What Is Endodontic Microsurgery?
Endodontic microsurgery, often referred to as apicoectomy or root-end surgery, is a specialized procedure performed by endodontists to address complex issues that cannot be resolved through traditional root canal therapy. It may be used to diagnose the problem or to remove calcium deposits that get in the way of root canal treatment. In cases where a past root canal treatment has failed (which could happen years after the initial treatment), microsurgery can often save the tooth.
Why an Endodontist Might Recommend Microsurgery
We typically perform microsurgery when conventional methods prove insufficient in resolving persistent infections, abscesses, or other challenges affecting the tooth’s root canal system. The primary goal of endodontic microsurgery is to save a compromised tooth and prevent the need for extraction.
This procedure is characterized by its precision, as endodontists use advanced magnification and illumination tools, including a dental operating microscope, to visualize the intricate structures within the tooth. This level of detail allows for precise identification and treatment of tiny anatomical variations or hidden canals that may contribute to persistent issues.
Microsurgery is often indicated when traditional root canal therapy hasn’t effectively resolved a problem, and the source of infection or inflammation remains within the tooth. By accessing the root tip directly, the endodontist can remove any diseased tissue, thoroughly clean the area, and seal it to prevent future infections. This meticulous approach enhances the success rate of the procedure and contributes to the preservation of the natural tooth, a primary objective in endodontics.
The Microsurgery Process
Here is an overview of the microsurgery process:
- • Diagnosis and Assessment: The process begins with a thorough examination, often involving advanced imaging such as cone-beam computed tomography (CBCT), to precisely diagnose the issue within the tooth.
- • Patient Preparation: The patient is prepared for the microsurgical procedure, usually involving local anesthesia to ensure a pain-free experience.
- • Access Opening: An access opening is created in the gum tissue near the affected tooth to expose the root tip.
- • Microscopic Visualization: The endodontist uses a dental operating microscope, providing enhanced magnification and illumination, to visualize the intricate structures within the tooth. This level of detail allows for precise identification of anatomical variations, fractures, or hidden canals.
- • Root-end Resection: A small section of the root tip (apex) is removed, along with any surrounding infected or damaged tissue. This is often referred to as an apicoectomy.
- • Cleaning and Shaping: The endodontist thoroughly cleans and shapes the root canal space to remove any remaining diseased tissue and debris.
- • Sealing the Root-End: The endodontist seals the root-end with a biocompatible material, such as MTA (Mineral Trioxide Aggregate), to prevent the re-entry of bacteria and promote healing.
- • Suturing: The gum tissue is carefully sutured back into place to facilitate proper healing.
- • Postoperative Care: The patient is provided with postoperative care instructions, including information about medications and follow-up appointments.
The Tools That Make Microsurgery Possible
In order to work on such a small scale, our endodontist needs very special equipment. This includes magnification to see the root tip better and a number of surgical tools to work on the affected area, from curettes that remove diseased hard and soft tissue to probes and explorers that measure and access diseased areas to pluggers and burnishers that place the filling and finish up.
Your Microsurgery Is in Good Hands at H.H. Hancock III in Raleigh
If you’ve been having problems with a previous root canal, don’t delay! Contact us here so that our endodontist can take a look. Your tooth could benefit from microsurgery. You can learn more about us by checking our business page, and make sure to get directions before heading our way.