| When
a root canal filling develops a granuloma, cyst, or some
other infected area at the end of the root, dentists will
sometimes endeavor to save the tooth by performing an operation
called apicoectomy. The area of infection seen on x-ray
pictures is actually a hole in the bone of the jaw eaten
away by bacteria and toxins. It contains pus, bacteria and
infected tissue.
The
apicoectomy surgery is done using a local anesthetic. An
incision is made in the gum and the dentist invades the
infected area and curettes away the diseased tissue.
In order
to be able to remove all infected tissue surrounding a tooth's
root end, it is sometimes necessary to also remove a portion
of the tooth's root end (apex). This is done with a surgical
dental burr or drill. The term apicoectomy was adopted because
the end tip of the root is so often removed during this
procedure.
Two
or three stitches are used to close the wound. These areas
experience some swelling for two or three days but generally
heal with very little discomfort. Usually new bone immediately
begins to grow and fill in the jaw at the end of the root,
and after six to 12 months one can no longer distinguish
the location of the infection sight. In other words, the
area's appearance is now normal.
At times
when cysts or other large areas of infection are found,
dentists will elect to do the root canal treatment and apicoectomy
at the same sitting. Generally I preferred doing both procedures
simultaneously because it was much easier to clean out the
root canal that way. In addition, we could spray a disinfectant
through the root canal and vacuum the debris and infected
material out from the root-end surgical area. |
