Endodontic microsurgery is recommended for root canal treatments when non-surgical methods fail to restore a tooth. Surgery becomes imperative to salvage teeth that would otherwise face extraction. Apicoectomy, or periapical surgery, is a frequently employed endodontic procedure designed to address tooth impairment by extracting the apex—the tip of the tooth—from the root.

Differentiating Between Root Canal and Apicoectomy

It's crucial to distinguish between root canal therapy and apicoectomy. Root canal therapy involves opening the tooth to eliminate diseased pulp, which is vital for the tooth's health and function. Conversely, apicoectomy precisely removes the tooth's tip, often performed after a root canal when issues persist.

The primary goal of apicoectomy is to save a tooth from extraction, which is recommended in cases of tissue injury or reinfection after an unsuccessful root canal. Other reasons include identifying hidden issues like fractures or loose teeth and addressing crowded roots effectively.

Procedure for Apicoectomy

Preparation: Apicoectomy typically lasts 30 to 90 minutes, focusing on achieving painless surgery. An X-ray is taken before the procedure for optimal planning, and a local anesthetic is used to numb the affected region.

Incision and Exposure: Microsurgical tools are employed to make a small incision, minimizing tissue disturbance while enhancing accuracy.

Tissue and Contaminated Root Tips Removal: The dentist carefully removes inflamed tissue and affected root tips, preserving healthy structure whenever possible.

Cleaning and Sealing: After meticulous cleaning, a root-end filling is administered to seal the root and prevent reinfection, ensuring long-term success.

Closure with Stitches: A few stitches seal the gum incision, promoting wound healing and minimizing postoperative pain. A postoperative X-ray will be taken to confirm the procedure's success.

Recovery and Postoperative Care

The procedure, typically conducted at the dentist's office, involves minimal discomfort. Driving home is feasible as no general anesthetic is required. During the healing phase, minor discomfort or swelling may occur, which is manageable with recommended medications.

Resting with your head elevated is advised to reduce initial bleeding. Antibiotics may be prescribed to prevent infections, and over-the-counter pain relievers can be used. Gentle oral hygiene practices are recommended, with sutures removed after a week, allowing a return to normal activities within a day or two.