Apicoectomy Before and After Surgery

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Why the procedure is needed:

In general, 10% – 30% of root canal treatments are unsuccessful, creating a need for retreatment or a surgical procedure called an apicoectomy. An apicoectomy is performed when the area around the end of the tooth root becomes infected or the root fractures. Your dentist can perform an apicoectomy to try and fix this problem in hope of avoiding the need to extract the tooth. An apicoectomy is generally performed after a tooth has had an unsuccessful root-canal treatment.

The dentist will open and lift the gum away from the tooth so the root is easily accessible. The infected tissue, called granulation tissue, will be removed along with a small part of the root tip. A dye will be used that highlights cracks and fractures in the tooth. If the tooth is cracked or fractured it may have to be extracted, and the apicoectomy will not continue, or more of the root tip may be
taken off. After shaving off the tip of the root, the end of the tooth is resealed (called a retrograde filling). This is one of the most common surgical procedures that can be performed to save a tooth.

What to expect after Surgery:

With an apicoectomy procedure, you can expect slight bleeding for the first 24 hours. Swelling could be excessive and reach into the tissue near the eye, and discomfort may be experienced for which you will receive appropriate medication. If surgery was performed in the lower jaw, a tingling of the lower lip is possible due to stretching of the nerve supply in this area. This is a rare occurrence and should subside within a few days. In some cases, facial discoloration (bruising) may be present for up to 10 days following surgery. This is a normal part of the healing process and will gradually disappear. There is a slight possibility for gums to recede after an apicoectomy, making your teeth appear longer after surgery. Even though gum tissue heals, the surgical site may be sensitive to touch for several months as new bone forms at the end of the tooth. Patient’s receiving an apicoectomy may also experience numbness which is generally temporary and rarely permanent.

Post-Operative Instructions:

• Rest as much as possible and avoid strenuous activity over the next 48 hours.
• Do not skip meals, drink plenty of fluids, and avoid hot liquids and foods.
• Eat soft bland foods for the next 48 hours. Avoid hard or chewy foods for one week.
• Avoid chewing around the surgical site until the sutures are removed.
• Ice the area 10 minutes on and 20 minutes off for (2) two days following surgery.
• Do not lift your lip to examine the surgical area, the stitches may tear.
• Brush your teeth as normal, but avoid the surgical site for 2 days.
• Rinse with 8 ounces warm water and 1 tsp. salt 2-3 times a day for 7 days.
• If you have been provided a mouthwash, moisten a Q-tip with the mouthwash and gently wipe the teeth surrounding the site. Otherwise, moisten the Q-tip with water.