Endodontic Micro Surgery

Endodontic micro surgery may be required when there is a persistent abscess in the bone that has become cystic or that can not be relieved through conventional root canal therapy.

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Why do I need endodontic surgery?

Before understanding endodontic surgery, it is important to understand nonsurgical endodontic treatment. Nonsurgical endodontic treatment is more commonly known as root canal treatment. It is necessary when the soft inner tissue of the tooth, the pulp, becomes inflamed or infected. Endodontic treatment involves removal of the damaged pulp. The canals are then cleaned, filled and sealed to preserve the tooth.

Sometimes, endodontic treatment alone cannot save your tooth, and your dentist or endodontist may recommend endodontic surgery. Endodontic surgery includes any surgical procedures used to remove the infection from your root canals and surrounding areas. Surgery can also be used in diagnosing problems that do not appear on your x-ray, such as root fractures, or in treating problems in the surrounding bone.

Who performs endodontic surgery?

All dentists are trained in endodontic treatment. Because endodontic surgery can often be more challenging than routine treatment, many dentists refer patients needing surgery to endodontists.

Endodontists are dental specialists who diagnose and treat oral pain. They specialize in endodontic (root canal) treatment, including any treatment for the inner tissues of the tooth. In addition to dental school, endodontists receive two or more years of advanced education. They study root canal techniques and procedures in greater depth, including the area of endodontic surgery.

What is an apicoectomy?

An apicoectomy is the most common endodontic surgical procedure. This procedure is used to remove infection or inflammation from the bony area around the end of your tooth. The endodontist starts by lowering the gum tissue near the tooth. This allows direct viewing of the underlying bone. Next, your endodontist will remove any inflamed or infected tissue. The very end of the root is also removed.

After the inflamed or infected tissue is removed, a small filling may be placed in the root-end to seal the root canal. A few stitches are placed in the gum to help the tissue heal properly. Within a few months, the bone heals around the end of the root.

Are there other types of endodontic surgery?

There are several other types of surgery that are performed, depending on the situation. Your endodontist will be happy to discuss the specific type of surgery that you might need.

Will endodontic surgery hurt?

Your endodontist will provide you with local anesthetics that will make the procedure more comfortable. As with any surgical procedure, there will be minor swelling following the procedure. The swelling usually peaks by the second day and is gone by the fourth day. Most people experience no pain during the procedure and mild post-surgery discomfort. Usually, only over-the-counter medications such as ibuprofen or acetaminophen are needed to manage the discomfort. Your endodontist will recommend appropriate pain medication to alleviate your discomfort.

What do I do after the surgery?

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

Can I drive myself home?

Patients who have had endodontic surgery are usually able to drive themselves home. It is, however, a good idea to talk to your endodontist about this prior to your appointment to decide if other transportation arrangements will be necessary.

When can I return to my normal activities?

Most patients return to their normal daily activities one or two days after their surgery. Your endodontist will discuss your expected recovery time with you.

Does insurance cover endodontic surgery?

Many insurance plans do cover endodontic surgery. Each insurance plan is different, however. You should consult with your employer or insurance company prior to treatment.

What are the chances that the surgery will be successful?

Your dentist and endodontist have suggested endodontic surgery because they believe it is the best option for you. Your endodontist will discuss your chances for a successful surgery so you can make an informed decision. Keep in mind that there are no guarantees with any surgical procedure.

What are the alternatives if I choose not to have surgery?

Most often, the only alternative to surgery is an extraction of the tooth. You must then replace the extracted tooth with an implant, bridge or removable partial denture. These will restore chewing function and prevent adjacent teeth from shifting. Because these alternatives require surgery or dental procedures on adjacent healthy teeth, endodontic surgery is usually the most cost-effective option. No matter how effective modern tooth replacements are, nothing is as good as your natural tooth.


Microscopes Help Endodontists See Inside Root Canal

A relatively new addition to the instruments used in dentistry, the operating microscope has been used by medical specialists for decades. Endodontists, the dental specialists who treat problems originating inside the tooth, began experimenting with microscopes in the early 1990s, using them to enhance surgical procedures they perform around the roots of teeth. The microscope helps not only by magnifying the surgical field but also by providing more light. In addition, tiny mirrors no more than one-tenth the size of traditional dental mirrors help the endodontist see into places where the human eye alone never could.

When endodontists perform endodontic (or root canal) procedures, the goal is to remove pulp tissue comprised of nerves, blood vessels, and connective tissue from canals inside the teeth. The canals are then cleaned, shaped and filled with a special material, and the tooth restored, usually with a crown. This procedure saves teeth when their internal tissues have been damaged by serious decay or other trauma. Without a root canal, these teeth would have to be extracted and replaced with expensive bridgework, partials, or implants.

In most teeth, a canal containing nerves and blood vessels runs from the center of the crown (the part you can see above the gumline) of the tooth through the root and out into the jaw. Near the end of the root, the canal branches into many smaller canals, almost like a river delta. These smaller branches of the canal can be much easier to see with the microscope.

After initially using the microscope in surgery, many endodontists discovered that it can also help with diagnosis and nonsurgical endodontic procedures. Endodontists have used the microscope to find tiny fractures, which are often difficult to detect with traditional diagnostic methods. In addition, very small or unusually positioned canals become easier to see.

Sometimes, a new infection or injury will cause a tooth that has been treated before to need a second endodontic procedure. Endodontists call this “retreating” the tooth. To accomplish retreatment, all previous filling material and posts that may have been placed to support a crown must be removed from the tooth. The microscope can help with these procedures as well.

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Contact Us for More Info About Our Root Canal Micro Surgery and to Schedule an Appointment Today

If you have any questions about root canal micro surgery or would like to schedule an appointment, please contact us by phone at 604-532-4090 or stop by our office. We are happy to help and look forward to connecting with you.