, Procedure, Recovery, Risks and Complications

What is Apicoectomy?

Apicoectomy is a minor surgical procedure that is done to save the at-risk teeth and to prevent any complication related.

It is also known as root end surgery as it involves the removal of the root tip and surrounding tissue. Apicoectomy is also called apical surgery as it refers to the apex or the end of the tooth.

Why is Apicoectomy Performed?

Apicoectomy is performed by a dentist and often by an endodontist (a dentist who specializes in root canal care).

It is performed if a tooth has already undergone a root canal and there is residual inflammation near the root tip that reaches the jawbone.

Sometimes there is an anatomical concern with the root tip. If one root tip is crowding in the space of the root next to it, an apicoectomy can help prevent a problem that would affect multiple teeth later.

Apicoectomy is recommended to those who have no alternative other than removal of the tooth.

Apicoectomy Procedure: How is Apicoectomy Done?

Apicoectomy procedure can be more invasive than the root canal. The recovery can take a longer time and is usually more painful.

Local anesthesia is given to the patient to prevent pain.

In a study it was found that the post-operative pain gradually decreased in most of the patients as these patients refused to take the pain medication.(1)

The Apicoectomy procedure is done in the following steps:

  • Before the Apicoectomy procedure, local anesthesia is given to the patient to numb the area.
  • To reach the root, the dentist cuts through the gum and pushes through the gum tissue. Infected tissues from the root along with a few more millimeters of gum tissue are removed.
  • After removing the root tip, the root canal is cleaned and filled to prevent any further infection. X-ray is taken to ensure that the gum is in good condition and there is no space for the new infection to take hold.
  • The tissue is then sutured and the gum is left to heal and grow back in space.

The whole Apicoectomy procedure takes around 30-90 minutes. Depending on the location of the tooth and the intricacy of tooth structure the time of surgery can be affected.

Recovery After Apicoectomy

After the Apicoectomy procedure, minor discomfort and swelling are there once the effect of anesthesia wears off.

It gradually lessens in a few days. After a day or two, you can resume your daily activities.

To prevent postoperative infection, antibiotics are prescribed by the doctor. Anti-inflammatory is given to alleviate the pain.

The stitches are removed within a week, therefore before this, you need to be careful while brushing and flossing your teeth at this place.

Risk and Complications Of An Apicoectomy

In very rare cases further infection or nerve damage is experienced, which are the unlikely complications that can occur after any kind of dental procedure.

The procedure is considered a failure, if it fails to relieve symptoms or if it does not heal properly. A study showed the main cause of apical surgery failure was a gap at the end of the root.(2)

Apicoectomy is a routine outpatient dental procedure. A study found that 97% of cases experience good results for up to 5 years and more than 75 percent of cases for up to 13 years.(3) It is the most reliable way to preserve the affected teeth from infection and other problems at the root. Do not delay the decision to get it done as the infection around one tooth can spread and cause a serious dental problem. Apicoectomy can be very important in preventing serious complications involving the health of the mouth and jaw.

Also, be known, that the alternative to apicoectomy is tooth removal. If your doctors recommend root tip surgery as an option, make your choice wisely.

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