Apicoectomy and endodontic microsurgery
When inflammation lingers at the tip of a root after a root canal, a small surgical procedure called an apicoectomy can treat it directly and save the tooth.
Mountain View 650-691-0999Saratoga 408-252-5700
When it helps
A root canal usually heals the tooth. When infection or inflammation persists at the root tip, or a crown and post make retreatment impractical, surgery on the root tip can save the tooth.
What happens
- Numbing. The area is numbed with local anesthetic.
- Reaching the root tip. Dr. Hirose makes a small opening in the gum to reach the end of the root.
- Treating the tip. He removes the inflamed tissue and the very end of the root, then cleans and seals the root end from below, all under the microscope.
- Healing. The gum is closed, and the bone around the root heals over the following months.
Why the microscope matters
How surgery is done matters a great deal. A meta-analysis comparing older root-end surgery with modern endodontic microsurgery, which uses a surgical microscope and fine instruments, found success rates of 59 percent for the traditional approach and 94 percent for microsurgery. That analysis came from the endodontics department at the University of Pennsylvania, where Dr. Hirose trained.
Sources
Questions patients ask
Does an apicoectomy hurt?
The area is numbed with local anesthetic, the same as for a root canal. Afterward, most people have some swelling and tenderness for a few days, which a cold compress and over-the-counter pain relievers usually manage.
How long is recovery?
Most people go back to work or school the next day. Stitches, if used, usually come out within about a week. Dr. Hirose gives you written instructions and checks on healing at follow-up visits.
Why not just pull the tooth?
An apicoectomy saves the natural tooth, so you avoid replacing it with an implant or bridge. When the tooth has a good outlook, keeping it is usually the simpler and less expensive path over time.
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Relief starts with a call
Call the office closest to you. If you are in pain, say so when you call, and the team will look for the soonest opening at either office.
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Mountain View
100 West El Camino Real, Unit 67
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Saratoga
18988 Cox Avenue, Suite D