In most of the cases we see, a root canal or root canal retreatment is enough to solve our patient’s tooth pain problems, and it’s always the first choice for treating this type of tooth pain. Sometimes, however, there are complications that make it impossible to accomplish this goal with traditional non-surgical endodontic treatment.

Patients needing an apicoectomy in Calgary have already tried to treat their problem with a filling or root canal. If the pain persists, the problem may be below the tooth, and Dr. Shackleton may recommend surgery to identify and repair the problem. An apicoectomy or root-end resection is used most frequently to save damaged teeth.

What Is an Apicoectomy?

An apicoectomy or root end resection is an endodontic surgical procedure performed at the apex of the tooth to uncover any fractures or hidden canals that don’t appear on x-rays, but which still cause pain in the tooth. Dr. Shackleton makes an incision near the root tip, exposing the apex, the bone below the tooth, and in most cases, inflamed tissue. During the surgery, he removes the infected tissue along with the damaged apex, and repairs the tooth with a root end filling. Finally, the wound is closed with sutures. Damaged root surfaces or the surrounding bone may also be treated with this procedure.

Why Is an Apicoectomy Required?

Usually, a root canal is all that is needed to remove the inflamed and infected pulp within a tooth, and to eliminate the pain a patient experiences as a result of this infection.
In some rare cases there are hard to spot features of the tooth, like fractures or hidden canals that aren’t visible on an x-ray. This allows the infection to spread, even after traditional treatments have been performed, and eventually, that infection can reach all the way through the tooth, to the nerves, gum and bone below. The longer this is left untreated, the more serious the infection will become, leading to larger areas of damaged bone and inflamed tissue, and of course, more pain.

In cases like these, no ordinary endodontic treatment will give the patient relief from pain, or prevent the further spread of the infection. The only solution is to perform this surgery at the apex, remove the infection, and close the canal that has allowed the infection to reach this area.

When a root canal has already been performed, this will usually also include a root canal retreatment, to remove and replace the material inside the tooth.

What Is Recovery from an Apicoectomy Like?

The root end resection or apicoectomy we perform in our Calgary office is minimally invasive, and is usually accomplished with local anesthesia. As with any surgery, some swelling and discomfort is to be expected after the surgery, but there are effective pain management options available to patients who have this procedure.

Most importantly, patients who have been suffering significant pain will experience immediate relief from the pain associated with the inflammation, and when healed, they should experience no further pain at all.

Why Is Apicoectomy Not Used More Often?

The best treatment is often the least invasive, and while an apicoectomy is not major surgery, it’s always preferable to attempt to resolve tooth pain using traditional endodontic procedures.

Sometimes, even when apicoectomy is the most suitable type of treatment, it may not be immediately apparent on a patient’s x-rays, and the only way to be sure is to perform the surgery and examine the area below the tooth.

For more information or to schedule an apicoectomy in our Calgary office, please contact us at 403-242-9952 today.