Surgical Endodontics

We are happy to accept referrals for consideration of peri-radicular surgery / apicectomy.

We would however respectfully request that the following be noted.

1) Location: Ordinarily we would only consider apicecting the upper anterior teeth (i.e. upper central & lateral incisors and the upper canine teeth). Due to a number of anatomical reasons, apical surgery on other teeth is difficult, caries several varying risks and is likely to be associated with poor outcomes.

2) Repeat orthograde root canal treatment. Existing guidance (see below) suggests that efforts should be made to repeat the orthograde root canal treatment / filling where at all possible before considering apical surgery - even if further primary care cost is involved. It would be inappropriate to carry out apical surgery in secondary care because there is 'no charge', over repeat RCT in primary care (with charge).

3) Radiographs. Referrals should be accompanied by an up-to-date, good quality, appropriately-sized radiograph as per our radiology guidelines mentioned elsewhere in this section.

We will consider apical surgery on, say, an upper first premolar if this should be part of an otherwise satisfactory bridge but the prognosis will be poor given the two-rooted nature of these teeth.

We will offer apical surgery under local anaesthetic and / or IV sedation.

The current guidance for Surgical Endodontics is as follows

FDS RCS (Eng) - Guidance for Surgical Endodontics 2012

Page updated 07/10/17