Although there are numerous surgical procedures that can save a tooth, this is the most common one performed. It is done when diseased or inflamed tissue around the end of the root will not heal. You may also hear the procedure called a root end resection or surgical retreatment.
The procedure is performed under local anesthesia. After this is achieved Dr. Semashko will make an incision into the gum (soft tissue) near the tooth causing the problem. The tissue is then pushed off (reflected) to expose the underlying bone and infection. Dr. Semashko will then remove the diseased tissue. The last 3 to 4 mm’s of the root will also be resected (removed) and a retrograde filling is placed at the end of the root. This helps seal the end of the root and the canal. If necessary a bone graft is placed in the area where the infected tissue was. On areas where a lot of bone has been damaged, tissue guided regeneration may also be necessary. If necessary the soft tissue removed from the end of the root is sent for a biopsy. The soft tissue (gums) is placed back with sutures. The sutures are removed about seven days after the surgery. Healing of the bone may take several months to over a year. Dr. Semashko will check the healing after one year. There is no charge to do this follow-up.
You may ask, “Why do I need to have endodontic surgery?”
It is used to help determine a diagnosis. If you continue to have symptoms and x-rays do not reveal a reason for this, a root fracture may be present at the end of the root. The surgery allows the doctor to physically look at the end of the tooth to determine this.
If parts of the root are calcified and the doctor could not get past this, the surgery allows the doctor to remove this. The remainder of the canal could be clean and sealed if the original root canal did not heal. This may occur years after the original dental root canal was completed. It may also be done to repair roots damaged by resorption.
Most of the time you can drive yourself home after the procedure. However, you should discuss this with Dr. Semashko or his staff prior to the surgery.
Most people return to normal activity within 24 hours. However, you should discuss this with Dr. Semashko.
Surgeries are highly successful but there is no guarantee for this. Dr. Semashko will happily discuss your chances of success based upon what he finds when he examines the area.
You may ask, “If I decide against doing a surgery what are my alternatives?”
Unfortunately the only alternative to the surgery would be extracting the tooth. If an extraction is done the area would have to be restored with an implant, bridge or removable partial denture to restore your bite.