Dr Michael I. Feinberg DDS
(718) 355-9939

Apicoectomy (Endodontic Surgery)

Why would I need Endodontic Surgery? Generally, a root canal is all that is needed to save a tooth with an injured pulp from extraction. Occasionally, this non-surgical procedure (the root canal) will not be sufficient to heal the tooth and your Endodontist or general dentist will recommend endodontic surgery. The tip of the tooth root is called the apex; "ectomy" at the end of a word implies removing something. Therefore, an apicoectomy implies the surgical removal of the tip of the root of the problem tooth. A draining pimple in the gum above or below the tip of the root of a tooth reveals the infection from the dead nerve inside the tooth has spread beyond the tooth root and into the surrounding bone. This usually happens before root canal therapy is initiated and is resolved by removing the dead nerve. In rare situations, it will happen after a root canal and that suggests that an apicoectomy is needed. This surgical procedure can be used to locate root fractures or hidden canals that do not appear on x-rays but still manifest pain in the tooth. Damaged root surfaces or the surrounding bone may also be treated with this procedure.

Surgical Instructions to Prepare for an Apicoectomy

This procedure is usually performed using local anesthesia. There are usually no restrictions after the procedure concerning driving or returning to work. If you have requested nitrous oxide (laughing gas) or IV sedation, you will receive special instructions at your consultation appointment about driving and recuperation after the procedure.

It is appropriate to eat a light meal and drink fluids before your surgical procedure unless you have elected an IV sedation or Nitrous Oxide/oxygen. In those cases, you must have an empty stomach for 6 hours before your procedure. You should also brush and floss after eating and prior to your arrival for your surgical appointment.

Continue all medications for blood pressure or thyroid problems and any other conditions as recommended by your physician. If you are a diabetic, you should ask your surgeon for special instructions about your pre-operative diet and how to take your insulin or oral hyperglycemic medicines. You will most likely be asked to stop blood thinners (Coumadin) at least three (3) days in advance of surgery. If there is a question, please call our office prior to your appointment.

If you have been advised by your physician or orthopedic surgeon to use antibiotic premedication because of mitral valve prolapse (MVP), heart murmur, artificial heart valve, total hip, total knee or other joint replacement, take your antibiotic one (1) hour before your surgery appointment. If there is a question, please call our office prior to your appointment.