Though conventional, nonsurgical root canal therapy will always be the preferred route for any endodontic problem, there are instances in which this method of treatment cannot save the tooth. For those instances, endodontists will resort to microsurgery. Endodontic microsurgery—more formally referred to as apicoectomy—is in a general sense “the treatment performed on the root apices of an infected tooth, followed by placement of a filling (retrofilling) to seal the root end.” (ENDODONTICS: Colleagues for Excellence) Initially, endodontic surgery was a somewhat primitive procedure. Endodontists, oral surgeons, and general practitioners performed the surgeries using a round bur attached to a straight handpiece to prepare the canal and used amalgam as the root-end filling material. Thanks to technological advances, endodontic microsurgery has seen great improvements in success rates. At York Hill Endodontics, our specialists utilize these advances every day, and by doing so, have saved teeth that would otherwise be subject to extraction.

What’s New in Microsurgery?

Research and technological advances have led to the refinement of the techniques, materials, and instruments used to execute apical surgery. These refinements have improved endodontic microsurgery in ways that affect the success rate, the overall case selection, the application for the procedure, and the postoperative healing sequelae.

The most significant way apical surgery has been improved is through the aid of the surgical operating microscope. Prior to the microscope, specialists relied on their eyes to map out the root canal, which would almost entirely neglect the now known certainty that each individual canal may be uniquely shaped. According to the American Association of Endodontics publication, Colleagues for Excellence:

“The microscope enables accurate visualization, identification and treatment of infected extranumeral canals, isthmuses and irregular anatomy unreachable with traditional instrumentation techniques.”

The root canal space houses a complex anatomy that requires close attention to detail when infected. The microscope is a fundamental instrument for cleaning and shaping the root canal by illuminating its complexities.

Another vital advance that improved cleaning and shaping the root canal is the refinement of osteotomy instruments. These instruments have progressively become smaller and more specialized. This allows specialists to remove the infection with precision, doing minimal damage to the surrounding bone and tissue. In addition, materials like MTA and Calcium silicate restorative materials with excellent biocompatibility, osteo- and cemento-inductive capabilities, reduce inflammation and promote faster radiographic healing.

At York Hill Endodontics, our specialists have access to the latest techniques, materials, and instruments, and they most certainly have the expertise to use them.

About York Hill Endodontics

York Hill Endodontics has been proudly serving the Toronto community since 1965. In fact, the practice is the longest established endodontic specialty practice in Canada. Our team of endodontic specialist take great pride in providing endodontic treatment in a relaxing and modern environment. Learn more about our services by contacting us today or calling 416-781-5251.


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Author: Professional Endodontics