Treatment
Endodontic microsurgery in Market Harborough
When infection persists at the tip of a root and it cannot be treated through the crown of the tooth, a small surgical procedure can remove the infected root tip and seal the canal from the outside. Performed under the microscope with fine instruments, modern apicectomy is far gentler and more predictable than the surgery of the past.
When surgery is the right option
- infection that persists after a well-executed root canal treatment or retreatment;
- a tooth with a post and a good crown, where reopening would damage the restoration;
- a canal that is blocked, calcified or sharply curved near the tip and cannot be reached conventionally;
- a cyst or lesion at the root tip that needs to be removed and examined;
- a fractured instrument or over-extended filling material beyond the root end.
Surgery is not a substitute for retreatment when retreatment is possible; we recommend it when it offers the better chance of keeping the tooth. The assessment includes recent X-rays and, where helpful, a 3D scan arranged through a suitable provider.
What the procedure involves
- Anaesthetic. The area is numbed with local anaesthetic, as for a filling. The procedure is not painful, although you will feel pressure.
- Access. A small flap of gum is lifted to expose the bone over the root tip, and a tiny window is made in the bone.
- Removing the infected tip. The last few millimetres of the root and the infected tissue around it are removed under magnification.
- Sealing the root end. A small cavity is prepared in the cut root surface with ultrasonic tips and filled with a biocompatible material that seals the canal.
- Closing. The gum is repositioned and held with a few fine stitches, which are removed a few days later.
The appointment takes about 60 to 90 minutes. Tissue removed during surgery can be sent for examination where indicated.
Recovery
Expect some swelling and bruising for two to four days, which cold packs and ordinary painkillers control well. Most people return to work the next day. Keep the area clean with a gentle mouthwash rather than brushing it for the first week, avoid strenuous exercise for a couple of days, and come back for stitch removal and a check. Bone healing is reviewed on an X-ray after several months.
How successful is it?
With magnification, ultrasonic root-end preparation and modern filling materials, success rates for microsurgery are high and comparable with other endodontic procedures. As always, the outlook depends on the individual tooth — the amount of bone support, the quality of the crown and whether a crack is present. We discuss the likely prognosis frankly before treatment and compare it with the alternatives, including retreatment and extraction.