Apicoectomy (Surgical Root Canal)
A surgical root canal attempts to re-treat a root canal treated tooth that has become re-infected. This is due to bacterial infection again at the root ends outside of the tooth. This infection can then damage the surrounding ligaments and bone of the tooth as well as neighboring teeth. An apicoectomy literally means the removal of the apex of the root of the tooth. This is done with an incision through the gum tissue and once localizing the bacteria, the diseased root end is cut off and the remaining bacterial infection cleaned out.
In order to prevent bacteria from invading this area again, a bone graft filling material is usually placed to seal the area and encourage bone healing of this area to seal the root end. Antibiotics are typically given for healing, and X-rays films are taken at three and nine months after the procedure to determine success of the procedure as measured by bone healing and lack of bacterial infection.
As long as bone fill occurs around the treated root, we can be fairly certain that the apicoectomy procedure will have lasting success. If bacterial re-infection of a root canal treated tooth is due to a hairline crack in the tooth, even an apicoectomy procedure will eventually fail, requiring the eventual removal of the tooth and implant replacement considered.