Endodontic surgery: What is it, why and when surgery needed, preparing for surgery and post-care

Endodontic Surgery - What it is

Why do I need Endodontic Surgery?

Endodontic surgery is recommended

When the root canal treated tooth did not heal despite adequate treatment
When conventional non-surgical retreatment is not recommended
In conjunction with conventional root canal retreatment
To explore cracks or possible fractures on the root
To perform biopsies and remove cysts or growths

Before Surgery: Radiograph of cyst	After Surgery: Radiograph of large post

Why do some root canal treated teeth fail?

Root canal treatment aims to eliminate bacteria and disinfect the tooth. However, as the root canal system is very complex, complete removal of bacteria may not always be possible. Accessory canals, especially at the root apices, could allow bacteria to persist despite best efforts to clean them out, giving rise to persistent infection.

Decay, cracks or defective fillings and crowns may allow bacteria to penetrate the root canal filling, eventually causing the root canals to be re-infected.

Some cysts at the root may not heal with root canal treatment alone.

What does it involve?

Endodontic surgery is usually performed under local anaesthesia. If the case is complex, general anaesthesia may be indicated. This procedure is performed with the aid of an operating microscope.
The gums are lifted to expose the bone and tooth beneath.
The root and its surrounding area will be inspected especially for any cracks or fractures.
Diseased tissues are removed and may be sent for a biopsy.
The affected root tip is removed and cleaning and filling of the root canal be performed from the end of the root.
The gums are stitched back.