Sometimes, even after root canal therapy, a tooth just doesn’t heal the way we hope. That’s where an apicoectomy in Hackensack comes in—a precise, minimally invasive endodontic surgery designed to remove lingering infected tissue and give your tooth a second chance.
At Roman Dental Arts, Dr. Donald Roman and Dr. Alissa Roman understand the importance of preserving your natural teeth. With decades of combined experience in dental medicine and a compassionate approach, we’re proud to offer advanced apicoectomy services to help you stay smiling. Our comprehensive endodontic services focus on preserving your natural smile whenever possible, and an apicoectomy is one of the most effective ways to save teeth when traditional treatments haven’t provided the healing you need.
What Is an Apicoectomy?
Think of an apicoectomy as a “root tip rescue.” When infection persists at the very end of a tooth’s root—even after root canal treatment—this surgical procedure allows us to gently remove the infected tissue and seal the area to prevent reinfection.
Unlike root canal treatment, which treats the tooth from the top down, an apicoectomy approaches the issue from the gum side. A small incision is made in the gum tissue to clean out the infection and seal the root tip, all while keeping you comfortable and informed every step of the way. This form of oral surgery is also known as a root end resection and involves careful removal of damaged tissue to promote proper healing.
Who Needs an Apicoectomy and When?
Not everyone needs an apicoectomy, but certain situations make this treatment particularly beneficial. You may be a good candidate if you have a tooth with persistent infection despite previous root canal treatment, especially when the structure remains strong and healthy above the gum line.
We also consider this option when you have adequate bone support around the affected tooth and when extraction would require more complex replacement procedures, such as dental implants. Your overall health, healing capacity, and commitment to follow-up care all play important roles in determining if apicoectomy is right for you.
If you’ve had a root canal but are still experiencing the following symptoms, an apicoectomy might be the solution you need to finally achieve lasting relief:
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Persistent pain or sensitivity
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Swelling near the affected tooth
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Recurring abscesses or a bad taste in your mouth
This treatment is especially helpful when endodontic retreatment isn’t possible due to complex root anatomy, hidden canals, fractures, or previous dental work like crowns or posts. Sometimes, damaged root surfaces or surrounding inflamed tissue cannot be addressed through a non-surgical procedure, making apicoectomy the most common surgery for saving damaged teeth.
Apicoectomy Process at Roman Dental Arts
We know surgery can sound intimidating, but we’re here to make it as smooth and stress-free as possible. Our team takes time to explain each step of the process and answer all your questions before beginning treatment.
Here’s how the procedure works:
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Comfort First: We start with local anesthesia to ensure you’re relaxed and pain-free.
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Precise Care: A small incision is made in the gum to access the root tip. We remove the infected tissue, including any surrounding inflamed tissue or damaged tissue, and seal the root with a biocompatible root end filling material.
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Healing Begins: The gum is gently stitched closed, and healing starts right away.
Most patients find the procedure takes between 30 to 90 minutes, depending on the tooth’s location and complexity. Our experienced team monitors your comfort throughout the entire process to ensure the best possible experience. The incision heals quickly, and within days, most patients report minimal discomfort.
Our Advanced Approach
At Roman Dental Arts, we use modern techniques and materials to ensure the best possible outcome for your apicoectomy. We employ precise surgical procedure instruments and biocompatible sealing materials that promote healing and prevent future infection. We may also use digital x-rays to locate fractures and assess the surrounding bone.
Our approach focuses on preserving as much healthy tissue around the root as possible while thoroughly addressing the problematic area. This conservative method helps maintain the structural integrity of your tooth and surrounding tissues, supporting long-term success. By carefully addressing damaged root surfaces and hidden canals, we save teeth whenever possible.
Recovery & Aftercare
You may experience slight swelling or discomfort for a few days—this is completely normal. We’ll provide personalized aftercare instructions to help you heal quickly and comfortably. Most patients are back to their routine within a few days, with the incision typically healing without complications.
During the healing process, we recommend eating soft foods, avoiding vigorous rinsing, and taking prescribed pain medication or appropriate pain medication as directed. Ice packs can help manage any swelling, and we’re always available to address any concerns during your recovery period. The bone naturally heals around the treated area over several months, restoring full function.
Comparing Your Options
While tooth extraction might seem like a simpler solution, preserving your teeth through apicoectomy offers significant advantages. Natural teeth provide better chewing function and maintain the structural integrity of your jawbone. They also eliminate the need for more complex and costly replacement procedures, such as dental implants or bridges.
When comparing apicoectomy to endodontic retreatment, this surgical approach often provides more direct access to the problematic area, especially when previous dental work makes retreatment challenging or impossible. Unlike a non-surgical procedure, an apicoectomy addresses issues in the surrounding bone and gum tissue that cannot be reached from the crown.
Long-Term Success
Apicoectomies have a high success rate, and with proper care and follow-up, your treated tooth can stay healthy and functional for many years. The procedure effectively eliminates infection while preserving your natural tooth structure, contributing to your overall oral health and comfort.
