Endodontic microsurgery in Rugby

When infection lingers at the tip of a root and cannot be treated through the crown of the tooth, a small surgical procedure — an apicectomy — removes the infected root tip and seals the canal from the outside. Under magnification it is a gentle, predictable way to keep a tooth that would otherwise be lost.

When surgery is the right option

infection that has not resolved after root canal treatment or retreatment;
a tooth with a post and a sound crown that would be damaged by reopening it;
a canal blocked or sharply curved near the root tip;
a cyst or lesion at the root tip that needs removing;
a fractured instrument or extruded filling material beyond the end of the root.

Where retreatment through the tooth is feasible it remains the first choice; surgery is reserved for cases it cannot resolve.

The procedure

Anaesthetic. The area is numbed with local anaesthetic, exactly as for a filling.
Access. The gum over the root is lifted as a small flap and a window a few millimetres across is opened in the bone.
Removing the infection. The infected tip of the root and the inflamed tissue around it are removed.
Sealing the root end. A small cavity is prepared in the cut root surface with ultrasonic tips and filled with a biocompatible material.
Closing. The gum is replaced and held with fine stitches, removed about a week later.

Recovery

Expect a few days of swelling, and sometimes bruising, which cold packs and ordinary painkillers keep comfortable. The majority of patients return to work the following day. Keep the area clean with a gentle mouthwash rather than brushing it in the first week and avoid strenuous exercise for a day or two. Healing of the bone is confirmed on a follow-up X-ray later in the year.

Outcomes

Root-end surgery performed with magnification and current materials has good success rates. The outlook depends on the tooth — its bone support, the quality of its crown and the absence of a crack — and is compared honestly with retreatment and with extraction before you decide.

Related endodontic care

Root canal treatment

Root canal treatment ends the pain of an inflamed or dead nerve, clears the infection and keeps the tooth. In Rugby it is carried out under magnification, with the tooth fully numbed and isolated, and most teeth are completed in a single visit.

Root canal retreatment

When a root-treated tooth becomes painful or infected again, retreatment can usually save it. The earlier root filling is removed, the canal system is cleaned thoroughly — including any canals missed first time — and the tooth is sealed and restored once more.

Microscope-assisted endodontics

Root canals can be finer than a hair and hide behind calcified dentine. Working under an operating microscope gives bright, magnified sight of the inside of the tooth — the difference between guessing and seeing. It is how every root canal treatment and retreatment is carried out here.