What Is Periapical Surgery?

What Is Periapical Surgery?

When it comes to your dental health, your gums are as important as your teeth. Infection and inflammation of the gums (known as periodontal disease, or periodontitis) can not only create problems with teeth, but they can also damage bone and cause your teeth to fall out. 

In America, this variety of gum disease affects millions of adults, with 47.2% of people over 30 dealing with it and the prevalence of it only increasing with age. Inflammation of the tissue around your teeth (called the periodontium) is known as apical periodontitis, and if it gets bad enough, it may require periapical surgery. Let’s get a better understanding of this specific condition, find out when surgery is needed, and how it’s done.

Patients in the Statesville and Hickory, North Carolina areas looking for relief from gum disease can get help from the friendly, patient-focused staff of Dr Robert Nance. Our experienced staff is dedicated to using our state-of-the-art facilities to create a pain-free environment in which you can be treated and recover comfortably.

Understanding apical periodontitis

The inflammation associated with this condition generally takes place at the apex of the tooth, otherwise known as the tip of the tooth’s root. It can be caused by a number of issues related to your teeth and gums, including an untreated cavity, an infected or dead tooth pulp, or an injury that affects your teeth. The resulting condition comes in two varieties:


As the name indicates, you can have this version of the conditions without experiencing any symptoms. This means the long-term effects can destroy the tissue around your teeth, as it often develops gradually. This is also the chronic version of apical periodontitis.


With this version, you experience pain and discomfort when biting down or when the inflamed area touches surrounding teeth. It tends to come on suddenly and painfully, and it can also become chronic.

When periapical surgery is needed

Commonly the first step to dealing with this form of periodontitis is to perform a root canal, which is designed to remove bacteria from your infected root and also helps prevent reinfection. When this is not enough to keep the area from getting infected again, periapical surgery (also known as an apicoectomy) is the next step. In this procedure, the tooth’s root and infected tissue are removed, and a filling is used to seal the end of the root.

How the procedure is done

The surgery starts with an anesthetic being applied to numb the area around the infected tooth. Then, we cut through the gum and move the tissue aside to reach the root. Next, we clean the infected tissue and root (often just a few millimeters) and the canal inside your tooth. After cleaning, we seal the tooth with a filling to avoid future infection, and we may take an X-ray to confirm there are no other spaces for infection to take hold. Finally, we suture the gum and tissue around the tooth, allowing everything to heal back in place.

The whole operation usually takes between 30-90 minutes, but specific complications with a tooth may require a level of intricacy that may take longer.

Be sure to take care of both your teeth and gums, as both are vital to overall mouth health. If you start experiencing problems with gum disease, make an appointment with Dr. Nance to get better.

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