To understand endodontic surgery, it helps first to know something about the nonsurgical endodontic procedure, or “root canal.” Root canal treatment is necessary when the soft inner tissue, or “pulp,” of the tooth becomes inflamed or infected. This may happen as a result of deep decay, repeated dental procedures on the tooth, or an injury to the tooth. Root canal (endodontic) treatment removes the damaged pulp. Then the tooth’s canals are cleaned and filled to help preserve the tooth.
In a few cases, however, root canal (nonsurgical endodontic) treatment alone cannot save the tooth. In such a case, your dentist or endodontist may recommend surgery.
All dentists received training in endodontic treatment in dental school. However, because endodontic surgery can be more challenging than providing nonsurgical treatment, many dentists refer patients needing surgery to endodontists.
Endodontists are dentists with at least two additional years of advanced education and training in root canal techniques and procedures. In addition to treating routine cases, they are experts in performing complicated procedures including surgery. They often treat difficult cases—such as teeth with unusual or complex root structure or small, narrow canals. This special training and experience can be very valuable when endodontic surgery is necessary.
Surgery can help save your tooth in a variety of situations.
Surgery may be used in diagnosis. If you have persistent symptoms but no problems appear on your x-ray, your tooth may have a tiny fracture or canal that could not be detected during nonsurgical treatment. In such a case, surgery allows your endodontist to examine the entire root of your tooth, find the problem, and provide treatment.
Sometimes calcium deposits make a canal too narrow for the instruments used in nonsurgical root canal treatment to reach the end of the root. If your tooth has this “calcification,” your endodontist may perform endodontic surgery to clean and seal the remainder of the canal.
Usually, a tooth that has undergone a root canal can last the rest of your life and never need further endodontic treatment. However, in a few cases, a tooth may not heal or it may become infected after treatment. A tooth may become painful or diseased months or even years after successful treatment. If this is true for you, surgery may help save your tooth.
Surgery may also be performed to treat damaged root surfaces or surrounding bone.