Root Canal Surgery (Apicoectomy)

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A

Air abrasion - is a drill-less technique that is being used by some dentists to remove tooth decay and for other applications
Amalgam - Material made from mercury and other alloy mixtures used to restore a drilled portion of a tooth. 
Anesthesia - Medications used to relieve pain.
Anterior teeth - Front teeth. Also called incisors and cuspids.
Arch - The upper or lower jaw.

B
Baby bottle tooth decay - Caused by sugary substances in breast milk and some juices, which combine with saliva to form pools inside the baby's mouth.
Bicuspids -Back teeth used for chewing.
Bitewings - X-rays that help a dentist diagnose cavities.
Bonding - Application of tooth-colored resin materials to the surface of the teeth.
Bridge - A fixed or removable appliance that replaces lost teeth.
Bruxism - Teeth grinding.

C
CAD/CAM dentistry, (Computer-Aided Design and Computer-Aided Manufacturing in dentistry), is an area of dentistry utilizing CAD/CAM technologies to produce different types of dental restorations, including crowns, crownlays, veneers,  inlays and onlays, fixed bridges, dental implant restorations and orthodontic appliances.
Calculus (tartar)-  Calculus is hardened plaque (a sticky substance) that has been left on the tooth for some time and is now firmly attached to the tooth surface. Calculus forms above and below the gum line and can only be removed with special dental instruments.
Canal - The narrow chamber inside the tooth's root.
Canines - Also called cuspids.
Canker sore - One that occurs on the delicate tissues inside your mouth. A canker sore is usually light-colored at its base and can have a red exterior border. 
Caries - Another term for decay, which causes cavities.
Cold sore - Usually occurs on the outside of the mouth, usually on or near the nose or lips. A cold sore is contagious because it is caused by the herpes simplex virus, and it is usually painful and filled with fluid. 
Composite filling - Tooth colored restorations, also known as resin fillings. 
Composite resin - A tooth colored resin combined with silica or porcelain and used as a restoration material.
Contouring - The process of reshaping teeth.
Crown - An artificial cover that is placed on the top of a tooth following restoration.
Cusps - The pointed parts on top of the back teeth's chewing surface.
Cuspids - Front teeth that typically have a protruding edge.

D
Dentin - The tooth layer underneath the enamel.
Denture - A removable set of teeth.

E
Endodontics - A form of dentistry that addresses problems affecting the tooth's root or nerve.

F
Fluoride - A naturally occurring substance added to water, toothpastes and some rinses and used for strengthening the tooth's enamel.
Fluorosis - A harmless over-exposure to fluoride and resulting sometimes in tooth discoloration.

G
Gingiva - Another word for gum tissue.
Gingivitis - A minor disease of the gums caused by plaque.
Gum disease - An infection of the gum tissues. Also called periodontal disease.

I
Impacted teeth - A condition in which a tooth fails to erupt or only partially erupts.
Implant - A permanent appliance used to replace a missing tooth.
Incisor - Front teeth with cutting edges; located in the center or on the sides near the front.
Inlay - An indirect artificial filling made of various materials, including porcelain, resin, or gold.  fitted to a cavity in a tooth and cemented into place.
Intracoronal - situated or made within the crown of a tooth

L
Laminate veneer - A shell that is bonded to the enamel of a front tooth. The shell is usually thin and made from porcelain resin.

M
Malocclusion - Bad bite relationship
Mandible - The lower jaw
Maxilla - The upper jaw
Molar - Usually the largest teeth, near the rear of the mouth. Molars have large chewing surfaces

N
Nightguard - Night mouth guards are bite pads that are worn at night as you sleep. There are also used as mouth guards for day use. These guards are made of high-grade plastic and are custom fit to the mouth. This device keeps the upper teeth from grinding with the lower teeth, offering an instant solution to teeth clenching problems.
Neuromuscular Dentistry - Are more than the aches and pains felt in and around the neck and head that are associated with your teeth and jaw.

O
Onlay - An indirect artificial filling made of various materials, including porcelain, resin, or gold;  fitted to a cavity in a tooth and cemented into place. It is designed to protect the chewing surface of a tooth by extending to replace a cusp.
Orthodontics - A field of dentistry that deals with tooth and jaw alignment.
Overdenture - A non-fixed dental appliance applied to a small number of natural teeth or implants.

P
Palate - Roof of the mouth.
Partial denture - A removable appliance that replaces teeth. Also called a bridge. 
Pedodontics - A field of dentistry that deals with children's teeth.
Perio pocket - An opening formed by receding gums.
Periodontal disease - Infection of the gum tissues. Also called gum disease.
Periodontist - A dentist who treats diseases of the gums.
Permanent teeth - The teeth that erupt after primary teeth. Also called adult teeth.
Plaque -Plaque is a sticky, colorless, almost invisible film or substance that forms on the teeth after sleep or periods between brushing. It is a growing colony of living bacteria, food debris, and saliva. 
Posterior teeth - The bicuspids and molars. Also called the back teeth.
Primary teeth - A person's first set of teeth. Also called baby teeth or temporary teeth.
Prophylaxis - The act of cleaning the teeth.
Prosthodontics - The field of dentistry that deals with artificial dental appliances.
Pulp - The inner tissues of the tooth containing blood, nerves and connective tissue.

