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Apicoectomy - What is it and when is it used?

What is an apicoectomy? When is it used? How is the procedure done? In this post we talk about apicoectomy, a procedure used in dentistry to treat infections in the root of the tooth.

1) When to perform an apicoectomy

If a tooth has suffered a traumatism and has changed its color, it indicates that it has lost vitality from its internal part, which is commonly known as a dead "nerve". This process causes the internal part of the tooth to become infected, extending to the end of the root, often creating a cyst or granuloma. This cyst can emerge through the gum and can be detected through an x-ray. This also often happens when deep decay has infected the dental pulp (nerve) or after trauma to a tooth.

Apicectomía infección raíz


The initial treatment for these cases is endodontics, also called root canal treatment. This process tries to eliminate necrotic debris to cure the infection. But if with this method the problem is not solved, the next step is the apicoectomy.

2) What is an apicoectomy?

Apicoectomy is a dental procedure used to eliminate an infection in the root of a tooth and adjacent tissues. It is performed in cases where the endodontic treatment has failed, presence of canals or false canals unsealed in teeth, or where the access to the apex is not possible by a conventional root canal treatment.


3) How is an apicoectomy performed?

After taking an X-ray and determining the condition of the tooth root, an incision is performed and sufficient bone is removed to get access to the root apex.  Then the infectious cyst is removed, cleaning and irrigating the area. A beveled shape cut is made to the root removing the apex and sealing the root with different materials. To finish, the area is sutured and over time the healing is completed.

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4) What to do after apicoectomy

Apicoectomy is a simple procedure that generally does not cause severe discomfort to the patient, but the following days after the procedure it is recommended:

4a. Keep the area properly sanitized

It is essential to promote dental hygiene to avoid infections. For this, rinses with chlorhexidine will be prescribed for a week. It is also important to keep brushing teeth after each meal, but avoiding the intervened area.

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4b. Maintain a proper diet

It is recommended to maintain a soft and cold diet for a few days after an apicoectomy. It is also important to avoid chewing with the treated area. The consumption of tobacco and alcohol is also discouraged, since these substances can delay healing.

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4c. Control physical activity

It is recommended to not do sports or great physical efforts on the days following the operation to avoid possible complications.

It is normal to feel a slight pain in the intervened area. For this reason, anti-inflammatories, analgesics and antibiotics are usually prescribed. The area should have fully regenerated after 2-3 months.

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5) Apicoectomy or tooth extraction?

Sometimes the tooth extraction is considered when an infection of this type occurs. However, apicoectomy is a simple process and usually gives very good results, unless the root in question presents a fissure or small fracture, in which case the tooth is almost always condemned to its extraction. As always, diagnosis is the key to success.

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