CBCT-Guided Endodontic Surgery for North Finchley Patients

A standard dental X-ray is a flat, two-dimensional image. It is useful, but it cannot show everything. When a root canal fails, the cause is often a hidden canal, a tiny fracture, or a complex infection that two-dimensional imaging cannot detect. A CBCT scan changes the game. It rotates around your head for a few seconds, capturing hundreds of images that are reconstructed into a precise three-dimensional model of your tooth, jaw, and surrounding tissues. For endodontic surgery, this means we can see the exact size and location of an infection, map out the nerve pathways to avoid, and plan the surgical approach with pinpoint accuracy before we begin. This technology is particularly vital for procedures like apicoectomy, where precision is essential for success rates that exceed 90 percent.

Endodontic surgery, most commonly an apicoectomy or root-end surgery, is typically recommended when a conventional root canal treatment has not resolved an infection. You may need this treatment if you have persistent pain, swelling, or an abscess linked to a tooth that has already had root canal therapy. It is also the preferred option when retreatment is not practical, for example if the tooth has a complex post and crown that would be risky to remove. A recent patient from North Finchley came to us with a molar that was still painful months after a root canal elsewhere. The two-dimensional X-ray was inconclusive, but our CBCT scan immediately revealed a hidden, infected fourth canal that was the source of the problem, making them a clear candidate for surgery to save the tooth.

First, you will have a sixty-minute consultation where Dr. Reddy, who holds an MSc in Endodontics, will perform a thorough assessment, including a detailed 3D CBCT scan. This scan is essential for planning the surgery. The surgical appointment itself typically lasts sixty to ninety minutes and is done under local anesthesia, so you will feel pressure but no pain. During the procedure, a small incision is made in the gum to access the tip of the infected root. The infected tissue and the very end of the root are removed. The root canal is then cleaned and sealed with a small filling to prevent reinfection. Finally, the gum is sutured back in place. We schedule a follow-up appointment for seven to ten days later to remove the sutures and check your healing.

After your surgery you can expect some manageable discomfort and swelling. For the first twenty four to forty eight hours, swelling may peak, and you should apply an ice pack to the area for twenty minutes on and twenty minutes off. Stick to soft foods like soup, yogurt, and smoothies. Most discomfort can be managed with over the counter pain relief such as ibuprofen. Avoid strenuous activity for a few days and do not brush the surgical site directly until your follow-up appointment. Red flags requiring contact: call our practice during office hours if you experience severe, increasing pain after day three, uncontrolled bleeding, a fever over 38 Celsius, or visible pus from the site. For emergencies outside these hours, go to A&E or call 111.

When a persistent infection survives a root canal you have a few options. One option is a non surgical root canal retreatment, where we try to clean and reseal the canals from inside the tooth again. But this may not be possible if there is a large post in the way or if the infection lies outside the tip of the root. The other option is tooth extraction. This removes the infection but creates a gap that can cause other teeth to shift and requires a replacement such as a dental implant or bridge, which involves more procedures and higher long term costs. Our philosophy is to save natural teeth whenever possible, and CBCT guided surgery gives us the best chance to do so.

To decide what is right for you, ask any dentist, whether at our Finchley practice or another in North London, these key questions. Why is endodontic surgery a better option for me than retreatment or extraction? Does the quoted cost include the 3D CBCT scan and all follow up appointments? What is your success rate with this specific procedure? What materials do you use to seal the root end such as MTA? What are the risks specific to my case based on the CBCT scan? Do you use a dental operating microscope for the surgery to ensure precision?

The cost for private endodontic surgery depends on the case complexity and which tooth is treated. At our practice, prices for an apicoectomy typically start from £850. This fee includes the initial consultation, the detailed 3D CBCT scan for diagnostics, the surgical procedure itself, and all necessary follow-up appointments. There are no hidden fees. We provide a precise, personalised quote after your initial assessment. We accept private dental insurance from providers including Max Bupa, Denplan, and Cigna, and our team can help you understand your coverage. For example, a patient with a complex infection on a front tooth visible on CBCT may have a lower cost than a molar with multiple roots near a sinus.