Why do I need an endodontic surgery?

  • Surgery used to aid in diagnosis is called ‘exploratory surgery’. If you have persistent symptoms but no problems appear on your x-ray, your tooth may have a tiny fracture or canal that could not be detected during nonsurgical treatment. In such a case, surgery allows your endodontist to examine the entire root of your tooth, find the problem, and provide treatment. With recent advances in cone beam imaging technology, it is possible that we can diagnose the root cause of the problem with just a three dimensional CBCT image & hence avoid this surgical procedure altogether.

  • If unable to achieve the desired outcome with re-treatment alone due to nonnegotiable obstruction in the canal or unusual canal anatomy that are hard to clean with re-treatment, additional endodontic surgery is required to clean and seal the remainder of the canal.

  • In a few cases, a tooth may not heal even with the best efforts or become re-infected. A tooth may become painful or diseased months or even years after successful treatment. This can due to highly resistant infections that did not respond to initial treatment/re-treatment. If this is true for you, surgery may help save your tooth.

  • Surgery may also be performed to treat damaged root surfaces or surrounding bone.How is it performed?

How is it performed?

After numbing, an incision is made in the gum tissue to expose the root and surrounding inflamed tissue. The damaged tissue is removed along with the end of the root tip. A root-end filling is then placed to prevent reinfection of the root and the gum is sutured. The bone naturally heals around the root over a period of months restoring full function.

Other types of surgeries include dividing a tooth in half (Hemisection), repairing an injured root (Surgical repair of perforation defects, invasive cervical resorption), or removing one or more roots (Root amputation).

In certain cases, a procedure called intentional replantation may be performed. In this procedure, a tooth is extracted, treated with an endodontic procedure while it is out of the mouth, and then replaced in its socket. We will be happy to discuss the specific type of surgery your tooth requires in detail during your initial visit to our office.

* Pictures reproduced with permission from the American Association of Endodontists