Apical
Surgery
Apicoectomy
I have found that root canals
rarely fail. When a root canal fails it is usually do to one of the following::
Unusual
and undetectable tooth anatomy.
Small
accessory and lateral nerve canals that can not be instrumented.
Cyst
formation
Cracked
tooth
Most of the "failures" can be
saved, with the exception of a severely cracked tooth, with a surgical
procedure called an apicoectomy. This surgery involves removal of the the
root tip or "apex" of the tooth root. This is normally where abnormal root
anatomy and extra canals are present. During the procedure, the area around
the root tip is also cleaned or curettaged to remove any granulation (abnormal
healing) tissue and cystic formations. Apicoectomy
is an in office procedure performed by an Oral Surgeon or Endodontic specialist.
The area is numbed with a local anesthetic and you may have IV sedation
to relax you. Pain medication will be prescribed to keep you from experiencing
any discomfort. The area may be sore for three to four days days.
Surgical
Details
|
|
|
Opening
and Root Tip Cut
|
Root
Tip Removed Reverse Filling Placed
|
Complete
Healing
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The gum is reflected (lifted)
from an area adjacent to the root area of the tooth. Access to the root
tip is then made by removing the thin bone covering the end of the root.
A small part of the the root tip is then removed and the remaining root
is checked to make sure it is sealed. Apical or Retrofilling (reverse filling)
will be required to seal all canals that are found that are not properly
sealed . Without proper sealing of all the canals present in a tooth
the procedure will not be successful.
The area around the root tip
is then cleaned and curetted. The gum is placed back into position and
sutured (stitched). After healing all infection at the tip of the root
should disappear and bone should heal to fill in the area around the root
tip.
Hemisection
Hemisection
is a surgical procedure which involves removing only one root of a multi-rooted
tooth, and may be required in one of the following situations:
-
Endodontic
Failure of an individual root which is not retreatable
-
Bone Loss
around an individual root (periodontal disease)
These teeth
usually do very well with one less root. Removing the front root
of a lower second molar and using it as a bridge anchor (abutment) to replace
a missing first molar, prevents the need for a partial denture or dental
implant.
[Endodontics]
[Endo. Procedure]
[Endo. Surgery]
[Apicoectomy]
Endodontic
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Stuart
A. Greene, DDS-FAGD
2009
Birdcreek Terrace Temple, TX 76502 254.773.9007 | Fax 254.773.8051
©2004
Stuart
A. Greene, DDS-FAGD | Online since 1996 | Updated Continuously
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