What is apical surgery?
Although there are many surgical procedures that can be performed to save a tooth, apicoectomy or root-end resection is most commonly performed. Following examination of the patient's mouth, assessment of radiographs (x-rays), a discussion of the options available to the patient, and informed consent, apicoectomy is performed in a single session and involves the following steps:
1. Local anaesthetic is administered. The site is checked for profound anaesthesia prior to starting the procedure. The gum tissue is then raised near the tooth to view the underlying bone.
2. The area of inflammation is identified. The inflamed tissue is then removed. A sample may be collected for biopsy.
3. Often, the tip of the root of the tooth is removed and a small retrofilling is placed. This is done to seal the tooth at the tip and to contain the infection.
4. Small sutures ("stitches") are placed and the patient is given instructions and prescriptions.
5. Generally, patients are seen twice more in the office. There is a short follow up appointment one week after the procedure to remove the sutures and to assess the soft tissue healing. A second appointment is generally six months or one year later. Radiographs are taken to assess bony healing.
Other surgical procedures performed in the office include removal of a cracked or diseased root (root amputation) and in very complex 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
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