Apicectomy

An ‘Apicectomy’ procedure, or ‘root end treatment’ as it is sometimes known, is a surgical procedure where we remove the tip of a tooth’s root. The surgical site is anaesthetised using local anaesthetic.

Indications for treatment:

• Where root canal treatment has been considered unsuccessful after a period of time. Sometimes an area of infection on the root can be seen on a dental radiograph. 

The dentist will make a small incision on the gum above the tooth in question and create a flap which is then lifted away from the tooth, exposing the bone surrounding the teeth. The dentist will then remove the infected tissue and some of the bone in the area, and then proceed to fill the cavity with a retrograde filling material such as Amalgam or Zinc Oxide cement. We also use high quality bone grafting materials to seal the area with the aim of preventing further infection. Finally the gum is sutured back into position using high quality suturing materials to aid in successful healing. X-rays of the surgical area are required to plan efficiently for the procedure.

We perform this treatment in the case where a root canal treatment has been unsuccessful and re-root canal therapy is not advised. Biological indications such as persistent symptoms after a root canal filling has been carried out or a continued presence of an infection then suggest an Apicectomy may be a recommended treatment.

Removal of the entire tip of the root ensures that no area of infection at the tip of the root remains.

Success rate usually depends on several factors such as:

• The condition of the root tip in terms of level of infection.
• General health of the patient, and their gum health.
• The quality of the Root canal filling that is already present.

In general, we always plan the procedure carefully taking into account all of these factors and only use the best materials which will aid success rate and healing time, which point to a success rate of more than 90%.

The recovery time is usually quick and without complications. Your dentist will discuss aftercare with you if this treatment is recommended to you. Stitches will need to be removed at the dental practice usually a week after the procedure.

Sadly, in some cases, extraction of the tooth may be the only alternative if all efforts in Root canal filling and Apicectomy treatment have been exhausted. Your dentist will then discuss tooth replacement options such as a dental implant, a bridge or denture with you.

Removal of Infection

This image above shows removal of infected tissue from the apex (tip) of the tooth root.

We make a small cut in the gum to be able to access the tip of the root, remove the infection and place a retrograde filling. We also use top of the range Bone grafting materials to help facilitate bone regeneration in the area where the infection was. 

Healing of affected area

This image above shows the healing of bone where the infection was before present.
Healing in its initial stages takes around 2 weeks, and then if the procedure is deemed successful, in 6 months bone regeneration has started to occur.