Regular dental exams help us monitor the healing process and ensure long-term success. Most patients find their treated tooth functions normally and remains comfortable for decades after the procedure. The bone and gum tissues heal completely, and the tooth regains full function.
Why Choose Roman Dental Arts?
We’re not just dental professionals; we’re a family practice that treats every patient like part of our extended family. Whether you’re dealing with post-root canal complications or just want to explore your options, we’re here to guide you with honesty and genuine care.
Dr. Donald Roman brings decades of experience to every procedure, while Dr. Alissa Roman represents the next generation of advanced dental medicine. Together, they combine time-tested techniques with the latest innovations in oral surgery. Our team’s approach ensures you receive comprehensive, exceptional care tailored to your individual needs, and we work with many dental insurance plans to make treatment accessible.
Schedule Your Apicoectomy Consultation at Roman Dental Arts
Don’t let persistent tooth pain affect your quality of life. Our experienced team at Roman Dental Arts is ready to evaluate your situation and determine if apicoectomy is the right solution for you. We take the time to explain all your options and help you make informed decisions about your oral health.
From our comfortable office environment to our gentle chairside manner, we’re committed to making your treatment experience as positive as possible. Please call our office today or schedule your appointment to find out if apicoectomy is right for you. Meet the doctors who will provide your care, and let’s work together to save your tooth and restore your comfort.
Frequently Asked Questions About Apicoectomies
What’s the difference between an apicoectomy and a root canal?
A root canal treats infection from inside the tooth by removing diseased pulp through the crown, working from top to bottom. An apicoectomy is a surgical procedure that treats infection from outside the tooth by accessing the root tip through the gum tissue, working from bottom to top. Root canals are non-surgical and always attempted first, while apicoectomies are surgical procedures performed only when root canal treatment hasn’t resolved the infection or when retreatment isn’t feasible due to posts, crowns, or anatomical obstacles. The apicoectomy procedure completes what the root canal started, giving your tooth the best chance for long-term survival.
How long is the recovery time after an apicoectomy?
Most patients return to normal activities the next day after apicoectomy surgery. You’ll experience mild swelling and discomfort for 2-3 days, easily managed with over-the-counter pain relievers like ibuprofen. Many patients don’t even need prescription medication. Apply ice packs during the first 48 hours to minimize swelling. While you’ll feel back to normal within a week, complete bone healing takes 3-6 months. Stick to soft foods initially, avoid the surgical area when brushing, and don’t smoke or use straws.
We’ll schedule a 6-month follow-up to confirm proper healing with an X-ray. The procedure itself takes 30-90 minutes under local anesthesia, so you won’t feel any pain during treatment.
How successful are apicoectomy procedures?
Apicoectomy procedures have excellent long-term success rates of 90-97%. Research shows 97% of apicoectomies remain successful after 5 years, and 75% function well after 10-13 years. At Roman Smiles, we use surgical microscopes and advanced digital imaging to ensure the highest precision, which significantly improves outcomes. Success depends on thoroughly removing infected tissue, properly sealing the root end, and following post-operative care instructions.
While no procedure is 100% guaranteed, an apicoectomy represents your tooth’s best chance for survival. The vast majority of patients experience complete infection resolution and keep their natural tooth for many years.
Is an apicoectomy painful?
No, an apicoectomy is performed under local anesthesia, so you won’t feel pain during the procedure, just pressure. Many patients are surprised by how comfortable the surgery is. The procedure takes 30-90 minutes, during which Dr. Roman makes a small gum incision, removes 3-4mm of the infected root tip, cleans the area with a surgical microscope, seals the root canal, and closes the incision with sutures.
After anesthesia wears off, discomfort is similar to a tooth extraction and is manageable with over-the-counter pain medication. Many patients actually feel better immediately since the infection source is removed. It’s far less painful than living with a chronic infection and much less invasive than tooth extraction and implant placement.
How should I care for my tooth after an apicoectomy?
Post-operative care is crucial for successful healing. For the first 24 hours, bite gently on gauze to control bleeding, apply ice packs (10 minutes on, 10 minutes off), and rest with your head elevated. Take prescribed or over-the-counter pain medication as directed and start any antibiotics if prescribed. Avoid smoking, drinking through straws, spitting forcefully, or rinsing vigorously for 48 hours, as these can dislodge the blood clot. Eat soft, cool foods for 2-3 day,s such as yogurt, smoothies, mashed potatoes, and scrambled eggs.
After 24 hours, gently rinse with warm salt water 3-4 times daily. Brush your teeth carefully, avoiding the surgical area for the first week. Avoid strenuous exercise for 3-4 days. Minor swelling and bruising are normal and should improve daily. Contact Roman Smiles immediately if you experience severe pain, excessive bleeding, significant swelling after 48 hours, fever, or signs of infection. Most patients heal quickly when following these instructions carefully.
