When Is an Apicoectomy Needed?

Certified by the American Board of Oral and Maxillofacial Surgery, Dr. Anup Muduli currently treats patients at his own practice in Oakland, New Jersey. Dr. Anup Muduli performs a wide range of surgical procedures on the teeth, jaws, and face, including apicoectomy.

An apicoectomy is a procedure to remove the tip of a tooth root, which is where the nerves and blood vessels enter the tooth from the jaw. Using microscopic instruments, the oral surgeon removes the root tip and surrounding infected tissues. A tiny filling is then placed at the end of the root.

This procedure is often indicated after an unsuccessful root canal treatment. Root canal treatment involves removing infected tooth nerves and pulp from the root canals and inside the tooth crown, and sometimes causes an infection in the tissues at the root tip. Often, infection occurs because of the complexity of root canals, which can be narrow or curved or contain tiny branches, making it difficult for the dentist or oral surgeon to adequately clean out debris. Sometimes, a second root canal treatment is performed and successfully removes the infection; however, more severe cases require apicoectomy. In addition, if the tooth already has a crown, apicoectomy is the only option, as a repeat root canal treatment would destroy the tooth restoration.

Dr. Anup Muduli explains Dental Implant Procedures

Dental implants are an alternative to dentures or bridgework for replacing one or several missing teeth. As the procedure requires many sequential visits, it can be a time-consuming process. The first step in the process involves an x-ray evaluation and a dentist’s assessment of the suitability of the patient’s remaining bone for the procedure. If insufficient bone is an issue, a surgeon may graft bone from other sites in the body to make implants feasible. Certain patients, including those who smoke, may not be suitable candidates.

The second step of the process involves inserting a threaded metal implant into the bone under anesthesia. Next, up to four months of healing are required for the implant to fully fuse with the bone, a process known as “osseointegration.” During this time, the dentist may attach a temporary cosmetic “flipper” to the implant. When the dentist verifies full healing of the implant, a permanent, cosmetically matched crown is attached. Minor bruising and swelling may develop after the operation, but they typically disappear soon afterward.

About the Author: Anup Muduli, DMD, serves as Vice President of the New Jersey Society of Oral and Maxillofacial Surgeons. He currently practices oral and maxillofacial surgery in Oakland, New Jersey.