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Apicoectomy page 2
Before the procedure, you will have a consultation with your dentist. Your general dentist
can do the apicoectomy, but with the advances in endodontic microsurgery, it is best to be
referred to an endodontist.

Your dentist may take X-rays and you may be given an antimicrobial mouth rinse,
anti-inflammatory medication and/or antibiotics before the surgery.

If you have high blood pressure or know that you have problems with the epinephrine in
local anesthetics, let your dentist know at the consultation. The local anesthetic used for an
apicoectomy has about twice as much epinephrine (similar to adrenaline) as the anesthetics
used when you get a filling. The extra epinephrine constricts your blood vessels to reduce
bleeding near the surgical site so the endodontist can see the root. You may feel your heart
rate speed up after you receive the local anesthetic, but this will subside after a few minutes.

How It's Done
The endodontist will cut and lift the gum away from the tooth so the root is easily accessible.
The infected tissue will be removed along with the last few millimeters of the root tip. He or
she will use a dye that highlights cracks and fractures in the tooth. If the tooth is cracked or fractured, it may have to be extracted, and the apicoectomy will not continue.

To complete the apicoectomy, 3 to 4 millimeters of the tooth's canal are cleaned and sealed.
The cleaning usually is done under a microscope using ultrasonic instruments.
Use of a surgical microscope increases the chances for success because the light and
magnification allow the endodontist to see the area better. Your endodontist then will
take an X-ray of the area before suturing the tissue back in place.

Most apicoectomies take between 30 to 90 minutes, depending on the location of the tooth
and the complexity of the root structure. Procedures on front teeth are generally the shortest.
Those on lower molars generally take the longest.

Sean P. Hart D.D.S ,M.S.D., P.C.
1533 Kossuth St. Lafayette, Indiana 47905
p: 765-742-8792