Apicoectomy in Greenbrae CA

Root Canal Surgery

The root canal system is the hollow space inside teeth that houses the nerve and blood vessel, which supply your tooth with hot and cold sensitivity. If a tooth has a deep cavity (or caries) that reaches into the pulp space or is significantly injured, the nerve and blood vessel may become inflamed or infected to such a point that it cannot heal on its own. In these instances, a root canal treatment (RCT) is a procedure performed either by an endodontist (root canal specialist) or general dentist that essentially removes the nerve, blood vessel, and any bacteria from the center of the tooth to eliminate pain and infection. For teeth with long-standing or significant infections that have developed at the tip of the tooth’s root, a root canal procedure is occasionally not enough to completely resolve the existing infection at the root tip. In these cases, your endodontist or general dentist may refer you to Dr. Mynsberge for a procedure called an “apicoectomy.”

The term “apicoectomy” literally translates to removal (Latin –“ectomy”) of the tip or apex (Latin –“apico”). That is exactly what an apicoectomy procedure entails: removal of the tip of the tooth root. There are two main reasons that a root canal treatment (RCT) may not have been able to completely eliminate the infection at the tip of the root. First, a long-standing infection can become “walled-off” and form into an infectious or inflammatory cyst, which is a cavity of pus protected by a thick layer of cells that can make it impenetrable to both root canal treatments and antibiotics. Second, the last 3-4 mm of the tip of a tooth root can sometimes contain a high concentration of “lateral canals,” which are small passageways that travel out the side of the tooth that, despite the efforts of even the most experienced and skilled endodontist, can be impossible to completely clean bacteria out of. In these instances, the apicoectomy procedure (removal of 3-4 mm of the tooth root tip) can definitively eliminate bacterial infection from the tooth by removing both the walled off cyst and the portion of the tooth that contains those pesky “lateral canals.”

In these situations, an apicoectomy can eliminate long-standing infection and help save your tooth from needing to be extracted!