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Apicoectomy

The teeth are held firmly in place by strong roots that extend into the jawbone. Molars and premolars tend to have several roots, whereas the front incisors only have a single root. The end or tip of each root is termed the apex. The apex is where the nerves and blood vessels enter the tooth, and aids in the delivery of blood to the crown (the part of the tooth you can see in your mouth).

A root canal treatment refers to the cleaning of the canals and the removal of infected and inflamed tissue within the root. When the inflammation or infection persists after the root canal treatment, an apicoectomy may be required. An apicoectomy is essentially the removal of the apex (or root tip), followed by a filling procedure to seal the root from further infection. When left untreated, infected roots can damage other teeth, spread infection, and cause regression of the jawbone.

Reasons for an apicoectomy

Infected and inflamed soft tissue around the root of a tooth can be exceptionally painful and debilitating to the patient. The purpose of an apicoectomy is to eliminate the infection in the tissue and to ultimately preserve the function of the tooth and save it from extraction. An apicoectomy will rarely be considered by the dentist unless a prior root canal treatment has failed.

There are several reasons why an apicoectomy may be necessary:

  • Small Adjoining Root Branches – Roots are extremely complex and can contain many tiny branches. If these tiny branches cannot be cleaned and sealed when the root canal treatment is performed, inflammation can persist.
  • Blocked Root Canal – In some cases, the dentist is unable to effectively clean a root canal because it is blocked by a fractured file left behind from prior root canal treatment. Infection and debris can quickly affect adjacent teeth.
  • Narrow or Curved Root Canals – When the root canal is poorly shaped, the endodontic files cannot reach the root tip. Continuing infection or re-infection can then occur.

What does getting an apicoectomy involve?

Prior to the surgery, the dentist will generally prescribe an antibiotic or anti-inflammatory medication to treat the underlying infection. Panoramic x-rays will then be taken to enable the dentist to plan the apicoectomy, which will be performed under local anesthesia.

The dentist will make a small incision in the gum and expose the root by lifting away the gum. In some cases, a tiny fraction of the jawbone may be removed to properly expose the root. The edge of the root tip and any infected connective tissue will be removed using ultrasonic instruments. The root will be sealed using a retrofill (filling material) and the dentist will suture the gum with several stitches.

This surgery does not require an overnight stay, and full aftercare instructions and pain medications will be provided as needed. After several days, the dentist will remove the stitches, and the connective tissues will fully heal several months after the procedure.

If you are experiencing any signs or symptoms, such as pain or swelling associated with a tooth that has had a root canal, we encourage you to contact our office immediately to schedule an appointment.

Testimonials.

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Testimonials

I loved my experience at Dr. Lopez's office. 20 years ago I had several unsightly metal fillings put in my mouth. Also, I've worn my teeth down by grinding considerably over the years. As I grew older, my teeth did not look good to me when I smiled. In July of 2015, I wanted to have all of the metal fillings in my mouth removed, and one of the fillings in particular had already cracked the tooth that it filled. Initially, I was very nervous, but Dr. Lopez and his staff completely put me at ease from the time I walked in the door. The way he rebuilt the grinding damage on my back teeth is remarkable. He is not only a great dentist but a gifted architect and engineer at the same time. I didn't even feel the numbing shots at all, and I actually fell asleep in the chair during the procedure thanks to Dr. Lopez's relaxing demeanor and the calming music in the room. To my wife, I affectionately refer to him as Dr. Lopezzzzzz, now, since I did fall asleep. I would recommend Dr. Lopez to even my closest family. Thank you, again, Dr. Lopez.

Chase H

I went to Dr. Lopez to get veneers on eight teeth (upper, front). From my initial consultation to getting my temporary veneers put in today, I have been consistently impressed by his practice. The entire staff operate as a single, professional team. Extremely courteous, knowledgable, and accommodating, they do everything they can to help patients feel both comfortable and fully informed of everything that goes on during their visit.

My process with the veneers thus far has been extremely smooth and easy. Despite what you may read on the Internet from other people who have gotten veneers elsewhere, Dr. Lopez goes through great measures to ensure that your experience is pain and worry free. He is truly a master at his craft, and his vast experience in the dental profession (equally reflected in his accolades) definitely shows.

I have a check-up for the temporary veneers in the next couple of weeks, and the permanent veneers will arrive shortly thereafter. I have full confidence that the rest of this process will go just as well as it has so far, especially after my visit today. Highly recommend this office for your dental needs. 5/5 stars.

Jason H

I have never liked going to the dentist because of painful past experiences. Shots, rough cleanings, etc. On my first visit, I had a cleaning . There was no pain. I was impressed. And a recent event that required shots, and extractions had me concerned about pain, but Dr. Lopez reassured me not to worry. As he began the shots,NO PAIN AT ALL!!! I was more than impressed! I knew I had found my dentist. Dr. Lopez and his staff are kind, gentle, professional, and the atmosphere is very relaxed and pleasant! I am very pleased, and highly recommend him!!!

Robin T

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Dr. Juan R. Lopez
Phone: 580-536-9647
6941 West Gore Blvd.
Lawton, OK 73505