Endodontic Surgery

Why do I need endodontic surgery?

Generally, a root canal is all that is needed to save teeth with injured pulp from extraction. Occasionally, this non-surgical procedure will not be sufficient to heal the tooth and your endodontist will recommend surgery. Endodontic surgery can be used to locate fractures or hidden canals that do not appear on x-rays but still manifest pain in the tooth. Damaged root surfaces or the surrounding bone may also be treated with this procedure. The most common surgery used to save damaged teeth is an apicoectomy or root-end resection.

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What is an apicoectomy?

In this 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 in the root to seal the end of the root canal, and a few stitches or sutures are placed in the gingiva to help the tissue heal properly.

Over a period of months, the bone heals around the end of the root.

If you have questions or concerns about dental emergencies, please contact our office.

Root Amputation

Root amputation is a specialized dental procedure, whereby one root is removed from a multi-root tooth. The tooth is then stabilized and rendered fully functional with a crown or filling. The multi-root teeth best suited to the root amputation procedure are the molars at the back of the mouth. These large flat teeth have either two or three roots depending on whether they are situated on the upper or lower jaw.

The general purpose of root amputation is to save an injured or diseased tooth from extraction. Most dentists agree that there is no better alternative than retaining a healthy natural tooth, and the root amputation procedure makes this possible. Dental implants, extensive bridgework and custom-made tooth replacements can be expensive and time-consuming. Generally, root amputation and the necessary crown work are less expensive and can be completed in 1-3 short visits.

When is root amputation necessary?

It is important to note that root amputation can only be performed on an otherwise healthy tooth. Even in the case of a “key” tooth, extraction will be performed if the tooth is diseased, badly fractured or otherwise injured. Suitable teeth for root amputation have a healthy tooth surface, strong bone support and healthy underlying gums.

There are several problems that may lead to root amputation, including:

  • Broken, fractured, or injured teeth and roots.
  • Embedded bacteria within the structure of the root

  • Severe bone loss in a concentrated area due to periodontitis

  • Tooth decay in a concentrated area of the tooth

What does root amputation involve?

Prior to root amputation, it is necessary to perform root canal treatment. The amputation itself involves cutting deep into the tooth where blood vessels and nerves are located. For this reason, the pulp of the tooth including these vessels and nerves needs to be removed before resectioning the roots. The root canal and amputation treatments will be performed under local anesthetic.

During the root amputation procedure, a small incision will be created in the gum to fully expose the roots of the affected tooth. The root will be sectioned off from the rest of the tooth and then removed. To kill any remaining bacteria, the whole area will be cleansed with saline solution, and then sutures (stitches) will be applied to seal the incision.

Finally, a temporary crown or filling will be placed to secure the tooth. Depending on the specific situation, painkillers, antibiotics and a medicated anti-microbial mouthwash may be prescribed. In 7-10 days, the stitches will be removed and the gum will have healed. Arrangements can now be made to place the permanent crown or filling.

If you have any questions or concerns about root amputation, please ask your dentist.

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Did you know…

Our endodontists are a local authority in the field of complex endodontic surgical procedures and teach their techniques to future dentists and endodontists.