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Apicoectomy

The teeth are held firmly in place by strong roots that extend into the jawbone. Molars and premolars tend to have several roots, whereas the front incisors only have a single root. The end or tip of each root is termed the apex. The apex is where the nerves and blood vessels enter the tooth, and aids in the delivery of blood to the crown (the part of the tooth you can see in your mouth).

A root canal treatment refers to the cleaning of the canals and the removal of infected and inflamed tissue within the root. When the inflammation or infection persists after the root canal treatment, an apicoectomy may be required. An apicoectomy is essentially the removal of the apex (or root tip), followed by a filling procedure to seal the root from further infection. When left untreated, infected roots can damage other teeth, spread infection, and cause regression of the jawbone.

Reasons for an apicoectomy

Infected and inflamed soft tissue around the root of a tooth can be exceptionally painful and debilitating to the patient. The purpose of an apicoectomy is to eliminate the infection in the tissue and to ultimately preserve the function of the tooth and save it from extraction. An apicoectomy will rarely be considered by the dentist unless a prior root canal treatment has failed.

There are several reasons why an apicoectomy may be necessary:

  • Small Adjoining Root Branches – Roots are extremely complex and can contain many tiny branches. If these tiny branches cannot be cleaned and sealed when the root canal treatment is performed, inflammation can persist.
  • Blocked Root Canal – In some cases, the dentist is unable to effectively clean a root canal because it is blocked by a fractured file left behind from prior root canal treatment. Infection and debris can quickly affect adjacent teeth.
  • Narrow or Curved Root Canals – When the root canal is poorly shaped, the endodontic files cannot reach the root tip. Continuing infection or re-infection can then occur.

What does getting an apicoectomy involve?

Prior to the surgery, the dentist will generally prescribe an antibiotic or anti-inflammatory medication to treat the underlying infection. Panoramic x-rays will then be taken to enable the dentist to plan the apicoectomy, which will be performed under local anesthesia.

The dentist will make a small incision in the gum and expose the root by lifting away the gum. In some cases, a tiny fraction of the jawbone may be removed to properly expose the root. The edge of the root tip and any infected connective tissue will be removed using ultrasonic instruments. The root will be sealed using a retrofill (filling material) and the dentist will suture the gum with several stitches.

This surgery does not require an overnight stay, and full aftercare instructions and pain medications will be provided as needed. After several days, the dentist will remove the stitches, and the connective tissues will fully heal several months after the procedure.

If you are experiencing any signs or symptoms, such as pain or swelling associated with a tooth that has had a root canal, we encourage you to contact our office immediately to schedule an appointment.

Testimonials.

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Testimonials

If you want to know what I think of Dr. Afzali and her staff all you really need to know is that I live in Portland and I fly to San Diego to see Dr. Afzali for all my dental work. That might seem a bit extreme, and perhaps it is, but hear me out before you decide. A couple of years ago when I was living in the Bay Area I had to have one of my front teeth removed and dental implant inserted in its place by a dentist in the Bay Area. The implant looked a little shorter and darker than my other teeth, and even made my gum above it look a bit darker than the adjacent gum. In short, it didn't look natural. So I wasn't completely satisfied with how my smile looked, but I thought that was the best that could be done. It wasn't.

Last summer while I was in San Diego visiting my parents I went to Dr. Afzali for a routine cleaning. She examined my mouth and immediately asked me whether I was happy with the way my implant looked. When I said I wasn't, she explained that she could make it look better and possibly even indistinguishable from my other teeth. She was right. My implant looks just like my other teeth, and my gum is pink again. In fact, my new implant looks so natural that I sometimes forget it's an implant. I couldn't be happier. One final point. Dr. Afazli's entire staff is great. When I walk in they all make me feel like I'm the most important patient they have. And Julie is particularly great. Because I live in Portland my visits to Dr. Afzali's office had to me perfectly timed with receipt of the various parts necessary for my procedures. Julie made sure that everything arrived when necessary, without fail, so that no flights or appointments had to be rescheduled.

Riley P.

Recently, while on a trip from Canada to visit friends in San Diego, I broke a tooth. I phoned RB Dentistry and was given an appointment without delay. Dr. Mary Afzali was reassuring and professional and did an excellent job fixing the broken tooth. Her dental assistant, Marinette, was kind and gentle and made me feel comfortable throughout the procedure. Julie at Reception was welcoming, warm and made me laugh with her wonderful sense of humour and handled the insurance processing with no complications. Thank you so much Dr. Afzali, Mari and Julie for one of the most pleasant dental appointments I've had in a long time! Hope to see you in Vancouver, B.C. sometime!

Pam C.

I know I am in good hands with Dr. Afzali at RB Family Dentistry. The cavity fillings and tooth root fillings I got there were done so well that when I went to the Southwest College Dental Hygenist school to help out a friend, they could barely even detect the fillings! The teachers there were very impressed. At RB Family Dentistry, the staff and hygenists are friendly, organized and very knowledgable, and the Dr. always gives me as much time as I need and answers all of my questions. The office is beautiful and state-of-the-art. They never try to sell me on additional products or services that I don't need.

Scripps Ranch M

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RB Family & Cosmetic Dentistry
16776 Bernardo Center Dr. #105 San Diego, CA 92128
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