When it comes to saving a damaged or infected tooth, two common procedures are often considered: root canal therapy and an apicoectomy. Both treatments aim to eliminate infection and preserve your natural tooth, but they differ in approach, complexity, and when they’re used. Understanding these differences can help you make an informed decision if you’re dealing with ongoing tooth pain or an unresolved dental issue.
At Hilltop Endodontics, we specialize in both root canals and apicoectomies, using advanced diagnostic tools and techniques to determine the best course of treatment for each patient. We also collaborate closely with Hilltop Internal Medicine and Endocrinology Oxon Hill to ensure that your overall health is taken into consideration throughout the treatment process.
What Is a Root Canal?
A root canal is the first line of treatment when the pulp inside your tooth becomes infected, inflamed, or damaged due to decay, trauma, or repeated dental procedures. During this procedure, an endodontist removes the infected pulp from inside the tooth’s root canals, carefully cleans and shapes the canals, and then fills and seals the space with a biocompatible material. A root canal is generally non-surgical and is performed through the top of the tooth. Once completed, the tooth is usually restored with a crown to protect and strengthen it.
What Is an Apicoectomy?
An apicoectomy is a surgical procedure typically recommended when a root canal has failed or when infection persists near the root tip (apex) of the tooth despite prior treatment. Instead of going through the top of the tooth, an apicoectomy is performed through the gum tissue. The endodontist makes a small incision near the affected tooth to expose the underlying bone and remove the infected tissue and the tip of the tooth’s root. The root end is then sealed with a small filling, and the gum tissue is sutured to allow healing. This treatment is often used when retreating the root canal internally is not possible or has already been attempted unsuccessfully.
Key Differences in Approach
The primary difference between a root canal and an apicoectomy lies in the access point and treatment method. A root canal is performed internally through the crown of the tooth and involves cleaning the entire root canal system. An apicoectomy, on the other hand, is a surgical endodontic procedure that addresses issues at the root tip from the outside by going through the gum and bone.
Additionally, a root canal is generally the initial treatment for a tooth with pulp damage, whereas an apicoectomy is considered a secondary or last-resort option after conventional root canal therapy has failed or is not viable.
When Is Each Procedure Needed?
If you are experiencing persistent tooth pain, sensitivity, or signs of infection, a root canal is usually the first recommended treatment. However, if a tooth that has already undergone root canal therapy continues to cause problems—such as chronic pain, swelling, or a visible lesion on an X-ray—your endodontist may recommend an apicoectomy to eliminate the remaining infection and prevent tooth loss.
Conclusion
Both root canals and apicoectomies are effective procedures designed to save natural teeth and alleviate pain, but they serve different purposes and are used at different stages of treatment. While a root canal is a non-surgical approach suitable for most cases of pulp infection, an apicoectomy is a surgical solution used when standard treatments are no longer effective.
At Hilltop Endodontics, we are committed to providing accurate diagnoses and personalized treatment plans to ensure the best outcomes. If you’re experiencing unresolved tooth pain or have questions about a previously treated tooth, reach out to our team for a thorough evaluation and expert care.
