Microscope Endodontic Surgery in Finchley

You usually need this surgery when a root canal has not healed or retreatment is not possible. You might be a candidate if infection persists despite treatment, often shown as a recurring pimple on the gum or a shadow on an X-ray. It is also used for teeth with complex root anatomy, such as hooked or very narrow canals that are hard to clean. For example, a North Finchley patient with a crowned front tooth might choose this to treat a root end infection without removing the crown. We use a 3D CBCT scan to map your tooth and confirm if surgery is the right step.

Using a dental operating microscope is the standard for endodontic surgery and what sets our practice apart. The microscope provides strong magnification up to 25x and coaxial illumination, lighting up the tiny surgical area. This allows us to see details invisible to the naked eye, such as microfractures, accessory canals, or the exact source of an infection at the root tip. This level of precision improves the outcome, with studies showing success rates for microscope assisted apicoectomy as high as 85 to 95 percent. A patient from East Finchley recently had a molar with a persistent infection after a previous root canal. We identified a tiny, unsealed canal branch at the root tip, which was the source of the problem. We cleaned and sealed it, saving a tooth that might otherwise have been extracted.

Your treatment starts with a 60 minute consultation, including a 3D CBCT scan to map out your tooth's root structure. The surgical appointment itself typically lasts 60 to 90 minutes and is performed under local anaesthetic, so you won't feel any pain. First, a small incision is made in the gum to access the infected root tip. Next, using the microscope for precision, the infected tissue and the very end of the root are removed. Then, the root end is cleaned and sealed with a biocompatible material to prevent reinfection. Finally, the gum tissue is sutured back into place with a few tiny stitches, which are usually removed after 5 to 7 days. You'll be able to go home the same day with full aftercare instructions.

Recovery after an apicoectomy is usually easy. For the first 24 to 48 hours you may have some swelling and mild discomfort. This can be managed with standard pain relief such as ibuprofen. Apply an ice pack for 20 minutes on and 20 minutes off to reduce swelling. Eat soft foods for a few days and avoid chewing on the treated side. Keep the area clean by rinsing with salt water or a prescribed mouthwash. Most people return to normal activities within a day or two. Red flags that require contact during office hours are severe or worsening pain after day 3, uncontrolled bleeding, fever, or persistent swelling. For emergencies after hours, contact NHS 111 or visit your nearest A&E.

While an apicoectomy is highly effective, it helps to know other options. The main alternatives are non surgical root canal retreatment or tooth extraction. Root canal retreatment involves reopening the tooth, removing the old filling material, and re cleaning the canals. It may be a good option if the initial root canal was not performed well, but it may not be possible if there is a complex post and crown in place. Tooth extraction is the last resort. While it removes the infection, it leaves a gap that can cause other teeth to shift. Replacing the tooth with an implant or bridge is a more complex and costly process than saving the natural tooth with surgery. We will discuss which option best fits your clinical situation and long term health goals.

To help you decide, here are important questions to ask any Finchley dentist offering this procedure. Do you use a dental operating microscope for all endodontic surgeries? What is your success rate for this procedure? Is a 3D CBCT scan included in the assessment and cost? What are the surgery costs and are follow up visits included? What postgraduate training do you have in endodontics? What are the risks in my case and what alternatives do you recommend? Do you accept private insurance such as Denplan or Cigna?