Endodontic Surgery
Occasionally, a nonsurgical root canal procedure alone cannot save your tooth. Endodontic surgery can be used to locate small fractures or hidden canals that weren't detected on x-rays or during previous treatment. Surgery may also be needed to remove calcium deposits in root canals, or to treat damaged root surfaces or the surrounding bone of the tooth.
There are many surgical procedures that can be performed to save a tooth. The most common is called an apicoectomy, or root-end resection, which is occasionally needed when inflammation or infection persists in the bony area around the end of your tooth after a root canal procedure. In this microsurgical procedure, the endodontist 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 to seal the end of the root canal and few stitches or sutures are placed to help the tissue heal. Over a period of months, the bone heals around the end of the root. Local anesthetics make the procedure comfortable, and most patients return to their normal activities the next day. Postsurgical discomfort is generally mild.
Other surgeries endodontists might perform include dividing a tooth in half, repairing an injured root, or even removing one or more roots. 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.
These procedures are designed to help you save your tooth. Your endodontist will be happy to discuss the specific type of surgery your tooth requires.
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. Because these alternatives require surgery or dental procedures on adjacent healthy teeth, endodontic surgery is usually the most biologic and cost-effective option for maintaining your oral health.
No matter how effective modern artificial tooth replacements are—and they can be very effective—nothing is as good as a natural tooth. You’ve already made an investment in saving your tooth. The pay-off for choosing endodontic surgery could be a healthy, functioning natural tooth for the rest of your life.