An apicectomy is the removal of the tip of the root (i.e. apex). This minor surgical operation is required if infection persists after root treatment, or if the dentist is unable to seal the root tip with a normal root filling.
Q & A
Why do I need an apicectomy?
The most common reason to consider an apicectomy is persistent infection around a root tip, after conventional root canal work. This infection can cause pain, swelling and discharge over the top of the tooth in the gum and can get quite extensive (see diag.1).
In some cases, it is preferable to repeat the root canal therapy, but this is not always possible or practical. Surgery is then the best option to deal with the infection.
The suitability of apicectomy treatment can only be determined after thorough examination of the tooth's appearance and x-rays.
How is the apicectomy carried out?
Local anaesthesia is used to numb the area around the tooth. The gum tissue is then gently raised away from the tooth to allow access to the infection and this area is thoroughly cleaned out. The tip of the tooth root is then removed and special cement placed over the new end of the root. This sets very hard and seals off any open channels in the root which could lead to another infection. The gum tissue is then put back into place to allow for healing.
How successful are apicectomies?
Success rates for first apicectomies are typically 75-80%, (assessing patients clinically and with x-rays three months after the operation). It is possible that the procedure will not completely resolve the problem and success rates are inevitably reduced for repeat apicectomies.
Will I be in pain afterwards?
You should not feel any pain immediately after the operation, as the area of surgery will be numb from the local anaesthetic. As the numbness wears off, the area might become uncomfortable and then you should take painkillers. We will supply you with these, with information about doses.
Could there be any after-effects?
This depends on the operation. If there are any issues in particular to be aware of, they will be discussed with you beforehand.
There may be swelling and bruising in the area of surgery, with some discomfort. Bruising is usually most obvious after two to three days and varies between patients. It normally resolves itself in 10 to 14 days.
Following an apicectomy, there can be a small amount of recession of the gum margin on the front of your tooth. This is not necessarily a problem in itself, but can affect the tooth's appearance.
The surgical techniques we use are designed to minimize this recession. Any new restorations (such as crowns) planned for your tooth by your dentist should only be placed once the gum margin has settled.
How can I aid my recovery?
See our Oral Surgery Post Operative Care guide