| When a root canal filling develops a | | | | doing both procedures simultaneously |
| granuloma, cyst, or some other infected area | | | | because it was much easier to clean out the |
| at the end of the root, dentists will | | | | root canal that way. In addition, we could |
| sometimes endeavor to save the tooth by | | | | spray a disinfectant through the root canal |
| performing an operation called apicoectomy. | | | | and vacuum the debris and infected material |
| The area of infection seen on x-ray pictures | | | | out from the root-end surgical area. |
| is actually a hole in the bone of the jaw | | | | |
| eaten away by bacteria and toxins. It | | | | It was also easier to get a good dense root |
| contains pus, bacteria and infected tissue. | | | | canal filling as any overpacking could easily |
| | | | be removed. |
| The apicoectomy surgery is done using a local | | | | |
| anesthetic. An incision is made in the gum | | | | In my practice I did a fair number of these |
| and the dentist invades the infected area and | | | | apicoectomy surgeries and I cannot recall any |
| curettes away the diseased tissue. | | | | which did not show full healing at the end of |
| | | | the root of the tooth, usually within the |
| In order to be able to remove all infected | | | | period of one year. We were not universally |
| tissue surrounding a tooth's root end, it is | | | | successful with teeth treated nonsurgically. |
| sometimes necessary to also remove a portion | | | | |
| of the tooth's root end (apex). This is done | | | | A couple of case history reports from my |
| with a surgical dental burr or drill. The | | | | files will allow you to see how well |
| term apicoectomy was adopted because the end | | | | infections responded to the apicoectomy |
| tip of the root is so often removed during | | | | procedure. |
| this procedure. | | | | |
| | | | The first is of a woman who came home from a |
| Two or three stitches are used to close the | | | | trip to Mexico with severe diarrhea and |
| wound. These areas experience some swelling | | | | intestinal involvement. When a leading |
| for two or three days but generally heal with | | | | Beverly Hills gastroenterologist was unable |
| very little discomfort. Usually new bone | | | | to cure her intestinal infection, the |
| immediately begins to grow and fill in the | | | | patient, knowing I was doing nutritional |
| jaw at the end of the root, and after six to | | | | counseling, sought my opinion. |
| 12 months one can no longer distinguish the | | | | |
| location of the infection sight. In other | | | | Oral examination didn't indicate any obvious |
| words, the area's appearance is now normal. | | | | pathologic conditions or tooth decay, but |
| | | | there were many fillings present. Full mouth |
| At times when cysts or other large areas of | | | | x-ray examination disclosed large abscesses |
| infection are found, dentists will elect to | | | | from accessory canals on both of her upper |
| do the root canal treatment and apicoectomy | | | | lateral incisors (the teeth next to the two |
| at the same sitting. Generally I preferred | | | | front teeth). |