Apicoectomy is a surgical method of removing the tip of a tooth root along with the accompanying lesion (usually a cyst or granuloma) in order to retain a tooth in the mouth, a procedure combined with previous endodontic treatment.

The reasons to proceed with a tooth apicoectomy are:

A. An endodontic treatment has already been successfully repeated in a tooth with a previous endodontic treatment and in the presence of periapical lesions, however, after 3-4 months the tooth continues to exhibit radiographic lesions with / without concomitant symptoms.

B. An apicoectomy performed immediately after the completion of the endodontic treatment because, according to the radiographic data, the size of the lesion at the apex is considered too large to heal on its own.

C. Inability to obturate the entire length of the root canal of a tooth during endodontic treatment and if the remaining part of the root canal is relatively small. In these cases, either immediately or after some time, if a radiographic lesion is observed, an apicoectomy is performed.

D. Fracture of the tooth confirmed radiographically near the apex.

E. In case of an inability to access an endodontically treated tooth where its preservation is considered important e.g. support of a prosthetic restoration.

Surgically, after local anesthesia of the area, the gums that cover this tooth are elevated and using a mechanically rotating surgical bur, part of the end of the root is removed. This is followed by a thorough cleaning of the area around the tooth and the surrounding bone with appropriate surgical tools. In some cases the root is ’sealed’ with a special biocompatible material, according to the doctor’s choice. The wound is sutured and appropriate postoperative instructions are given to the patient, whose compliance is considered absolutely necessary for the uncomplicated course of healing. The removed inflamed tissues should be sent for histopathological examination while every 3 months it is recommended to have the area checked, until the healing of the bone peripheral to the lesion is completed.

Frequently asked questions

Does the tooth undergoing apicoectomy become shorter? Will it be long lasting in the mouth?

In the procedure of apicoectomy, in most cases, 2-3 mm are removed from the root tip. However, this loss is not significant enough to be considered that the tooth has insufficient support. The time that the tooth can be maintained in the mouth is long and is not substantially affected by this operation.

Should I have an apicoectomy on a tooth or should I remove it?

Each case of a tooth that could possibly undergo apicoectomy or extraction is particular and must be carefully evaluated by the Doctor in order to reach the best possible decision. The personal desire and requirements of the patient are also seriously taken into account in the final treatment plan.

If the tooth is finally lost after an apicoectomy, can I have a dental implant in its place?

Although a small amount of bone is removed from the jaw during the apicoectomy procedure, healing follows, which regenerates part of the removed bone. Therefore, the chance of an implant being placed in the same area after many years is not affected.