Apical Surgery

What is apical surgery?

Apical surgery  is also know as an “apicectomy”. It is a term used to describe a surgical procedure to treat infections that cannot be dealt with traditional root canal treatment.

Because the aim of an apicectomy  is to treat the last few millimeters of the root tip, it requires surgical access. A small incision is made into the gums which allows the Endodontist to view and treat the root tip with precise management. The Endodontists at Camberwell Endodontics use operating microscopes and specialized equipment to carry out these procedures.

Both treatments deal with an infected tooth. Root canal treatment treats infection by cleaning and sealing the root canal system. This is normally carried out in two visits.  

Apical surgery treats the infection by removing the tip of the root and the infection surrounding it. This is carried out in a single visit.

What is the difference between a traditional root canal treatment and apical surgery?

Both treatments deal with an infected tooth. Root canal treatment treats infection by cleaning and sealing the root canal system. This is normally carried out in two visits.  

Apical surgery treats the infection by removing the tip of the root and the infection surrounding it. This is carried out in a single visit.

Why would I need surgery?

Apicectomies are generally recommended for the following reasons

  1. A tooth has already had root canal treatment (perhaps twice already) and an infection persists. This can happen in approximately 10% of the cases. There can be multiple reasons for persistence of infection which your Endodontist can discuss with you.
  2. Redoing conventional root canal treatment is not an option due to the presences of posts in the root canal that block access to the root canal.

Is it done under local anaesthetic?

Most apicectomies are simple procedures and can be carried out under local anaesthesia.

What can I expect afterwards?

Apicectomies can take up to an hour. On completion some stitches are placed which are removed 1 week later. Some discomfort, swelling or bruising can be expected in the first week.  Use of an ice pack and mild analgesics such as Nurofen or Panadol are recommended post operatively. Most patients find they are fit to resume work the within a day or 2 after  surgery.