Your teeth are held in place by roots which extend into the jawbone. Each root carries nerves and blood vessels into the pulp within the tooth. When a tooth is broken or cracked, and the pulp is exposed, it can become infected and become extremely painful. In these cases, a root canal treatment is performed to remove the infected tissue and debris in the canals of the root and seal the tooth's pulp. An apicectomy is usually needed after a root canal treatment has failed to seal the root or there is persisting infection around the apex or root tip within the jaw bone. An apicectomy is a surgical procedure in which the root tip of the tooth and residual infective tissue is removed.
Root canals can be very complex, with many tiny branches off the main canal. Sometimes, even after root canal treatment, infected tissue can remain in these branches. A root canal treatment performed by a dentist for various indications might fail because of persistent infection in the bone around the root tips. Sometimes root cracks go unnoticed even with x-ray examination that can cause the tooth to stay sensitive. A surgical apicectomy might be required in an attempt to save the tooth and relieve any uncomfortable symptoms.
These procedures can be performed under a local anaesthetic, but more invasive procedures require general anaesthetic. Dr Kruger will make a small incision in the gum to expose the tip of the root. He will then remove the tip and any infected tissue and seal the end of the root if required. Bone grafting is usually performed to facilitate healing.
After the surgery, it is quite normal to experience some pain and swelling, but Dr Kruger will try to make you as comfortable as possible and prescribe medication to relieve any pain and discomfort.
Apicectomies are not always successful, and the tooth might still need removal if symptoms continue. A dental implant will then be recommended to replace the problematic tooth.