Endodontic treatment is necessary when the pulp (it contains blood vessels, nerves, and connective tissue) becomes inflamed or infected. The inflammation or infection can be due to a variety of causes: deep decay, repeated dental procedures on the tooth, or a crack or chip in the tooth or traumatic injury to the tooth. If pulp inflammation or infection is left untreated, it can cause pain or lead to an abscess.
Signs of pulp damage include throbbing pain, prolonged sensitivity to heat or cold, discoloration of the tooth, swelling and tenderness in the nearby gums. Sometimes, there are no symptoms. Endodontic treatment can often be performed in one or two visits depending on the complexity of the canal system and the severity of the infection. If symptoms persist even after successful non-surgical endodontic treatment the endodontist may advise surgery to save your tooth. Sometimes calcium deposits make a canal too narrow for the instruments used in root canal treatment requiring a surgical procedure to treat an infection or inflammation in the bony area around the end of your tooth. Surgery will aid in diagnosis and treatment. Surgery allows your endodontist to examine the root of your tooth, find the problem, and provide treatment. Most common surgical procedure rendered is called Apicoectomy or Root end resection
Apicoectomy: In this surgical procedure your endodontist reflects the gum tissue near the root end of the tooth, examines the underlying bone, gains access to the root end, removes infected tissue and resects the root end. He then seals the root end with an inert filling material and sutures the gum tissue back. Over a period of months the bone heals around the resected root end.