3D-Guided Apicectomy in East Finchley for Failed Root Canals

An apicectomy, or root end surgery, is suggested when a conventional root canal has failed and infection remains at the tip of the tooth root. You might be a candidate if you have ongoing swelling, a pimple like bump on your gum, or discomfort long after the initial root canal. It is also chosen when retreatment isn’t possible because a post and crown cannot be safely removed. The goal is to remove the infected root tip and seal the end to prevent bacteria from re entering, preserving the natural tooth.

We rely on 3D Cone Beam Computed Tomography to guide the surgery. A CBCT scan gives a detailed three dimensional map of the tooth, roots, and surrounding jawbone, more precise than a 2D x-ray. This helps Dr. Ashok Reddy locate the infection, understand complex root anatomy, and plan the operation to avoid nerves and sinuses. Used with a dental operating microscope for magnification, this approach provides maximum precision and minimizes removal of healthy tissue, contributing to high success rates of microsurgical apicectomies, which exceed 90 percent. Case example: A Highgate patient had a persistent infection on an upper molar near the sinus. The 3D CBCT revealed a hidden canal at the root tip. The guided approach allowed us to remove the infected tissue precisely without disturbing the sinus lining, saving the tooth.

The process starts with a 60 minute consultation that includes the 3D CBCT scan. The apicectomy is performed under local anaesthetic and typically lasts 60 to 90 minutes. Dr. Reddy will make a small gum incision, remove the infected root tip, and seal the canal with a small biocompatible filling. The gum is closed with several small stitches. Most patients feel pressure rather than pain during the procedure. You return 5 to 7 days later for a brief follow up to check healing and remove sutures.

Days 1 to 3 may bring swelling, bruising, and mild to moderate discomfort. You can manage this with over the counter painkillers such as ibuprofen. Apply ice to the outside of your face for 20 minute intervals to reduce swelling. Eat soft foods like soup, yogurt, and smoothies and avoid chewing on the treated side. In Week 1 the discomfort and swelling should lessen gradually. Be gentle when brushing around the surgical site. We will see you for a follow up within 5 to 7 days to check healing and remove sutures. Most people can return to work and normal activities within a day or two. If you have severe or increasing pain after day 3, uncontrolled bleeding, or a fever above 38C, contact our practice during office hours. Our hours are Monday, Wednesday, Friday 9 to 5 and Tuesday, Thursday 11 to 7. For emergencies outside these hours, call 111 or visit your nearest A and E.

While a 3D guided apicectomy is often the best choice after a failed root canal, it helps to know your other options. Non surgical root canal retreatment is possible when feasible. This involves removing the old filling, re cleaning the canals, and resealing them. It isn’t an option if there is a large post in the tooth that cannot be removed without risking fracture. The final alternative is removing the tooth and replacing it with a dental implant, a fixed bridge, or a removable denture. Our goal is to save the natural tooth whenever there is a good chance of success, which an apicectomy often provides.

As a private procedure, the cost of a 3D guided apicectomy reflects the advanced technology and postgraduate training involved. We will provide a transparent itemised treatment plan after your initial consultation and 3D scan, with no hidden fees. The fee covers the CBCT scan, surgical procedure, and all follow up visits. We are a private practice and do not offer NHS treatment. We do accept plans from major private dental insurers including Denplan, Max Bupa, and Cigna. Please contact our East Finchley practice to discuss your case and insurance coverage.

To help you decide, whether you choose us or another practice in North London, consider asking these questions: you should confirm that a 3D CBCT scan is used for planning every apicectomy, that the procedure is performed with a dental operating microscope, and you should ask for the surgeon’s specific postgraduate training in endodontics. Also inquire about the total cost, including the scan and follow up care, and ask who will perform the surgery and what experience they have in this procedure. Finally ask what material is used to seal the root end and what risks apply to your case, such as proximity to nerves or sinuses.