During your endodontic appointment with us, we may recommend a surgical approach to your treatment for a number of reasons. It is a valid choice of treatment if you’re experiencing pain in a tooth which has previously had a root canal.
There may be very small cracks in your teeth, invisible even on an X-ray, where bacteria can leak through and causes secondary infection. Sometimes, for varying reasons, previous root canal procedures did not reach all the way to the bottom of the canal. If a previous root canal did not remove all of the tooth pulp, infection and inflammation can return, causing pain and discomfort. While some problems can be solved with endodontic retreatment, we may recommend surgery.
In other situations, a root canal is not appropriate for the particular situation at hand. If the root surfaces or bone surrounding the tooth are damaged, a root canal procedure may actually do more to hurt than help the tooth. There are some cases in which it is best to treat the roots surgically.
Our office will need a complete medical history and list of your current medications before deciding that surgical treatment is right for you. Some patients with certain health conditions may need to take an antibiotic on the day of their procedure.
The most common endodontic surgery procedure is referred to as an apicoectomy, or a root-end resection. The endodontist applies a local anesthetic to the area. A very small incision is made in the gum immediately outside and adjacent to the affected root, and small flaps are opened displaying the root(s). This gives direct access to the surgical field.
All of the surrounding infected tissue and the very tip of the root canal is removed. The hole in preparation of the rootend(s), the prepared areas are filled and sealed with a biocompatible filling material. The gum is sewn closed with sutures. Over a period of months, the bone will heal back around the root(s) of the tooth. If the size of the initial infection has damaged a significant amount of the bone, then bone grafting or other techniques may be required to replace what has been lost.
This microsurgery is performed with advanced technologies, including ultrasonic instruments which clean where traditional files cannot. Microscopes with LED lights are used to get a complete view of the root(s). These allow Dr. Woodard to perform your procedure quickly and efficiently. Appointments are usually completed in under two hours, although times do vary. Patients are able to drive home from their procedure and return to their normal activities the next day.
Discomfort and swelling may continue for a few days or up to a couple of weeks after the surgery, but it is usually manageable with over-the-counter analgesics. Serious complications are rare, but some patients do experience excessive bleeding, pain, or postoperative infection. Contact our office immediately if you have these symptoms after your procedure. While surgery is generally only recommended if a root canal is not appropriate, it is a safe and effective way to return your teeth to health while preserving your natural smile.