Endontic surgery can help save a tooth so that you can have a healthy, functioning, natural tooth for the rest of your life.
A tooth that has had a root canal will typically last the rest of your life without further endodontic treatment. There are a few cases, however, where a tooth may not heal or may become infected. A tooth may become painful or diseased months or even years after successful treatment. When this happens, surgery may help save the tooth.
One scenario in which surgery can help is when calcium deposits make a canal too narrow for the instruments used in nonsurgical root canal treatment to reach the end of the root. In this case, endodontic surgery to clean and seal the remainder of the canal may be required.
Surgery may be used as a diagnostic tool if you have persistent symptoms but no problems appear on your X-ray. In such a case, surgery allows your endodontist to examine the entire root of your tooth, find the problem, and provide treatment.
Surgery may also be performed to treat damaged root surfaces or surrounding bone.
Root-End Resection (Apicoectomy)
The most common type of endodontic surgery is an apicoectomy, or root-end resection. A root-end resection may be indicated when inflammation or infection persists in the bony area around the end of your tooth after a root canal procedure.
In this procedure, the endodontist opens the gum tissue near the tooth, exposing the underlying bone. The endodontist will remove any inflamed or infected tissue along with the very end of the root. A small filling may be placed in the root to seal the end of the root canal, and a few stitches or sutures are placed in the gums to help the tissue heal properly. Over a period of months, the bone will heal around the end of the root.
Other Types of Endodontic Surgery
In certain cases, a procedure called intentional replantation may be performed. In this procedure, a tooth is extracted, treated with an endodontic procedure while it is out of the mouth, and then replaced in its socket.
Other surgeries endodontists might perform include dividing a tooth in half, repairing an injured root, or even removing one or more roots. Your endodontist will be happy to discuss the specific type of surgery your tooth requires.
Endodontic Surgery Alternatives
Often, the only alternative to surgery is extraction of the tooth. The extracted tooth must then be replaced with an implant, bridge, or removable partial denture to restore chewing function and to prevent adjacent teeth from shifting. No matter how effective modern artificial tooth replacements are, nothing is as good as your natural tooth.