A female asked:
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is it unsafe to have an apicoectomy of tooth #19? my dentist has made x-ray and found the infection under the root canal. i had my root canal done 3 years ago and just got a new crown. i had an appointment with oral surgeon today. he said that there is a

7 doctor answers
Dr. Mitchel Blumenthal
38 years experience Dentistry
Do : Do not have the apico done. Chances of success are poor at best. You will be much better served to have the tooth extracted and have an im.
Answered on Oct 3, 2016
Dr. Sander White
49 years experience Cosmetic Dentistry
Apicoectomy : Apicoectomy in this area is quite difficult and has risks of nerve damage. I would opt to have the root canal treatment redone or consider an implant instead.
Answered on Oct 3, 2016
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Dr. Raya Ben Dor
27 years experience Dentistry
I : I would have a consult with a good root canal specialist and not an oral surgeon.Depending on your case they might recommend root canal retreatment or apicoectomy or extraction.
Answered on Oct 3, 2016
Dr. Neil McLeod
48 years experience Prosthodontics
Just : Just so that we start off answering this question by the book you should know that the current trend is to discredit the long lasting value of re-treating "root canal treated teeth" in favor of extraction and implant replacement therapy. That being said i want to express my confidence in the capabilities of experienced competent endodontists (root canal specialists). If you were in los angeles i would refer you to one of my colleagues like dr etessami. As far as nerve damage during endodontic surgery is concerned, he would tell you that he has not encountered one single case of parasthesia (numbness) in 26 years of practice and he must have performed over 10, 000 surgeries in which 2000 have been lower posterior teeth. In regards to the prognosis and longevity of the tooth and surgery vs. Implant (or extraction) i would need to see the x-ray as a regular re-treatment should not be overlooked either sometimes surgery is not necessary. So to answer your question, please get a second or third opinion. Dr. Neil mcleod dentistry that lasts - quality that counts.
Answered on Oct 4, 2016
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Dr. Alex Shvartsman
24 years experience Cosmetic Dentistry
It depends: The best answer is to get a 3-d x-ray called a cone beam x-ray. Evaluation the tooth position relative to the nerve with 3-d x-rays will give the best answer. You may consider re-treating the root canal by a root canal specialist. This has a higher chance for success and less danger of nerve damage during an a pico.
Answered on Dec 10, 2013
Dr. Randolph Todd
43 years experience Endodontics
Safe procedure: If an appropriate clinical and radiographic evaluation has indicated that re-treatment is not an option and no other periodontal or anatomical factors are compromising the outcome, the risk factors are low for a competent endodontist or oral surgeon to successfully surgically treat the tooth. Professional literature supports the concept of retention of natural teeth over extraction.
Answered on Jul 6, 2013
Dr. Jonathan Richards
17 years experience Endodontics
Retreatment vs Apico: Both retreatment and apicoectomy have their place in dentistry. I prefer retreatment as a primary next step because it is a more conservative treatment and can be quite successful. This is not a discredit to apicoectomy though. Your case will be unique and should be evaluated by a competent endodontist. The use of cbct 3-d imaging will help with the decision-making. The os will say extract.
Answered on Sep 30, 2013

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