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What is an Apicoectomy?

An apicoectomy is a specialized dental procedure aimed at saving a tooth when traditional root canal therapy can't resolve an infection. It involves the removal of the tooth's apex (tip) and the surrounding infected tissue. This microsurgical approach can be a tooth's last line of defense against extraction. Intrigued by how this could save your smile? Discover the step-by-step process with our illustrative guide.
Mary McMahon
Mary McMahon
Mary McMahon
Mary McMahon

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.

Radiography may be used after the procedure to ensure the apicoectomy is healing as it should be.
Radiography may be used after the procedure to ensure the apicoectomy is healing as it should be.

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.

An apicoectomy is typically performed by an oral surgeon experienced in the procedure.
An apicoectomy is typically performed by an oral surgeon experienced in the procedure.

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.

Many patients experience oral pain in the wake of an apicoectomy.
Many patients experience oral pain in the wake of an apicoectomy.

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.

Mary McMahon
Mary McMahon

Ever since she began contributing to the site several years ago, Mary has embraced the exciting challenge of being a TheHealthBoard researcher and writer. Mary has a liberal arts degree from Goddard College and spends her free time reading, cooking, and exploring the great outdoors.

Learn more...
Mary McMahon
Mary McMahon

Ever since she began contributing to the site several years ago, Mary has embraced the exciting challenge of being a TheHealthBoard researcher and writer. Mary has a liberal arts degree from Goddard College and spends her free time reading, cooking, and exploring the great outdoors.

Learn more...

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Discussion Comments

anon338527

I am having one done in five days. I have a cyst that goes up into one of my sinuses. I am just hoping I will be better off in the long run.

anon163117

I'm getting my done in an hour and a half. Can't wait! Not! My daughter had two done, and still had to get the tooth pulled. It goes fast she said, but the pain and throbbing come after the meds wear off. I can't wait! Not!

anon151223

I had one two years ago and it still bothers me. The dentist told me it might always bother me, like a bum knee. I wouldn't go through this again!

anon138352

i had one done a couple days ago. i also had one done two years ago. you will be in pain but it is worth it and is something you should get done!

anon65224

I had one done two weeks ago I was given liquid valium - don't remember a thing! Was a little sore, but nothing too bad and I am a big coward! You will be fine. In fact, you will feel a lot better given the pain you have been in.

anon37893

I am scheduled for an apicoectomy next thursday and I am scared to death...I have an abscessed tooth and I am on vicodin and penicilln...is this a bad thing to have done and painful??

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    • Radiography may be used after the procedure to ensure the apicoectomy is healing as it should be.
      By: Robert Kneschke
      Radiography may be used after the procedure to ensure the apicoectomy is healing as it should be.
    • An apicoectomy is typically performed by an oral surgeon experienced in the procedure.
      By: Vladimir Melnik
      An apicoectomy is typically performed by an oral surgeon experienced in the procedure.
    • Many patients experience oral pain in the wake of an apicoectomy.
      By: Igor Mojzes
      Many patients experience oral pain in the wake of an apicoectomy.
    • A dentist will take X-rays prior to an apicoectomy.
      By: Andrey Armyagov
      A dentist will take X-rays prior to an apicoectomy.
    • Antibiotics may be prescribed to prevent infection following an apicoectomy in order to ward off infection.
      By: andreeastock
      Antibiotics may be prescribed to prevent infection following an apicoectomy in order to ward off infection.
    • Regular dental checkups may help reduce the need for an apicoectomy.
      By: SLDigi
      Regular dental checkups may help reduce the need for an apicoectomy.