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An apicoectomy is a kind of surgical procedure that is done in the event of a persistent infection near the apex (the tip) of the roots. There are several reasons why this could be an option that your dentist puts in front of you.
Why Would You Need An Apicoectomy?
When a root canal is performed, the dentist will try to gain access to the centre chamber of your tooth and clean out the roots till their tips. Once this is done, the roots will be filled up with an inert material and hopefully, there should be no troublesome symptoms after that.
Sometimes, though, the infection goes beyond the tip of the root into the surrounding areas. This infection can be extremely hard to get rid of and can result in the formation of an abscess or a cyst. Some of the symptoms that people suffer from when this happens include pain, swelling, the development of a boil-like growth from where pus continues to flow, and a bad odor in the mouth.
In such cases, it is necessary to gain direct access to these infected sites and then clean them out.
There could also be another reason where a part of the root canal is calcified due to calcium deposits and cannot be bypassed non-surgically. In such a condition, the only way to gain access to and instrument the part of the root beyond the calcification is with the help of an apicoectomy.
Cysts are large fluid-filled pockets that can grow to considerably large sizes. These need to be removed because they can cause damage to the nearby structures and can get infected over a period of time. Numerous cysts develop near the root tips of the teeth and during the procedure of removing these cysts, a part of the apex of the root also has to be sacrificed.
How Is Apicoectomy Performed?
Apicoectomy would be termed as a minor oral surgical procedure that is performed by a general dentist confident and experienced enough to perform the procedure or by an oral surgeon usually in conjunction with an Endodontist.
Your dentist will take some X-rays of the area before the procedure is performed and maybe put you on some antibiotics a couple of days before the surgery. The entire procedure should take from anywhere between 30 and 90 minutes depending upon the tooth which is being operated on. The front teeth have only a single root and are more easily accessible, thus take the shortest amount of time while the back teeth with multiple roots are a much more complex undertaking.
An apicoectomy is performed under local anesthesia and thus the patient will be aware of everything that is going around, only the area being operated on will be numb. A small cut into the gums will be given so that they can be removed from on top of the tooth and the bone near the apex.
Most often, the persistent infection would have destroyed the bone at the apex and the diseased tissues would be directly accessible. In other cases, however, it can be sometimes necessary to remove some of the bone as well.