Why would I need endodontic surgery?

Endodontic surgery may be needed when a tooth cannot be fully treated with a standard root canal or when symptoms continue after treatment. It can help your endodontist find hidden problems, such as tiny fractures, complex canals, or infection that does not appear clearly on an x-ray.

Surgery may also be recommended if calcium deposits block the canal, if infection returns months or years after a root canal, or if the root surface or surrounding bone is damaged.

The most common endodontic surgery is an apicoectomy, also called a root-end resection. This procedure treats inflammation or infection around the tip of the tooth root to help save the natural tooth.

Local anesthetics make the procedure comfortable. Of course, you may feel some discomfort or experience slight swelling while the incision heals. This is normal for any surgical procedure. Your endodontist will recommend appropriate pain medication to alleviate your discomfort.

Your endodontist will give you specific postoperative instructions to follow. If you have questions after your procedure, or if you have pain that does not respond to medication, call your endodontist.

When can I return to my normal activities?

Most patients return to work or other routine activities the next day. Your endodontist will be happy to discuss your expected recovery time with you.

Does insurance cover endodontic surgery?

Each insurance plan is different. Check with your employer or insurance company prior to treatment.

What is an apicoectomy?

An apicoectomy, also called root-end surgery, is a procedure used to treat infection or inflammation around the tip of a tooth root. During the procedure, the endodontist opens the gum tissue, removes the infected tissue and the very end of the root, then seals the root canal with a small filling.

Stitches are placed to help the gum heal, and over the next few months, the bone gradually heals around the root.

Are there other types of endodontic surgery?

Other surgeries endodontists might perform include dividing a tooth in half, repairing an injured root, or even removing one or more roots. Your endodontist will be happy to discuss the specific type of surgery your tooth requires.

In certain cases, a procedure called intentional replantation may be performed. In this procedure, a tooth is extracted, treated with an endodontic procedure while it is out of the mouth, and then replaced in its socket.

These procedures are designed to help you save your tooth.