Endodontic Surgery

There are cases where an abscess develops at the root tip even after root canal treatment. This occurs when all the infected bacteria could not be removed within the root or when the initial infection was severe. Surgery is an alternative option to root canal retreatment to remove the bacteria from the root tip without disturbing the crown of the tooth. An incision is made in the gum tissue and the apical portion of the root is located in the  bone where the infection can then be cleaned out. The tip of the root is cut off in a procedure called an apioectomy and the root canal system is re-sealed with a small retrograde filling to help the bone reform. This procedure can be utilized as an alternative to conventional root canal therapy when the tooth has a good crown or cap on it due to previous dental work and re-treatment would cause an undue expense. Each case must be decided on its own merits.There are some cases where the procedure may be unsuccessful and the tooth may still require extraction. Where root canal therapy is approximately 90% successful, root canal surgery is only successsful in about 80% of cases.