Micro-Surgical Retreatment

Sometimes, the tools used in a standard root canal treatment can’t reach into narrow canals or canals blocked by calcium deposits. In this case, micro-surgical retreatment can help access these canals to clean them out or remove calcification and then seal them.
In other cases, your tooth may not have appropriately healed after the initial root canal treatment, or you may have suffered an additional infection. These issues can stem from:

• Undetected complications during the initial procedure
• Too much time between the treatment and any additional tooth restoration
• The tooth’s seal allowing bacteria or saliva to enter the inside of the tooth
• Exposure of the root canal filling material from further tooth decay
• A crack or break in the crown or veneer over the tooth
• Loosening of the filling from the previous procedure

These issues may present themselves months or even years after a root canal procedure. Often non-surgical retreatment can treat an infection or a tooth that has failed to heal. Other times micro-surgical retreatment may be the last resort before tooth extraction.

Micro-surgical retreatment, or apicoectomy, involves opening the gum tissue near the top of your tooth to uncover the underlying bone and remove inflamed or infected tissue, as well as the tip of the tooth’s root.
Once removal is complete, our endodontist, Dr. Russo, will apply a root cap and filling material to prevent further infection. A small filling seals the end of the root canal, and a few sutures close the gum tissue so that it heals properly.

Over time, the bone will heal around the end of the root. Unlike after non-surgical retreatment, you may not need to get a new crown or restoration. Since the surgery takes place below the gumline, previous restorations can be left untouched and in place.

Our caring staff will go above and beyond to ensure that your procedure is as comfortable as possible. We use local anesthetics to ensure you won’t feel any pain. After the procedure, you may experience minor swelling and discomfort, which can be managed with over-the-counter pain relievers.

Most of our patients are able to return to work or other activities with a day, though it will take several months for the bone to grow back around your tooth. You’ll leave our office with in-depth instructions to ensure that your recovery goes as smoothly as possible. You’ll also need to return in three to five days after your apicoectomy to remove the sutures, but the appointment will only take 5-10 minutes.

We’ll schedule another follow-up appointment a few weeks after your procedure to check on the healing process. Dr. Russo will examine the surgical area to see if the bone is appropriately forming. You’re always welcome to contact us with any questions or concerns.