Endodontic Microsurgery

Endodontic Microsurgery is so named because the microscope and special microsurgical instruments are utilized during the procedure. The increased magnification and illumination greatly improve the diagnostic capabilities and the precision of surgical procedures.

Why would I need Endodontic Microsurgery?

Generally, a root canal treatment is all that is needed to save teeth with an injured pulp from extraction. Occasionally, this non-surgical procedure will not be sufficient to heal the tooth and Dr. Heitman will recommend surgery. Endodontic surgery can be used to locate root fractures or hidden canals that do not appear on x-rays, but can account for pain in the tooth. Damaged root surfaces or the surrounding bone may also be treated during this procedure. The most common surgery used to save damaged teeth is an apicoectomy or root-end resection.

What Is Apicoectomy?

An incision is made in the gum tissue to expose the bone and surrounding inflamed tissue. The damaged tissue is removed along with the end of the root tip. A root-end filling is placed to prevent reinfection of the root, and the gum tissue is sutured. The bone naturally heals around the root over a period of months, restoring full function. This procedure is performed in the office with local anesthesia and without discomfort. Following the procedure, there is minimal soreness while the area heals.

After Your Treatment

The tooth may be tender or sore for a few days, especially to touch or bite. This reaction is normal and has no bearing on the successful outcome of treatment. Usually, ibuprofen (Advil), aspirin, Tylenol, or any similar pain medication that you take for minor discomfort will take care of the soreness. If you have severe pain that is not relieved by one of these medications, or if swelling should occur, please call our office. If an antibiotic has been prescribed, take the antibiotics on schedule and always until completed.

If you have discomfort or swelling, use hot salt water as follows: place one teaspoon of salt in a glass of hot water. Take a sip and hold it in the area of soreness or swelling until the water cools off. Then empty this out and take another sip. Repeat this procedure for five minutes every hour as needed. This increases the circulation in the area, eases the discomfort, and helps the body fight any infection that may be present.

Eating or drinking is not usually a problem after the appointment. However, the tooth may be sore, or if it is a posterior tooth, it may be weakened until your dentist restores it with a crown, so in those situations, avoid heaving chewing on the tooth.

Endodontic Retreatment

With the appropriate care, teeth that have had endodontic treatment will last as long as other natural teeth. Occasionally, however, a tooth that has received treatment may fail to heal or pain may continue. This problem may occur months or even years after treatment. If so, endodontic retreatment may be needed. In this situation, the tooth is reopened, the root canal filling is removed, and the canals are again cleaned. With the use of the microscope, the interior of the tooth and the canals are inspected for extra canals or cracks. If there are no cracks, the canals are resealed. The presence of a crack may necessitate surgery or extraction.

Instrument Sterilization

We adhere to the most rigorous standards of infection control advocated by OSHA, the Centers for Disease Control and the American Dental Association. We utilize autoclave sterilization, barrier techniques, "closed water" systems, and disposable instruments and supplies to eliminate any risk of infection.