When it comes to endodontic procedures, you will encounter terms like retreatment and apicoectomy. While both are aimed at preserving your teeth and alleviating pain, they are recommended for different reasons. In this blog post, we’ll explain the nuances of each procedure, highlighting their differences and when we may recommend them.
Understanding Retreatment
Retreatment, also referred to as root canal retreatment, is aimed at salvaging a tooth that has previously undergone root canal therapy but is experiencing persistent issues. This procedure involves re-cleaning and sealing the root canal system to address any remaining infection or inflammation.
How is retreatment done?
It’s important for us to understand why your original root canal treatment is not working and what change can we make to create success. We’ll begin with a thorough assessment to evaluate the tooth’s condition and assess the previous root canal treatment. This evaluation guides our decisions for retreatment and procedure planning. Retreatment can be a great option when a nerve canal was not treated during the initial root canal treatment or if it appears the tooth requires further disinfection from the inside.
We then carefully reopen the tooth to access the root canal system, removing any existing restorations or root filling materials. We locate any untreated canals and meticulously re-clean and disinfect the canals using specialized instruments to remove debris and bacteria, essential for promoting healing and preventing infection.
After cleaning the canals, we then fill them with biocompatible materials to seal off the tooth’s interior and prevent reinfection.
When do we recommend retreatment?
- Missed nerve canals: If any nerve canals were not treated during the initial root canal treatment this can lead to persisting infection within the tooth. We are always using our 3-D imaging in order to evaluate if all nerve canals were treated/ if this could be the reason for an unsuccessful treatment.
- Inadequate disinfection during the initial root canal: Sometimes the root canal system is not cleaned as thoroughly as possible. We make every effort to make sure your root canal system is cleaned as effectively as necessary.
- Leaking fillings/ new decay that compromised the root canal system: these issues can lead to bacterial recontamination of the root canal treatment.
Retreatment offers a second chance to save a tooth that has experienced complications following root canal therapy. By addressing residual infection, retreatment can help you maintain your natural teeth and avoid the need for extraction.
Exploring Apicoectomy
An apicoectomy is an advanced surgical procedure to address persistent issues in a tooth’s root canal system. This procedure becomes necessary when conventional root canal therapy or retreatment is either ineffective or not feasible. During an apicoectomy, we remove the tip of the tooth’s root and seal the nerve canals from the “back side” to eliminate the source of infection and promote healing.
How is apicoectomy done?
The procedure starts with a small incision near the affected tooth. We’ll then remove the tip of the tooth’s root and any diseased tissue, which is crucial for eliminating infection.
Afterward, we shape and clean the “back side” of the nerve canals, ensuring a nice seal of the root canal system. Finally, the incision is closed with sutures, allowing the surrounding gum tissue to heal. We provide post-operative care instructions to aid in the recovery process.
When do we recommend an apicoectomy?
- Failed retreatment: If conventional retreatment of a root canal is unsuccessful or not feasible due to anatomical complexities, an apicoectomy may be a great option to preserve your tooth.
- Calcified canals: Sometimes nerve canals can “obliterate” and make it challenging/ not possible to treat the tooth with a traditional root canal. This is a time when surgical removal of the un-treatable root portion may be necessary.
- Separated instruments: If an instrument was separated in the nerve canal during the original root canal treatment, preventing the clinician from cleaning the root canal system beneath the instrument, an apicoectomy may be required to remove the now inaccessible root canal system.
- Biopsy required: If a root canal infection is persistent or does not resolve, a biopsy of the infectious tissue may be helpful in order to understand the details of the infection. Surgical access is required to retrieve biopsy tissue from the end of the root.
An apicoectomy serves as a valuable treatment option for preserving natural teeth and promoting oral health in cases where conventional root canal therapy or retreatment is insufficient. By addressing underlying issues at the root tip surgically, we can avoid the need for tooth extraction.
Make an informed decision — we can help!
Retreatment and apicoectomy are both valuable procedures aimed at preserving natural teeth and promoting oral health. Understanding the differences between these procedures can help you make informed decisions about your dental care.
At Endodontic Excellence of Atlanta, our experienced team is dedicated to providing the highest quality endodontic care tailored to your unique needs. Whether you require retreatment or an apicoectomy, we’re here to guide you through every step of the process and ensure your comfort and overall well-being.
Contact us today and take the first step toward preserving your natural smile with confidence — no referral is needed!