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Apicectomy

An apicectomy, sometimes called a root-end resection, is a type of dental surgery that deals with the extractions of an infected tooth root end. An abscessed tooth is not something you should ignore, if you have had an unsuccessful root canal and an abscess has developed, don’t waste any time in seeing a dentist, without treatment the infection will get worse and become much more painful.

Because a root canal is a very complicated and delicate procedure, a lot can go wrong. That’s not to say it necessarily will, but preventing infection is a tricky business – especially in the mouth. Most apicectomies are the result of a failed root canal, due to the bacteria surviving deeper into the root system of the teeth. This is why it’s the duty of any good dentist to keep a close eye on the patient’s recovery; some re-infection may not cause any immediate pain, so x-rays are usually taken to make sure everything is progressing as it should.

Whenever possible its recommended that if root canal treatment fails, to try to redo the root canal as re-root canal treatment is more successful than apicectomy. Root canal treatment has a success rate of around 70-90% as opposed to apicectomy which has a success rate of around 50-70%. However some apical infections are so severe that root canal treatment alone will not resolve the infection and apicectomy along with cyst enucleation may also become necessary.

Apicoectomies will generally take up to an hour to complete, depending on the condition of the roots beforehand, and how far along infection has spread. Back teeth will sometimes take longer than front teeth, this is simply because of their position and anatomy. After anaesthetic has been administered, the dentist will cut along the gum line and remove a section so that they have access to the root of the tooth, then the infected area will be excavated and some part of the root will be removed to try and prevent further infection. Then the canal is cleaned and filled to protect it, and the soft tissue is sutured back together. Some dentists use amalgam silver fillings as their material of choice for apicectomy. Other dentists use MTA instead. MTA has been shown in many studies to provide superior apicectomy results however its costs are higher than amalgam.

For those patients of a nervous disposition, apicectomy can also be carried out under Intra venous sedation. Intra-venous sedation relaxes patients and along with the local anaesthetic allows the apicectomy procedure to be carried out painlessly.

After the apicectomy is complete, you might feel some slight discomfort or experience swelling of the area, this is normal and shouldn’t be any cause for alarm. Just apply some ice to the jaw or take some painkillers, such as ibuprofen, to ease the pain. If you feel that you are need of medical assistance, give the emergency dentist a call and they may prescribe you some stronger painkillers or antibiotics if the area has started to look inflamed or infected.

Following the procedure, it will take some time for the root to heal and begin functioning again, and patients will be called back to the surgery for review and x-rays to make sure that everything is healing well. If you have an apicectomy at the Pearl Dental Clinic, you can expect to have a one-week post-surgery appointment, followed by a one-month check-up and finally a six-month review, if there are no further problems. Any questions or concerns can be addressed at these times, or if you feel you would like to see a dentist at any point in between, you are free to make your own appointment.