CBCT-Guided Apicectomy for North Finchley Patients

A standard 2D dental X-ray does not always show the full picture. A Cone Beam Computed Tomography CBCT scan provides a detailed 3D image of your tooth, roots, and surrounding jawbone. For an apicectomy this is essential for precision and safety. The 3D view reveals how the roots sit in relation to important structures like sinuses and nerves. It can uncover hidden canals, fractures, or the exact extent of infection that a flat image would miss. This level of detail helps plan the surgery, minimize bone removal, and improve the chances of a successful outcome. At our Finchley practice, every apicectomy is planned with CBCT so we have all the information before the procedure begins.

An apicectomy is a targeted procedure and isn t required for every tooth problem. It is usually advised after a conventional root canal fails and non surgical retreatment isn t an option or has failed. You might be a candidate if you have persistent pain or swelling around a root treated tooth, or if an X‑ray shows a lingering infection at the root tip that isn t healing. It is also considered for complex cases, such as a blocked or unusually shaped canal, or when a post and crown on the tooth makes retreatment too risky. Our goal is to save your natural tooth, and an apicectomy is a highly effective option when other measures have been tried.

Your first visit includes a thorough assessment and a 3D CBCT scan, which takes less than a minute. Dr. Reddy uses these images to map the surgery precisely, locating the infection and nearby nerves. This appointment lasts about 45 minutes.

The procedure is performed under local anaesthetic, so you will feel no pain. A small incision is made in the gum to access the underlying bone. With a dental operating microscope for magnification, the infected tissue at the end of the root is removed. A few millimetres of the root tip are also removed, the root canal is cleaned and sealed with a biocompatible filling. The gum is then stitched back in place with dissolvable stitches.

We schedule a follow-up to ensure healing is progressing. The bone will gradually heal around the root end over the coming months, and we may monitor this with a follow-up X-ray. Modern microsurgical apicectomy has a high success rate, often over 90 percent, in saving the tooth long term.

Proper aftercare supports a smooth recovery. In the first 24 to 48 hours you may notice some swelling and mild discomfort, which you can manage with over‑the‑counter pain relief. Use an ice pack on the area for 20 minutes at a time to reduce swelling. Stick to a soft diet and avoid strenuous activity for a few days. Keep the area clean by rinsing with warm salt water starting the day after surgery. The stitches dissolve on their own within about two weeks. Red flags: contact our practice during office hours if you experience increasing pain after day 3, persistent bleeding, or a fever. For after hours emergencies, go to A&E or call 111.

When you face a failing root canal, you have three options. An apicectomy fits when the crown and post are sound and the problem is limited to the root tip. Root canal retreatment involves removing the old filling and re cleaning the canals from the top of the tooth, and may be preferred if the original work was not thorough. The final option is tooth extraction followed by an implant or bridge. Extraction removes the infection, but our aim is to save the natural tooth whenever possible. An apicectomy, with its high success rate, is often the best way to achieve this without removing a crown that still works.

To make an informed choice about this advanced procedure, whether you come to us or another practice in North London, ask these questions: Do you use a CBCT scanner to plan every apicectomy? Do you perform the surgery with a dental operating microscope? What is your personal success rate with this procedure? What filling material do you use to seal the root end? What are the full costs including the scan, surgery, and follow-up? What risks are specific to my tooth location such as proximity to a sinus? Who handles my care if I have after hours complications?