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Apicectomy

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What is apicectomy?

An apicectomy is a surgical procedure to remove the infection, usually resulting from a failed root canal treatment, from the tip of the tooth root (apex).

When a root canal treatment fails, it is usually due to unusual and undetectable tooth anatomy, small nerve canals that cannot be cleaned, cyst formation or a cracked tooth. Most of these failed root canals can be saved, with the exception of a severely cracked tooth.

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What to expect during apicectomy?

The resulting infection of a failed root canal may be present in the absence of pain, and X-ray evidence is usually required to diagnose the problem. An infection shows up on an x-ray as an unresolved black circle around the tooth. Sometimes a gum boil, or pimple, might be present in the gum. Additional treatment may be needed if there’s an abscess on the gums.

The procedure takes between 30 to 90 minutes, depending on the tooth’s location and the complexity of the root structure. Treatments on front teeth are generally the shortest, while those on lower molars typically take the longest. The long-term success rate or prognosis for a tooth is significantly reduced when an apicectomy is needed. An apicectomy is more challenging to perform in posterior teeth because of difficulty in vision, surgical access and the complexity of multi-rooted teeth.

During the procedure, our oral surgeon will cut and lift the gum away from the tooth, so the root is easily accessible. The infected tissue is removed along with the last few millimetres of the root tip. If the tooth is cracked or fractured, it may have to be extracted, and the apicectomy will not continue.

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