Endodontic Surgery, Apicoectomy, and Retrofill

Endodontic surgery is sometimes considered when conventional endodontic treatment cannot be performed, or was not successful.   Endodontic surgery may

also be considered if no obvious cause can be found for a tooth’s symptoms; in these cases, surgery allows examination of the entire root of the tooth.

There are different types of endodontic surgery.  An apicoectomy is performed when there is infection at the tip of the tooth that root canal treatment cannot reach.  This procedure involves surgically removing the tip of the tooth’s root, along with any infected tissue, and sometimes a retrofill where a filling is placed into the root tip.

Failed root canal, apicoectomy, and retrofill.

Failed root canal, with infection around the roots (red arrows). Apicoectomy (removal of the diseased part of the root) and retrofill (green arrows – filling/sealant into the bottom of the root)

A hemisection can be used in multi-rooted teeth that have suffered gum disease and loss of bony support.  The tooth and roots are separated to allow for a more hygienic environment.

While there are other types of endodontic surgery, your endodontist will discuss with you whether surgery is required, and the likelihood of success.

 

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