Dr. Hawryluk has preformed hundreds of successful apicoectomy procedures at his clinic in Port Credit, Mississauga. It is considered an ‘endodontic’ treatment which is a class of dental treatment that involves the inside of a tooth.

An apicoectomy is performed if root canal treatment has failed to resolve an infection around a tooth. It is carried out only after at least one root canal has been performed on the tooth in question. It is usually the last resort in efforts to save a tooth. Sometimes Dr. Hawryluk will perform a second root canal to clear canals that the previous dentist was not able to locate in the first root canal.

If the initial root canal was done at our office your chances of needing an apicoectomy procedure are very low. This is because Dr. Hawryluk ensures the best possible root seal with conventional root canal treatment. One way we ensure this is a dental microscope is used in treating every root canal that is done at our office. The majority of teeth we treat at St. Lawrence Dentistry with apioectomy had their initial root canal work done somewhere else.

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Root Canal Procedures Can Save Teeth

You may need an apicoectomy if your root canal treatment did not remove all infected tissue inside your tooth. Because a tooth canal system is a complex structure, even a root canal re-treatment may not be able to clear the canal completely. This can mean bacteria persists inside the tooth and in the bone in the immediate vicinity of the tooth. Usually the infection occurs at the narrow tips of the root (root apex) and an apicoectomy fixes the problem by removing the root tips along with the infected tissue. The ends of the roots are then sealed. Dr. Hawryluk uses a cement compound called MTA to seal the root which has been found to be highly effective. The process of sealing the end of the root is known as the ‘reterofill’. An apicoectomy allows you to keep the tooth which otherwise may have required extraction because of the infection.

Figure 1: Tooth (Left) which has been successfully treated by the apicoectomy procedure

Before an apicoectomy you will be given an antimicrobial mouth rinse, an anesthetic, and (sometimes) medicine to counter inflammation. The anesthetic can increase your heart rate so please let your Dr. Hawryluk Jr. know if you have high blood pressure. Dr. Hawryluk will then access the root through the gum. At this point the abscess tissue will be visible and it will be completely cleaned out with instruments that look like mini spoons (curette). The root is cleaned and the root tip is removed. To ensure the greatest precision, Dr. Hawryluk uses a surgical microscope so complete visibility of the working area is obtained. An x-ray will be taken of the cleaned area to inspect the work done. Finally, the surgical area is then sutured back. If any cracks or fractures are found in the tooth, it will have to be removed and the apicoectomy will end.

Figure 2: Magnified photograph inside a tooth. Notice crack to the left. This tooth is not a good candidate for apicoectomy procedure due to crack

An apicoectomy can take between 45-90 minutes. This procedure takes the longest on the lower molars because the roots are housed in several millimeters of bone, the bone is more dense in the area, and molars have multiple roots. In contrast the upper front teeth take the least amount of time for the exact opposite reasons.

Many patients find this procedure more comfortable with very mild sedation with Ativan Tablets. We have the tablets at St. Lawrence Dentistry so there is no need to pick them up at a pharmacy. Please inform the staff if you wish to have this. You cannot drive for several hours after taking Ativan.

Dr. Hawryluk will review the post procedure instructions with you in detail. In general, after the procedure you should avoid hard and crunchy foods. Apply ice to the area for around 12 hours after the surgery. Do not rinse vigorously or pull your lips as this may loosen the sutures. The sutures will be removed in around a weeks time. In around fourteen days any remaining swelling is typically gone completely.

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Apicoectomy – Root End Procedure that Can Save Teeth

If you have a tooth which has already had a root canal procedure but is still giving you issues you may be a candidate for this procedure. The first step in treating this possible issue is to have a consultation with Dr. Hawryluk. He will investigate your dental issue and give you all the options. For your convenience our dental clinic is open Saturdays in addition to all the weekdays. Please give us a callclick here if you would like to learn more about this subject.