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