Endodontic surgery can help save your tooth in a variety of situations. The benefit of choosing endodontic surgery could be a healthy, functioning, natural tooth for the rest of your life.
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 enables an oral surgeon to examine the entire root of your tooth, find the problem, and provide treatment.
Sometimes calcium deposits make a canal too narrow for the instruments used in nonsurgical root canal treatment to reach the end of the root. Your oral surgeon may perform endodontic surgery to clean and seal the remainder of the canal.
Usually, a tooth that has undergone a root canal can last the rest of your life and never require further endodontic treatment. However, in a few cases, a tooth may not heal or become infected. It may become painful or diseased months or even years after successful treatment.
If this is true for you, endodontic surgery may help save your tooth. Surgery might also be performed to treat damaged root surfaces or surrounding bone.
Apicoectomy (Root-End Resection)
Although there are many surgical procedures that can be performed to save a tooth, the most common is called apicoectomy or root-end resection. When inflammation or infection persists in the bony area around the end of your tooth after a root canal procedure, your oral surgeon may have to perform an apicoectomy.
In this procedure, the oral surgeon opens the gum tissue near the tooth to see the underlying bone and to remove any inflamed or infected tissue. The very end of the root is also removed. 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 gingiva to help the tissue heal properly. Over a period of months, the bone heals around the end of the root.
Sometimes, 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, then replaced in its socket.
Other endodontic surgeries include dividing a tooth in half, repairing an injured root, or removing one or more roots. Your oral surgeon will be happy to discuss the specific type of surgery your tooth may require.
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.