Endodontic Surgery

Why Might You Require Endodontic Treatment?

All dentists are trained in general root canal treatment. However, more complex cases requiring surgical intervention are referred to Endodontists because of their special training and experience with dental pulp and the surrounding tissue.

Endodontic surgery may be necessary for a variety of reasons. On occasion, a diseased tooth that has had non-surgical endodontic treatment may fail to heal. The tooth may spontaneously become painful or infected, years after successful treatment. The tooth may experience complication due to damage to bone or tooth structure, or if one of more of the root canals could not be successfully cleaned without a surgical approach. In any of these cases, the Endodontist will need to perform a follow-up surgery to clean and seal the remainder of the canal(s).

What's Involved in a Surgical Root Canal Procedure?

After the administration of sedation or local anesthetic, the Endodontist creates an access through the gums in order to visualize the underlying bone. By assessing the area surrounding the tip of the root, infected tissue can be identified and removed.

The tip of the root is then trimmed and a space is created using precise ultrasonic instruments. The root end is then filled and the gums carefully structured in place to maximize tissue healing. Over time – which can be months to years – the area around the root tip will heal with bone.

What Are the Other Types of Endodontic Surgery?

Other endodontic surgeries include procedures like hemisection, where the tooth is divided in half, with one half of the tooth removed. This surgery is performed when decay or loss of bone has extended to the area between the tooth roots, otherwise known as furcation. The division of the tooth provides an easier access to the area, making it easier to clean and treat.

Another type of endodontic surgery is root amputation, where one or more of an infected or damaged root is entirely removed from a multi-root tooth. This procedure is meant to save the tooth and avoid the need for dental implants or bridgework that would otherwise follow an extraction. After a root amputation, it is crucial to perform a root canal treatment.

Hemisection and root amputation procedures are usually performed as a temporary solution to allow for adequate bone healing. An implant is usually then placed later on.

A third surgical treatment is intention replantation, where the tooth is extracted temporarily, rapidly treated, and then immediately placed back into the socket. This serves as a treatment option in cases where tooth restoration with a dental implant or bridge is not practical.

Another related procedure is autogenous tooth transplantation, or autotransplantation, where a tooth is taken from an inconspicuous area of the mouth and placed into the site of a freshly extracted tooth. This surgery is an excellent method of tooth replacement for some patients.

All of the procedures mentioned above are designed to save natural teeth or maintain optimal function for the patient. For more information on these other surgeries, feel free to as Dr. Isaac for more details during your consultation.