Endodontic surgery can help to save your tooth by treating damaged root surfaces and surrounding bone. Surgery may also be used to make a diagnosis in the case that symptoms are present but no problems appear on your x-ray by allowing the endodontic to examine the root of your tooth. If your tooth has calcification (calcium deposits which make the canal too narrow to perform a root canal) endodontic surgery may be necessary to clean and seal the remainder of the canal.
The most common endodontic surgery procedure is the apicoectomy. Apicoectomy is an effective procedure involving the surgical removal of a root end cavity and sealing of the root canal. The purpose of this procedure is to fight infection in the tissues surrounding the tip of the root, thereby saving the tooth from extraction.
If the nerve within your tooth becomes infected, successful root canal treatment can keep you from losing the tooth while treating the infection before it causes health complications.
Properly performed, a root canal is no more uncomfortable than having a cavity filled, though the procedure is more complex. It is the removal of infected or dead pulp (the inner nerves and blood vessels) from inside the tooth, and the filling and sealing of the resulting space.
An infected (abscessed) tooth causes discomfort in the form of swelling and toothache. It can also cause severe health complications, because the bacteria from the infection can enter the bloodstream and travel to other parts of the body.
One way to treat the infection is to remove the tooth and disinfect the area. However, tooth loss creates a gap between surrounding teeth that often necessitates a dental implant or bridge. It is preferable to save the tooth if possible through root canal (endodontic) treatment.
The dentist begins by applying local anesthesia and isolating the area with a rubber dam. Then they drill an opening in the tooth to access the infected pulp, and remove it and clean the area with specialized tools. The dentist fills the root space with a filling material. Finally the dentist must seal the surface of the tooth with a crown to prevent further infection and restore the function and appearance of the tooth.
The root canal treatment is typically performed in one visit. A second visit may be required to complete the crown restoration.
With the appropriate care, your teeth that have had endodontic treatment will last as long as other natural teeth. Yet, a tooth that has received treatment may fail to heal or pain may continue to exist. Sometimes, the pain may occur months or years after treatment. If so, Endodontic Retreatment may be needed.
Improper healing may be caused by:
• Curved or narrow canals were not treated during the initial treatment.
• Complicated canals went undetected during the initial treatment.
• The crown or restoration was not placed within the appropriate amount of time following the procedure.
• The crown or restoration did not prevent saliva from contaminating the inside of the tooth.
In some cases, new problems can influence a tooth that was successfully treated:
• New decay can expose a root canal filling material, causing infection.
• A cracked or loose filling or crown can expose the tooth to new infection.
Once retreatment has been selected as a solution to your problem, the doctor will reopen your tooth to gain access to the root canal filling material. This restorative material will be removed to enable access to the root canal. The doctors will now clean your canals and carefully examine the inside of the problematic tooth. Once cleaned, the doctors will fill and seal the canals and place a temporary filling in the tooth.
At this point, you will need to return to your dentist as soon as possible in order to have a new crown or restoration placed on the tooth to restore full functionality.