Endodontics is a sub-speciality of odontology that deals with the study and treatment of the tooth pulp (nerve) diseases. Root canal therapy is made by cleaning and shaping the canal and later filling it with a special material before sealing it permanently. This treatment is recommended for severe cases of cavities in order to avoid removing the tooth.

Ongoing training and new technologies such as microscopy, ultrasound and digital X-ray are tools today for a high quality treatment and improve the prognosis of the case.

In a few cases, however, nonsurgical endodontic treatment alone cannot save the tooth, In such a case, your dentist or endodontists may recommend a surgery.

Who does the endodontic treatment?
Endodontists in addition to treating routing cases they are expert in performing complicated procedures including surgery. This special training and experience can be very valuable when endodontic surgery is necessary.

Why would I need endodontic surgery?
Surgery can safe your tooth in a variety of situations.

  • Surgery may be used in diagnosis. If you have persistent symptoms but no problems appears on your x-rays, your tooth may have a tiny fracture or canal that could be not detected during nonsurgical treatment . In such a case the surgery allows your dentist to examine the root or your tooth, find the problem and provide the treatment.
  • Sometimes calcium deposit make a canal too narrow for the cleaning and shaping instrument used in nonsurgical root canal treatment to reach the end of the root. If your tooth has this calcification , your endodontists may perform endodontic surgery to clean and seal the reminder of the root canal.
  • Usually, a tooth that has undergone a root canal can last the rest of your life and never need further endodontic treatment. However, in a few cases, a tooth may fail to heal. The tooth may become painful or diseased months or even years after a successful treatment. If this is true for you, surgery may help save your tooth.
  • Surgery may also be performed to treat damaged root surfaces or surrounding bone.

Although there are many surgical procedures that can be performed to save a tooth, the most common is called: apicoectomy or root end resection. When inflammation or infection persists in the bony area around the end of your tooth after a root canal procedure, your endodontists may have to perform a apicoectomy.

What is an apicoectomy?

In this procedure, the endodontists opens the gun tissue near the tooth to see the underlying bone and to remove any inflamed or infected tissue. The very end of the root is also removed.

A small filling can be placed to seal the end of the root canal and few stitches or sutures are placed in the gum to help the tissue heal properly.

Over a period of months, the bone heals around the end of the root.

Are there other types of endodontic surgery?
Other surgeries endodontists might perform include dividing a tooth in a half. Repairing an injured root or even removing one or more roots. Your endodontists will be happy to discuss the specific type of surgery your tooth requires.

In certain cases, a procedure called intentional replantation may be performed. In this procedure a tooth is extracted, treated with a endodontic procedure while it is out of the mouth and the replaced in its socket.

These procedures are designed to help to save your tooth.

Will the procedure hurt?
Local anesthetic makes the procedure comfortable and with modern techniques like Dental Microscope and ultrasonic tips, most patients report to feels  fine during and after the procedure. Of course, you may feel some discomfort or experience slight swelling while the incision heals. This is a normal for any surgical procedure. Your endodontists will recommend appropriate pain medication alleviate your discomfort.

Your endodontists will give you specific postoperative instruction to follow. If you have questions after your procedure, or if you have a pain that does not respond to medication, call your endodontists.

Can I drive myself home?
Often you can, but you should ask your endodontists before your appointment so that you can make transportation arrangements if is necessary.

When can I return to my normal activities?
Most patients return to work or other routine activities the next day. Your endodontists will be happy to discuss your expected recovery time with you.

How do I know the surgery will be successful?
Your dentist or endodontists is suggesting endodontic surgery because he or she believes is the best option for you. Of course; there are no warranties with any surgical procedure. Your endodontists will discuss your chances for success so what you can make an informed decision.

What are the alternatives to endodontic surgery?
Often, the only alternative to surgery is the extraction of the tooth. The extracted tooth must then be replaced with an implant, bridge or removable partial denture to restore chewing function and to pervert adjacent teeth from shifting. Because these alternatives require surgery or dental procedures on adjacent healthy teeth, endodontic surgery is usually the most cost effective option for maintaining your oral health.

No matter how effective modern tooth replacements are-and they can be very effective- nothing is as good as a natural tooth. You´ve already made an investment in saving your tooth. The pay off for choosing endodontic surgery could be a healthy, functioning, natural tooth for the rest of your life.