Endodontic (Root Canal) Surgery
Sometimes calcium deposits make a canal too narrow for the instruments used in nonsurgical root canal treatment to reach the end of the root. If the tooth has this “calcification,” an endodontist (root canal specialist) may perform root canal surgery to clean and seal the remainder of the canal. Usually, a tooth that has undergone a root canal treatment can last the rest of your life and never need further root canal treatment. However, in a few cases, a tooth may not heal or become infected. A tooth may become painful or diseased months or even years after successful treatment. In this occasion, surgery may help save your tooth.
Surgery may also be performed to treat damaged root surfaces or surrounding bone.
Although there are many surgical procedures that can be performed to save a tooth, the most common is called apicoectomy or root-end resection. When inflammation or infection persists in the bony area around the end of the root after a root canal treatment, your endodontist (root canal specialist) may have to perform an apicoectomy and often place a root-end filling.
Frequently Asked Questions about Endodontic Surgery
What is an apicoectomy and retrograde filling?
After an apicoectomy, special ultrasonic instrument is used under dental operating microscope to remove the potentially contaminated root canal filling and prepare the root canal space in retrograde direction. Then, small filling with biocompatible material is placed into the prepared root canal space to seal the root end. The stitches or sutures are placed in the gingiva to help the tissue heal properly.
The bone healing around the resected end of the root is observed at the follow up visit a year after the apicoectomy in vast majority of the cases.
Are there other types of endodontic (root canal) surgery?
In certain cases, intentional replantation may be performed. In this procedure, a tooth is extracted, root canal space is disinfected, shaped and filled while the tooth is out of the mouth, and then replanted back into its socket.
These procedures are designed to help you save your tooth.
Will the procedure hurt? Will there be pain after?
Of course, there may be some discomfort or slight swelling while the incision heals like 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.
Can I drive myself home?
When can I return to my normal activities?
Does insurance cover endodontic surgery?
How do I know the surgery will be successful?
What are the alternatives to endodontic (root canal) surgery?
No matter how effective modern tooth replacement options are, nothing is as good as your own natural tooth. You’ve already made an investment in saving your tooth with root canal treatment. Choosing endodontic surgery can help you to keep a healthy, functioning natural tooth for the rest of your life.