3D-Guided Apicoectomy in Finchley for Complex Cases

A 3D guided apicoectomy is usually needed after a conventional root canal fails and retreatment is not practical. You have a persistent infection at the root tip visible on an X ray. It is also chosen if there is a cyst or an anatomical issue like a curved root that stops standard retreatment from working. The 3D guided approach is especially helpful when the tooth sits near nerves or sinuses, because it offers high precision. Many patients from across North London are referred here when a more advanced approach is needed to save the tooth from extraction.

First, you have a 60 minute consultation during which we take a high resolution 3D CBCT scan to map the root and plan the surgery. From this scan we design and print a custom surgical guide. Then in the surgery, usually 60 to 90 minutes, we numb the area with local anaesthetic. A small gum incision gives access to the root tip. The 3D guide sits over the teeth to direct instruments with sub millimetre accuracy, removing only the infected tissue and the very tip of the root. The root end is sealed and the gum closed with a few stitches. You return for a follow up 7 to 10 days later to check healing and remove stitches.

Right after the procedure numbness lasts a few hours. Expect mild to moderate swelling and discomfort peaking around 48 to 72 hours. We provide instructions for using ice packs 20 minutes on 20 off. Eat soft foods like soup yogurt and smoothies and avoid chewing on the treated side. Over the counter painkillers such as ibuprofen usually control pain. A recent patient from Finchley, a teacher, had the procedure on a Thursday and was able to return to work by Monday.

Long term success relies on good healing. Avoid vigorous rinsing or exercise for the first few days. Gentle brushing with a soft brush is important. Call during office hours if you experience severe or increasing pain after day 3, a fever above 38 C, or persistent bleeding. For genuine emergencies outside these hours, call 111 or go to the nearest A&E. Once healed, the tooth should function normally for years with good oral hygiene.

Before proceeding with an apicoectomy we discuss options. The main alternatives are root canal retreatment or tooth extraction. Retreatment redoes the original root canal inside the tooth and can be successful but may not address infection at the root tip. Extraction removes the tooth and may relieve the infection but creates a gap that then needs a dental implant or bridge, which is a longer and more costly process. We aim to save the natural tooth when possible, and an apicoectomy is often the last best chance. For example a patient from Barnet with a crowned front tooth had a recurring infection; an apicoectomy treated it without removing the cosmetic crown, which retreatment would have required.

To make an informed choice, ask the right questions whether you use our Finchley practice or another. Ask: What is your success rate with this procedure? Do you use a dental operating microscope and 3D CBCT planning? What does the quoted fee include the scan, the surgical guide, and all follow up visits? What are the specific risks for the tooth in question? What is your experience with complex cases like mine? How much time should I book off work for recovery? Understanding these points helps you feel confident in your decision.

As a highly specialised procedure, the price reflects the advanced technology and training. Prices typically range from £800 to £1,500 depending on the tooth location and case complexity. This includes the initial consultation, the 3D CBCT scan, the surgical guide, the procedure, and all follow up visits. There are no hidden fees. We are private only and do not offer NHS treatment. We do accept private plans from Denplan, Cigna and Max Bupa. We can provide documentation to help with a claim.