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An apicoectomy is a dental procedure in which the tip of a tooth's root is removed through an incision made in the gum and replaced with a small filling. This procedure is usually used to treat persistent infections which resist other root treatments such as root canals, and it may sometimes be used in lieu of a root canal if a dentist feels that this is necessary. Apicoectomies can be performed by endodontists, dentists who specialize in diseases of the root, or by an oral surgeon.
Before an apicoectomy takes place, a dentist usually x-rays the tooth to get an idea of what is going on inside the jaw. After reviewing the images and discussing the situation with the patient, the dentist may offer apicoectomy as an option. The advantage to an apicoectomy is that it resolves the infection by removing it altogether, which can cut down on oral pain and future visits to the dentist. The use of dental amalgam to fill the gap left behind by the removed root should also prevent the recurrence of infection.
The apicoectomy procedure lasts around 30 minutes. The specialist who performs the procedure is a dentist who has received additional training in oral surgery. Endodontists and oral surgeons both receive around two to three years of additional training after they qualify as dentists to learn about the specific issues which surround oral surgery. Patients are usually referred to an oral surgery provider by a general practitioner who believes that apicoectomy is a good choice for a patient.
Many patients experience oral pain in the wake of an apicoectomy. Pain management medications are typically provided, along with aftercare instructions which are designed to keep the patient comfortable and reduce the risk of infection. Special flushes and soaks with salt water or antibacterial solutions may be used to keep the mouth clean, and the patient may be advised to follow certain dietary restrictions, such as avoiding hot and crunchy foods while the site heals.
In some cases, a few small stitches may be used to close the apicoectomy site. Whether or not stitches are used, the patient must go to a follow up appointment so that the oral surgeon or endodontist can confirm that the site is healing properly. X-rays will also be taken to check on the progress of healing inside the jaw. When an apicoectomy is recommended to a patient, he or she should ask what the alternatives are, and what kind of pain levels and healing time to expect.