Apicoectomy to Treat Infection By Bruce Wilderman on March 29, 2018

Many people have heard the term root canal infection, but what exactly does that mean? A root canal infection describes a situation in which the roots and tissues that lie within a tooth have become inflamed. A root canal infection can develop when bacteria enters through tooth enamel and reaches the pulp that lies at the center of the tooth. A patient is most at risk of developing a root canal infection when the structure of the tooth has been compromised by decay, erosion, or oral injury. Root canal therapy cleans out the center of the tooth to eliminate damaged and infected tissues. In most cases, root canal therapy effectively treats infection to preserve the natural tooth. Unfortunately, sometimes treatment is ineffective or an infection recurs. When reinfection occurs, the patient is likely to need an apicoectomy. An apicoectomy eliminates any remaining infection for our Philadelphia, PA, patients so that they can enjoy a strong, healthy smile.

Illustration of the outer and inner layers of a tooth

Why Would an Apicoectomy Be Needed?

It is understandably frustrating for a patient to undergo root canal therapy and have it be unsuccessful. Unfortunately, in a small number of cases, root canal therapy is unable to eliminate all traces of infection. To understand why an apicoectomy is sometimes needed, it is helpful to explain the structure of a tooth. Within the crown of each tooth, there is a collection of sensitive nerves and tissues, called the pulp. These tissues connect to the jawbone through the tooth’s root canals. Each tooth is slightly different. While the front teeth tend to have just a single root, molars can have two or more roots. If there are multiple branches of roots that break off from one another, some may be missed during root canal therapy. If a root canal is not cleaned properly, bacteria and infection can remain in that part of the tooth and eventually reinfect the tissues in the pulp of the tooth. If the infection continues to be a problem, an apicoectomy may be the best solution for finally eliminating the infection.

The Procedure

During an apicoectomy, Dr. Wilderman will access the roots of the infected tooth so that they can be thoroughly cleaned and all traces of the infected can be removed. The procedure will begin with an incision being made in the gum line. Dr. Wilderman will lift the gum tissue so that he can work directly with the roots of the tooth. He will remove all infected tissue, as well as the last few millimeters of the root’s tip, which is called the apex. After he is sure that there is no infection remaining in the tooth, the root of the tooth will be sealed with a material that is very similar to a dental filling. When the root has been sealed, the gum tissue will be stitched back in place.


Following an apicoectomy, the teeth and jaw are likely to be sore. Patients may even notice bruising or swelling on the face near the treatment site. Patients should use cold compresses on the face to control inflammation and discomfort. Although some sensitivity may persist for a week or two after treatment, most discomfort will subside within a few days. To avoid complications during the first couple days of recovery, patients should avoid hard, crunchy foods. Patients should also be sure to take any prescribed antibiotics, as this will further ensure that all infection is eliminated.

Contact Us

At his cosmetic dentistry practice, Dr. Bruce Wilderman offers a wide range of restorative dentistry treatments that are meant to improve oral health while preserving the patient’s natural teeth. If you are suffering from a root canal infection or other dental complications and would like to learn more about these treatments, contact us at your earliest convenience. We look forward to hearing from you!

Related to This

Dr. Wilderman on cover of suburban life

Artistic Expressions Dentistry

Dr. Bruce Wilderman has been providing comprehensive cosmetic dentistry services since 1986. By combining a true sense of artistry with state-of-the-art technology, he can provide stunning results. At Artistic Expressions Dentistry, we are proud to be affiliated with:

  • The American Dental Association
  • The American Academy of Cosmetic Dentistry

For more information about our services, contact our practice online or call (215) 340-1199 today.

Get In Touch

Rate, Review & Explore

Social Accounts Sprite