Below the hollow enamel surface of your teeth (the crown) lies an area of tissue known as the pulp chamber. Inside the pulp chamber there are nerves and blood vessels that carry nutrients to help keep your teeth healthy, strong and hydrated. The soft tissue in the pulp chamber also provides sensitivity to hot or cold stimuli. The area of the tooth where nerves and blood enter the pulp chamber is called the apex. If a tooth infection reaches the pulp chamber it will likely cause moderate to severe pain. In those cases a dentist will typically perform an endodontic treatment known as a root canal. A root canal is designed to remove the infected dental pulp and clean the canals through which nerves and blood travel up to the apex. Some teeth have one root, although many teeth have multiple roots and nerve canals. Root canal treatment are not always successful and they may fail for a number of reasons. Traditional dental x-rays don’t capture the unique 3-dimensional nature of a tooth or dental instruments may not reach the apex of the nerve canal.
If a root canal procedure fails to completely remove an infection, the tooth will likely become re-infected and may have pain or swelling. An apicoectomy, is a treatment option when root canal treatment has been unsuccessful. An apicoectomy is a procedure that involves the removing the apex (tip) of the tooth root and any infected tissue in the area.
This procedure should be performed by a surgical specialist, such as an Oral and Maxillofacial Surgeon (Oral Surgeon). Dr. Calat, has extensive specialty training and experience with this procedure. Prior to deciding if an apicoecotmy is your best choice, Dr. Calat will review your medical and dental history and perform a careful examination. In our office we have a 3-dimensional x-ray machine (I-CAT). This may be recommended and can help confirm your diagnosis, to make certain that an apicoectomy is best treatment choice for you.
Dr. Calat often uses the Waterlase laser for apicoectomies, this can significantly help with your procedure and recovery. The Waterlase laser can be used to gently remove the infection and make the procedure less traumatic then if the apicoectomy is performed with traditional instruments.
An apicoectomy can be performed with either local anesthesia or IV sedation / general anesthesia in about an hour and dissolving sutures are normally used. As with any surgical procedure post operative treatment may include antibiotics and appropriate pain medication will be prescribed. After your procedure, you will be seen for follow-up care. For post-surgical information should visit out patient care page here. After consulting with an Manhattan Oral Surgeon about your particular condition, you may find that the apicoectomy procedure may be the most effective option or the prognosis on an apicoectomy for your tooth is not favorable. In this situation we may suggest you consider a tooth extraction and dental implant procedure instead.
If you would like to consult with Dr. Calat about an apicoectomy procedure please call 212-696-2677 in New York City, 201-659-6999 in Hoboken, or email us.