Apicectomy/Endodontic Microsurgery

An apicectomy, also known as root-end resection or endodontic microsurgery is a surgical dental procedure performed to treat persistent infections in the root tip (apex) of a tooth, particularly after an unsuccessful root canal treatment.

The goal of an apicectomy is to remove the infected tissue, clean and seal the end of the tooth's root and prevent the spread of infection to the surrounding bone. The procedure is commonly performed by an endodontist, a dental specialist in diagnosis and treatment of dental pulp and root canal-related issues.

Apicectomy is usually performed under local anaesthesia. The endodontist cuts and opens the gum tissue near the tooth to see the underlying bone and to remove any inflamed or infected tissue. The very end tip of the root is also removed. A small filling may be placed to seal the end of the root canal and a few sutures are placed to help the tissue heal. Figure 4 illustrates the overall procedure of apicectomy.

The procedure is usually recommended when a standard root canal treatment has already been performed on a tooth but isn’t sufficient to save the tooth and prevent further complications. In cases where there’s an anatomical concern with the root tip, such as one root crowding into the space of the root next to it, an apicoectomy may be helpful in preventing problems that could affect multiple teeth in the future.

While apicoectomy is generally a safe and effective procedure, there are risks and potential complications. An apicoectomy can be more invasive than a typical root canal surgery, meaning the recovery time is usually more painful. Nonetheless, studies showed that postoperative pain usually decreased steadily within the first few days. It's important for patients to follow postoperative instructions carefully and attend scheduled follow-up appointments to ensure proper healing.



Figure 4. Illustration of the overall procedure of apicectomy.

Source :
https://www.endodonticspecialists.net/Endodontics/Procedures/EndodonticMicrosurgery.aspx#:~:text=In%20this%20procedure%2C%20the%20gum,the%20root%20is%20also%20removed

Reference :

1. Endodontic Surgery explained [Internet]. 2017 [cited 2023 Dec 18]. Available from:
https://www.aae.org/patients/root-canal-treatment/endodontic-treatmentoptions/endodontic-surgery/endodontic-surgery-explained/

2. Roland J. Apicoectomy: Procedure, Pros and Cons, and more [Internet]. Healthline Media; 2020 [cited 2023 Dec 18]. Available from:
https://www.healthline.com/health/dental-and-oral-health/apicoectomy#about

3. 1. A; CRL-BP. Patient discomfort following periapical surgery [Internet]. U.S. National Library of Medicine; [cited 2023 Dec 18]. Available from:
https://pubmed.ncbi.nlm.nih.gov/18230393/

© KL Endodontic Dental Clinic Sdn Bhd 202201021734 (1467431-M) All Rights Reserved.