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What is an apicectomy?
Your teeth are held in their place by roots that extend all the way into your jawbone. Your front teeth usually have one root while other teeth like your premolars and molars may have two or more roots. The tips or the end of the roots are called the apex and this is where the nerves and the blood vessels enter the tooth. These nerves travel through the canal of the root all the way into the pulp chamber. The chamber is found inside the crown which is the part of the tooth that is visible in your mouth.
During root canal treatment, the canals are cleaned and any inflamed or infected tissue is removed. An apicectomy is necessary when infection develops and refuses to go away after a root canal treatment. Root canals are very complex and they have several small branches off the main canal. There are times where even after root canal treatment; there will still be infected debris in the branches. This will prevent healing and may even cause more infections later on. In an apicectomy, the root tip or the apex is removed along with the infected tissue. A filling is placed afterwards so that the end of the root is sealed. Apicectomies are usually referred to as endodontic microsurgery since it is usually done under an operating microscope.
Why would I need an apicectomy?
If a root canal procedure was done in the past and your tooth still becomes infected then the problem may be near the apex of the root. In several cases, another root canal treatment is done before an apicectomy. With the advances in technology, dentists will be able to detect other canals that were not treated properly. In this situation, the infection can be cleared up by doing a second root canal. When this is done, an apicectomy is avoided.
An apicectomy can be done in order to fix the problem so that tooth extraction is avoided. Apicectomy is only done after two root canal treatments that are unsuccessful. For instance, retreatment is not a good option if a tooth has a crown or if it has a bridge. Retreatment of the root canal will require cutting through the crown or through the bridge and may weaken or even destroy it. Apicectomies are considered in this situation. Apicectomies are not the same as root resectioning because root resectioning removes the entire root whilst apicectomies merely remove the tip.