Endodontic Surgery: Root Amputation vs. Apicoectomy

Root amputation and apicoectomy are two important endodontics procedures that may be your options if you’re suffering from infection or tooth fracture. Although similar in nature, these procedures have distinct differences. 

The reason you’d get a root amputation or apicoectomy is if you had a tooth that received a root canal treatment that didn’t completely solve the issue. After a root canal, certain problems can arise that endodontic retreatment can’t fix. If left untreated, those problems could lead to losing the tooth.

Here’s what to know about root amputation and apicoectomy.

[Related: Your Guide to Endodontic CT Scans]

Root Amputation

What Is a Root Amputation?

Root amputation is the surgical removal of a multi-rooted tooth. Your endodontist generally performs it on the upper molars because they have three roots. They usually give root amputation treatment to eliminate infection or prevent further bone loss in an area where infection or tooth fracture has caused it.

What Type of Tooth Qualifies for a Root Amputation?

Your tooth is a good root amputation candidate if a root on which you had root canal treatment suffers from any of these:

• Embedded bacteria
• Severe bone loss due to infection or fracture 
• Decay in a concentrated area

If the root suffers from decay, the remainder of the roots need to have sufficient bone to support the tooth. Essentially, if the issue affects only one root and the remaining tooth structure is healthy, your endodontist can successfully perform a root amputation to save your tooth.

[Related: How To Deal With Tooth Pain]

What Happens if I Don’t Get a Root Amputation?

If left untreated, the infection or decay can spread to the surrounding areas and result in bone loss. This jeopardizes the stability of not only the tooth but also the surrounding teeth.

Eventually, the problem will compromise the whole tooth, and your dentist will need to extract it. Removing one root can help save the tooth and prevent you from needing extraction and replacement with a partial, bridge or implant.

Apicoectomy

What Is an Apicoectomy?

An apicoectomy is the removal of the tip (or apex) of the tooth’s root. Your endodontist usually performs an apicoectomy after a root canal treatment if the infection didn’t completely resolve or you have infection at the apical foramen.

What Type of Tooth Qualifies for an Apicoectomy?

Issues near the tip of the root cause most problems in teeth that have undergone root canals. An endodontist performs apicoectomies when endodontic retreatment won’t be effective.

Indications for an apicoectomy include the following:

• Infection after root canal treatment or retreatment
• Inability to clean a root canal blocked by a broken file that your dentist can’t remove
• A fracture or crack on the apical portion of a tooth root
• A curved root canal that prevents endodontic files from reaching the root’s apex
• Calcification in the tooth that prevents endodontic files from reaching the apex

An apicoectomy is often your last resort to save a tooth before extraction.

[Related: Addressing Common Concerns About Root Canals]

Contact Cascadia Dental Specialists To Learn More

Are you unsure whether you need a root amputation or apicoectomy? Contact Cascadia Dental Specialists today for a consultation, or schedule an appointment.

Feel free to check out our patient testimonials for more about how we serve your apicoectomy needs, as well as other endodontics procedures.