Apical Surgery
What is Apical Surgery?
Apical surgery is a small operation to treat a tooth with a long-lasting infection. This infection usually happens when a root canal treatment has not completely worked. The infection is often at the tip of the tooth root inside the jawbone.
The surgery is usually done with local anaesthetic (numbing medicine), so you stay awake. You can go home right after the surgery, and many people don’t need to take time off work.
What Causes Infection at the Tip of the Root?
Infection at the root tip (called the root apex) usually comes from an infected root canal (the small canal inside the tooth root containing nerves and blood vessels).
Root canal treatment (filling the root canal) usually fixes this infection, but apical surgery may be needed if:
- The root canal treatment didn’t work and cannot be done again or may fail.
- The root canal treatment was repeated but still did not work.
- Small pieces of root filling material pushed through the root tip cannot be removed.
- A small sample (biopsy) of the infected area needs to be taken.
What Does the Procedure Involve?
The experience is similar to a normal dental visit. Your tooth and gums will be numbed just like other dental treatments.
The dentist will make a small cut around the tooth and gently pull back the gum. This shows the jawbone where the infection is. All infected tissue will be taken away.
Then, using a drill, the dentist will carefully remove the tip of the root. A special filling will be put on the cut root to seal it and help stop infection from coming back.
Finally, the gum is stitched back in place.
Procedure Steps:
What Are the Risks?
Like all treatments, apical surgery has some risks:
- Pain and swelling: Usually mild and controlled with normal painkillers. Some people may get bruises inside or outside the mouth.
- Infection: Rare, but can happen. If so, antibiotics may be needed.
- Gum shrinkage: The gum may pull back a little after surgery, possibly showing the edge of a crown, which might look unpleasant and need fixing.
- Treatment failure: Surgery might not work and the tooth might have to be taken out.
Most people recover well and often don’t need time off work, but it’s best not to plan important events for a few days after surgery.
How Successful Is It?
Apical surgery is usually done when other treatments have failed. Success depends on the tooth’s condition and previous treatments. On average, it works well in more than 85% of cases.
Are There Any Other Options?
The main alternative is to try root canal treatment again before surgery.
If that is not possible or doesn’t work, the tooth may need to be removed and replaced with a denture, bridge, or implant.
