Apicoectomy (Endodontic Surgery)

Routine root canal therapy has a very high success rate of ~90-95%; a tooth that has had a prior root canal will likely never have to be redone. However, in some rare situations a prior infection will persist inside or outside a specific area of an already root canal treated tooth. In situations where a focused area of persistent infection is present in a root canal treated tooth, Apicoectomy (also called Endodontic Surgery) is necessary to remove the infection. Apicoectomy can be a very predictable treatment option, but many factors need to be considered that will determine the overall success of your specific surgical procedure. Generally, Apicoectomy has a success rate of ~92-96%.

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Apicoectomy is a highly specialized procedure that is performed entirely with the use of a custom surgical operating microscope. This enables Dr. Kruszewski to examine areas of your tooth/infection smaller than 1mm wide to perform extremely targeted and conservative therapy.



After gently numbing your tooth and gums with special topical jelly and anesthetics, Dr. Kruszewski will make a series of tiny cuts in the gums near the infected tooth. The gums will be carefully retracted, and the area of infected tissue surrounding the tooth’s root tip will be removed.

Next, Dr. Kruszewski will remove a small portion of the infected root tip, and use a special blue dye to examine the tooth for cracks or extra areas of infection. The tip of the tooth will be cleaned out with tiny vibrating instruments, called ultrasonics. A small root-end filling, called a retrofill will then be placed at the tip of the tooth root. An xray will be taken to verify adequate placement of the filling. The entire surgical area will be generously flushed with sterile saline solution to ensure you will heal as predictably as possible. A series of small stitches/sutures will be placed in your gums to make the healing process faster and more comfortable. These stitches will dissolve on their own in a few days.

After treatment, you may have some mild discomfort in the gum for a few days to 1 week while the area is healing. Dr. Kruszewski will explain which medications are appropriate to use during healing. We will re-examine you at a follow-up visit 1 week after the surgery to make sure the gums are healing properly.

Your body will begin to heal the area in the bone where the infection was located near the root tips. This process usually takes 1-2 years to occur, and in some cases may take up to ~4 years. We will re-examine your tooth at appropriate times after treatment to ensure the bone is healing properly.