Endodontic (root canal) treatment is generally successful. In the rare cases when root canal treatment fails, it may be possible to save the tooth with a minor surgical procedure (root canal surgery).
Endodontic surgery may be needed because of chronic infection, root anatomy variations or calcifications, or to repair root perforations.
One of the most common endodontic surgical procedures is an apicoectomy. This is an in-office procedure where the root tip of the tooth is treated. The area around the tooth is anaesthetized with a local anaesthetic. The root tip of the tooth is exposed. If there is any infected tissue around the root end, it is removed so that healthy bone can then grow in around the root. If the root end is not adequately been sealed, a small filling can be placed at this time. It may take a number of months before the bone completely heals around the root end.
A hemisection or root amputation are other types of surgery that can be done on root canaled teeth. A hemisection is when one root of a lower molar, which has two roots is removed. A root amputation is when one of the three roots of an upper molar is removed. These procedures are performed on multi-rooted teeth where one root cannot be treated with root canal therapy but others have been successfully treated. A hemisection or root amputation may also be required if there is extensive bone loss around one root. These procedures leave a smaller tooth in the original tooth space. Your dentist will discuss options to fill this space.
As in most surgical procedures, no guarantees can be given as to the results of the treatment but endodontic surgery is an excellent opportunity to save your tooth.