Endodontic Microsurgery may be the best treatment option if a tooth, previously treated by Root Canal, exhibits signs or symptoms of persistent or recurrent infection. Root Canal treatment has a very high rate of success, but as with other medical or dental procedures, infection or inflammation may persist or recur despite our best efforts. Research articles have shown that infection can persist because bacteria can live outside of the tooth and in the bone. Although Root Canal treatment is usually the more conservative, preferred treatment option for persistent infection, Endodontic Microsurgery has some advantages in certain situations. We will discuss treatment options to help determine which procedure is right for you. Endodontic Microsurgery will not be performed at the initial consultation and will therefore require a second appointment for the procedure.
The most common Endodontic surgery is called a root-end resection or ‘Apicoectomy.’ After profound local anesthetic is achieved, a small incision is made near the gum line and the gum tissue is temporarily moved in order to gain access to the inflamed or infected area. The tip of the root is removed, using a surgical operating microscope.The resected root surface is stained and inspected to identify the source of infection, after which the canals are cleaned with an ultrasonic instrument and a root-end filling is placed to seal the canal. Finally, a few stitches are placed to allow the gum tissue to properly heal. A follow up appointment is required to remove the sutures and evaluate healing.