Endodontic Surgeries

In some cases, root canal therapy alone cannot save a tooth, and our doctors may suggest surgery.

While there are many endodontic surgeries, the most common is an apicoectomy. Also known as a root-end resection, an apicoectomy literally means the removal of the apex of the root of the tooth. This procedure, done following a root canal, treats the bony area surrounding the end of your tooth, which has become inflamed or infected. By folding back the gum near the tooth, our doctors can access the underlying bone and extract the inflamed tissue. At the same time, the very tip of the root is removed and usually replaced with a small plug or filling. At this time, your doctor may treat the area with antibiotics and will then close the area with a small suture. Eventually, the jaw surrounding the tooth will fill in with bone, supporting the tooth as before. This procedure helps ensure the lasting result of your endodontic treatment.

Other endodontic surgeries include:

  • removing one or more roots
  • dividing a tooth in half
  • repairing an injured root

In addition, an intentional replantation may be performed. During this procedure, which is reserved for complex cases, the tooth is extracted. Endodontic treatment is then performed on the tooth while it is outside the mouth. After treatment, the tooth is placed back in the socket.

Reasons for Endodontic Surgery

Most of the time, a root canal or endodontic retreatment is enough to save a damaged too. However, endodontic surgery can help save a tooth when:

  • There are small fractures or hidden root canals that do not appear on an X-ray and are not recognized during root canal therapy but are still causing pain.
  • The end of a root has embedded bacteria that are causing infection.
  • Root surfaces are damaged
  • Surrounding bone has infection

Alternatives to Endodontic Surgery

In general, the only alternative is tooth extraction. The extracted tooth must be replaced with a crown or other restoration, and thus this alternative will be much more expensive and time consuming.