R
Radiographs - Diagnostic X-rays essential for detection of decay, tumors, cysts, and bone loss.  X-rays also help determine tooth and root positions.
Receding gum - A condition in which the gums separate from the tooth, allowing bacteria and other substances to attack the tooth's enamel and surrounding bone.
Resin filling - An artificial filling used to restore teeth. Also called a composite filling.
Root canal - A procedure in which a tooth's nerve is removed and an inner canal cleansed and later filled.
Root planing - Scraping or cleansing of teeth to remove heavy buildup of tartar below the gum line.

S
Sealant - A synthetic material placed on the tooth's surface that protects the enamel and chewing surfaces.

T
Tartar - A hardened substance (also called calculus) that sticks to the tooth's surface.
Tooth decay –   Tooth decay occurs when the acids found in plaque erode the natural enamel found on the teeth.  This phenomenon can easily be prevented by using proper home hygiene methods. Tooth decay is one of the leading causes of tooth loss, and its treatment often requires complex dental procedures.Teeth polishing: Removal of  stain and plaque that is not otherwise removed during tooth brushing and scaling.
TMD - Temporomandibular joint disorder. Health problems related to the jaw joint just in front of the ear.

V
Veneer - A laminate applied or bonded to the tooth.

W
Whitening - A process that employs special bleaching agents for restoring the color of teeth.
Wisdom tooth - Third set of molars that erupt last in adolescence.
 

Occasionally, root canal treatment proves unsuccessful at resolving an infection in the tissues near a tooth's roots. That's when a minor surgical procedure called an apicoectomy may be recommended. Because this procedure is often performed with the aid of a microscope and other small specialized tools, it's considered a type of endodontic microsurgery. Probably the most common type of root canal surgery, an apicoectomy involves removing a small portion of the apex (tip) of the tooth's root, along with any surrounding hard or soft tissue that may be infected.

What would cause you to need an apicoectomy? There could be several reasons, including a canal that is blocked or inaccessible, an anatomical irregularity, or a fracture or crack in the tooth's roots. The procedure is normally only recommended after one or more root canal treatments have been attempted, and have failed. Since this type of problem generally occurs near the apex of the root, the procedure is often an effective way to treat a persistent infection.

Root canal surgery apicoectomy.Before an apicoectomy procedure, diagnostic images (such as X-rays) of the affected tooth and surrounding bone, a careful review of your medical history including medications you take (both prescription and non-prescription), and other factors are reviewed. If an apicoectomy is recommended, the reasons for it will be explained to you.

The Apicoectomy Procedure

Root canal surgery is usually performed under local anesthesia such as a numbing shot, so you won't feel any pain. To begin the procedure, a small incision is made in the gum, and the infection at the end of the tooth's roots is exposed. The infected tissue is then removed, along with a few millimeters of the root tip itself. A dye may be used to help make cracks or fractures easy to see; if we discover that the tooth is fractured, it may be better to extract (remove) it at this time instead of completing the apicoectomy.

Next, a microscope and light are used to examine the tiny canals. They will be cleaned with an ultrasonic instrument, then filled with an inert material and sealed up with a small filling. To finish the procedure, a small bone graft may be placed at the affected site, and then the gum tissue covering the tooth's root will be sutured (sewn) closed. X-rays may also be taken as the procedure nears completion. Afterwards, instructions on postoperative care will be given, and you'll go home. Most apicoectomies take about 30 to 90 minutes to complete.

Following the procedure, you may experience some swelling and soreness in the area that was treated. Over-the-counter non-steroidal anti-inflammatory medications (such as ibuprofen) are usually all that's needed to control any discomfort. You can probably return to normal activities the following day, but you may want to avoid eating hard or crunchy foods or brushing vigorously for a few days afterwards. If your sutures aren't self-dissolving, you will be asked to return in about a week to have them removed.

The Goal: Saving Your Tooth

Although apicoectomy is typically a safe and effective procedure, there are slight risks with any type of minor surgery. That's why apicoectomies are not recommended unless further root canal treatment won't be effective. An alternative treatment in most cases would be extraction of the tooth. However, our goal as dentists is to help you preserve your natural teeth for as long as possible.

While there are excellent methods of tooth replacement (such as dental implants), these involve further and more complex treatments, and they can be costly. An apicoectomy is generally a permanent and cost-effective solution which can help the tooth last for the rest of your life.

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