Occasionally, a nonsurgical root canal procedure alone cannot save your tooth and we will recommend surgery.
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.
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. Endodontists use advanced technologies like digital imaging and operating microscopes to perform surgeries quickly, comfortably and successfully.
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, the endodontist 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.
Other types of surgeries include dividing a tooth in half (Hemisection), repairing an injured root (Surgical repair of perforation defects, invasive cervical resorption), or removing one or more roots (Root amputation).
In certain cases, a procedure called intentional replantation may be performed. In this procedure, a tooth is extracted, treated with an endodontic procedure while it is out of the mouth, and then replaced in its socket. We will be happy to discuss the specific type of surgery your tooth requires in detail during your initial visit to our office.