Posts for tag: Apicoectomy

By Lexington Endodontics
December 05, 2019
Category: Dental Procedures
Tags: Apicoectomy  

Untreated tooth decay can destroy your teeth; prompt action as soon as its diagnosed will help prevent that undesirable outcome. And even if decay has advanced into the tooth's pulp and root canals, there's still a good chance we can stop it with a root canal treatment. Using this procedure, we can clean out the infection and refill the tooth's interior space with a special filling to protect it from further infection.

Although root canal treatments have gained an unwarranted reputation for pain, they rarely cause even the mildest discomfort. More importantly, they work, which is why they're the go-to treatment dentists use for advanced decay.

But sometimes a unique dental situation might make performing a root canal extremely difficult—possibly even doing more harm than good. For example, trying to access the interior of a tooth with a crown restoration might require removing the crown, which could further weaken or damage the tooth. In other cases, the root canals might have become calcified due to trauma or aging and become too narrow to access.

Even so, we may still be able to save a tooth through a minor surgical procedure called an apicoectomy. Rather than access the diseased area through the tooth crown as with a root canal treatment, an apicoectomy makes access to the infected tissue at the root end.

An apicoectomy also differs from a root canal treatment in that we'll need to surgically go through the gum tissue. After numbing the area with a local anesthetic, we'll make a small incision through the gums at the level of the infection. After removing any infected tissue, we would then fill the space with a small filling to prevent re-infection. We then close the incised gum tissues with sutures and allow them to heal.

With the help of fiber optic lighting and surgical microscopes, endodontists (specialists in interior tooth problems) can perform an apicoectomy quickly and with very little trauma at the surgical sight. If you undergo an apicoectomy, you should be back to normal activity in a day or two at the most. And like its sister procedure the root canal, an apicoectomy could help preserve your teeth for many years to come.

If you would like more information on this and other treatments for tooth decay, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Apicoectomy: A Surgical Option When Root Canal Treatment Fails.”


Your tooth is in peril if its innermost layer, the pulp, becomes infected and inflamed. Deep tooth decay, repeated dental procedures or fractures can all expose the pulp and ultimately the roots to infection and lead to tooth loss.

But that scenario isn't inevitable — we can often save the tooth with a root canal treatment. By accessing the tooth's interior through a prepared hole, we're able to clean out the infected tissue in the pulp chamber and root canals, and fill the empty space with a special filling. We then cap the tooth with a custom crown to protect it from a re-infection.

Root canal treatments have a very high success rate — chances are good your tooth will survive for many years afterward. But there's a slight chance the tooth may become re-infected; in that case, a second root canal treatment may be in order.

In a few cases, though, a second root canal may not be advisable, and could even accelerate damage to the tooth. For example, if past dental work resulted in an extensive crown restoration, accessing the root canals the conventional way will require disassembling that restoration. This could weaken the tooth significantly.

We can approach the problem from a different route: instead of accessing the tooth's interior through the crown (the visible part of the tooth), we instead perform a surgical procedure called an apicoectomy, which accesses the tooth at the root end through the gums.

In this procedure we numb the area with local anesthesia and then make a small incision through the gums at the level of the affected root. After access, we remove any diseased tissue around the root and a few millimeters of the root tip itself. We then insert a small filling in its place to seal the canal and prevent further infection. In some cases we may also insert a graft to encourage bone growth and aid in healing.

Over time, the affected area will heal and return to normal function. Even if a traditional root canal treatment can't be used, an apicoectomy could be another option for saving your tooth.

If you would like more information on your options for preserving a problem tooth, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Apicoectomy.”

By Lexington Endodontics
July 20, 2016
Category: Dental Procedures
Tags: Apicoectomy  

Find out more about this endodontic surgery and how it could save your tooth.

Decay and infection can take down even the most resilient of teeth. Fortunately, a root canal is often the solution you need to protect your  teeth from further damage and to save your smile. However, there are some rare cases in which infected tissue within the tooth remains apicoectomyin the tips of the canals, making it almost impossible to heal. If this happens, then our Lexington endodontist Dr. Ramzi Antoine Sarkis may recommend an apicoectomy.

What is an apicoectomy?

This endodontic treatment is designed to treat a dental infection that will not go away with traditional root canal treatment. During this procedure, the apex, or tip of the root is removed along with any infected tissue to preserve the rest of the tooth and prevent a future infection or need for a tooth extraction.

When is an apicoectomy recommended?

If you’ve had a root canal in the past and the same tooth has become infected again, this can often be because the apex of the root, where small branches come off the main canal, still have bacteria. When this happens, your Lexington dentist will recommend another root canal. If root canal retreatment is unsuccessful or not recommended, then an apicoectomy is the next best option.

How is it done?

After administration of adequate local anesthesia a tiny incision is made in the gums and the gums are carefully lifted away from the tooth. Lexington endodontist Dr. Ramzi Sarkis is highly trained in, and also teaches, microscopic surgery will use ultrasonic instruments to access the root of the tooth disinfect and seal the canal. The use of the dental operating microscope and ultrasonic instruments is critical to the success of the apicoectomy. X-rays will also be taken before the gums are stitched back up. This procedure takes anywhere from 60 to 90 minutes depending on which tooth is being treated and how severe your condition is. Front teeth often take the shortest amount of time to treat, while molars take the longest time.

Whether you are experiencing dental pain or you just need to schedule a consult or get a second opinion, turn to the dental professionals at Lexington Endodontics to keep your smile preserved for life.

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Lexington Endodontics

Lexington, MA Endodontist
Lexington Endodontics
922 Waltham Street, Suite 204
Lexington, MA 02421
(781) 325-8181