Occasionally, a nonsurgical root canal procedure alone cannot save your tooth and Dr. Amoroso will recommend surgery. Endodontic surgery can be used to locate small fractures or hidden canals that weren’t detected on x-rays or during previous treatment. Surgery may also be needed to remove calcium deposits in root canals, or to treat damaged root surfaces or the surrounding bone of the tooth. To learn more about endodontic surgery, ask Dr. Amoroso.
There are many surgical procedures that can be performed to save a tooth. The most common is called an apicoectomy, or root-end resection, which is occasionally needed when inflammation or infection persists in the bony area around the end of your tooth after a root canal procedure. In this microsurgical procedure, Dr. Amoroso opens the gum tissue near the tooth to see the underlying bone and to remove any inflamed or infected tissue. The very end of the root is also removed. A small filling may be placed to seal the end of the root canal and few stitches or sutures are placed to help the tissue heal. Over a period of months, the bone heals around the end of the root. Local anesthetics make the procedure comfortable, and most patients return to their normal activities the next day. Postsurgical discomfort is generally mild.
Why would I need endodontic surgery?
- Surgery can help save your tooth in a variety of situations.
- Surgery may be used in diagnosis. If you have persistent symptoms but no problems appear on your x-ray, your tooth may have a tiny fracture or canal that could not be detected during nonsurgical treatment. In such a case, surgery allows Dr. Amoroso to examine the entire root of your tooth, find the problem, and provide treatment.
- Sometimes calcium deposits make a canal too narrow for the instruments used in nonsurgical root canal treatment to reach the end of the root. If your tooth has this “calcification,” Dr. Amoroso may perform endodontic surgery to clean and seal the remainder of the canal.
- Usually, a tooth that has undergone a root canal can last the rest of your life and never need further endodontic treatment. However, in a few cases, a tooth may not heal or become infected. A tooth may become painful or diseased months or even years after successful treatment. If this is true for you, surgery may help save your tooth.
- Surgery may also be performed to treat damaged root surfaces or surrounding bone.
Although there are many surgical procedures that can be performed to save a tooth, the most common is called apicoectomy or root-end resection. When inflammation or infection persists in the bony area around the end of your tooth after a root canal procedure, Dr. Amoroso may have to perform an apicoectomy.
What is an apicoectomy?
In this procedure, Dr. Amoroso opens the gum tissue near the tooth to see the underlying bone and to remove any inflamed or infected tissue. The very end of the root is also removed.
A small filling may be placed in the root to seal the end of the root canal, and a few stitches or sutures are placed in the gingiva to help the tissue heal properly.
Over a period of months, the bone heals around the end of the root.
Are there other types of endodontic surgery?
Other surgeries Dr. Amoroso might perform include dividing a tooth in half, repairing an injured root, or even removing one or more roots. Dr. Amoroso will be happy to discuss the specific type of surgery your tooth requires.
Will the procedure hurt?
Local anesthetics make the procedure comfortable. Of course, you may feel some discomfort or experience slight swelling while the incision heals. This is normal for any surgical procedure. Your endodontist will recommend appropriate pain medication to alleviate your discomfort.
Your endodontist will give you specific postoperative instructions to follow. If you have questions after your procedure, or if you have pain that does not respond to medication, call Dr. Amoroso.
Can I drive myself home?
Often you can, but you should ask Dr. Amoroso before your appointment so that you can make transportation arrangements if necessary.
When can I return to my normal activities?
Most patients return to work or other routine activities the next day. Dr. Amoroso will be happy to discuss your expected recovery time with you.
Does insurance cover endodontic surgery?
Each insurance plan is different. Check with your employer or insurance company prior to treatment.
How do I know the surgery will be successful?
Your dentist or Dr. Amoroso is suggesting endodontic surgery because he or she believes it is the best option for saving your own natural tooth. Of course, there are no guarantees with any surgical procedure. Dr. Amoroso will discuss your chances for success so that you can make an informed decision.
What are the alternatives to endodontic surgery?
Often, the only alternative to surgery is extraction of your tooth. The extracted tooth must then be replaced with an implant, bridge, or removable partial denture to restore chewing function and to prevent adjacent teeth from shifting. Because these alternatives require surgery or dental procedures on adjacent healthy teeth, endodontic surgery is usually the most biologic and cost-effective option for maintaining your oral health.
No matter how effective modern artificial tooth replacements are—and they can be very effective—nothing is as good as a natural tooth. You’ve already made an investment in saving your tooth. The pay-off for choosing endodontic surgery could be a healthy, functioning natural tooth for the rest of your life.
