What are the alternatives to apicoectomy surgery?

Apicoectomies are performed on teeth that have had a prior root canal procedure that has failed. This procedure is a 'reverse' root canal in which the tooth's apex is cleaned, shaped and sealed through a surgically made window near the end of the root. Although apical surgery is a viable way of addressing a failed root canal, patients do have two other treatment options.

If the tooth is amenable, than a conventional endodontic retreatment probably has a greater chance of success. This is a good option if the tooth has not been restored with a post and core or if an endodontist feels that a post maybe safely removed in order to retreat the root canal conventionally.

Another option that has become increasingly popular is to skip an apical procedure and instead extract the tooth in question and place an implant instead. Proponents of this treatment usually maintain that it is better to place an implant while there is sufficient bone at the site. (Usually performing apical surgery involves removing some additional bone at the apex in order for the surgeon to have better access to the end of the root.)Further more they often point out that apical surgeries have a lower rate of success than implants do.

Personally I believe that each case should be considered on an individual basis with a patient's individual circumstance carefully evaluated, before a decision is made on which course of treatment is best.