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Endodontics (Root Canal)

Root Canal Surgery

Manhattan, New York

In some cases, an infection persists or recurs around the tooth even after routine root canal surgery has been completed. In such cases it becomes necessary to surgically access the infection through the gum and bone tissues and clean it out from around the root of the tooth. This is called "Surgical Root Canal Therapy" (SRCT).

There are different types of endodontic surgeries:

Root Canal Surgery
Extracting the Root

Apicoectomy
Apicoectomy - Root Canal Surgery

Infected Root
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Apicoectomy is the most common surgery performed. It is apical surgery which involves accessing the tip of the root directly, removing diseased tissue, and preparing and filling the root tip itself (Steps of the procedure)

Pros of Apicoectomy
The overall success rate is 80 - 85% when measured at ten years after the procedure. A ten-year success will most likely continue to hold up for the life of the tooth. This is all the more remarkable when one considers that the procedure is typically performed on failing teeth to begin with.

Cons of Apicoectomy
The downside of apicoectomy is primarily that it requires a surgical procedure to perform and therefore there is a brief postoperative recovery period to negotiate. While many patients prefer to have only a local anesthetic (the administration of numbing medicine to the area being worked on) more often patients choose to be asleep or sedated. That is a decision best left up to the doctor and patient and can be explored more fully during your consultation visit.

Post Operative Care Instructions for an Apicoectomy


Steps of Apicoectomy Procedure
Step 1 The endodontist opens the gum tissue near the tooth to see the underlying bone and to remove any inflamed or infected tissue. The very end of the root is also removed. Step 2 A small filling may be placed to seal the end of the root canal, and a few stitches or sutures are placed in the gum to help the tissue heal properly. Step 3 Over a period of months, the bone heals around the end of the root.
Apicoectomy - Root Canal Surgery Step 1

Remove Infection
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Apicoectomy - Root Canal Surgery Step 2

Filling Added
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Apicoectomy - Root Canal Surgery Step 3

Bone Healed
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Apicoectomy Xrays
Apicoectomy - Root Canal Surgery x-ray
Apicoectomy x-ray
Root Canal Surgery x-ray


Root Amputation

Root amputation is the removal of selected roots.


Intentional Replantation

Intentional replantation is the removing and reinserting of the tooth. Instructions on what to do if your teeth are knocked loose:

Tooth Replantation
Accidents and sports injuries can lead to the avulsion (loss) of a tooth. Once a tooth has fallen out, it can be saved if it is replanted as soon as possible. However, it may not always be possible to see a dentist immediately.

To ensure the best outcome, call your dentist immediately. Do not clean or touch the root surface of the tooth. The cells on the root surface must be preserved and kept moist. Place the tooth in a solution of isotonic saline from the pharmacy, or in cold milk to keep it moist. Replantation within two hours provides the best results.

Copyright © 2008 Dr. Michael Iott