Apicodental surgery, also known as epichoectomy or endodontic surgery, is an advanced dental procedure for saving teeth that cannot be saved with conventional root canal treatment (nervectomy). This surgery is performed with the aim of removing infection or inflammation at the tip of the tooth root and surrounding tissues to prevent tooth extraction. Due to the advances in dentistry, epico surgery is an effective option for people who do not want to lose their natural teeth. In this comprehensive article, we will examine this method in detail, the reasons for its need, prevention methods, alternative treatments and care tips so that complete information is provided to you. **What is dental apico surgery?** Apico surgery or apicoectomy is a specialized surgery performed by endodontists or maxillofacial surgeons. In this method, the dentist accesses the tip of the tooth root by cutting the gum, removes the inflamed or infected part of the root and fills the root canal with special materials. This procedure is usually recommended when primary root canal treatment has failed or anatomical problems prevent non-surgical treatment. ### **The difference between epicocectomy and denervation** Unlike **nerve extraction** which is done through the crown of the tooth, epico surgery focuses directly on the root of the tooth. This method is also known as retrograde surgery, because access to the root is done in the reverse direction (from gum to root). The main purpose of this surgery is to remove lesions such as **cyst**, granuloma or abscess around the root. ### **Reasons for the need for dental apico surgery** #### **Problems after root canal treatment** One of the most common reasons for the need for this surgery is the failure of primary root treatment. This problem may occur for the following reasons: - **Incomplete root canal treatment:** If the root canals are not completely cleaned or filled, the infection remains. - **Sub-canals:** The presence of small and inaccessible canals in the root that are not treated in normal denervation. - **Stable lesions:** Cysts or granulomas that have not improved after denervation. #### **Anatomical problems** Some teeth are not suitable for conventional root canal treatment due to their special structure, such as calcification (calcium deposition), canal obstruction or root curvature. In these cases, epico surgery is an effective solution. #### **Remedial Considerations** Teeth that have veneers or Post & Core may face the risk of root fracture in retreatment. **Epicectomy** is suggested as an option to save these teeth. #### **detection of hidden waste** In some cases, infection or root fracture is not evident on radiographic images. Epico surgery can be used to accurately diagnose and treat these problems. ### **Methods to prevent the need for epico surgery** #### **Oral care** It is possible to prevent the need for dental epic surgery by observing **oral and dental hygiene**. These measures include the following: - **Regular brushing:** at least twice a day with fluoride toothpaste. - **Dental floss:** To remove plaque and food particles from between the teeth. - **Mouthwash:** Using antibacterial mouthwashes to reduce the risk of infection. #### **regular visits to the dentist** Periodic checkups (every 6 months) help in early detection of dental problems such as decay or infection. This can reduce the need for complex treatments such as **epico surgery**. #### **healthy diet** Consuming low-sugar foods rich in calcium and vitamin D helps strengthen teeth. Avoiding sticky and sweet foods reduces the risk of caries. #### **Protection of teeth** Using a mouth guard in contact sports or during bruxism can prevent damage to the teeth. ### **Alternative Therapies for Epicosurgery** #### **Re-treatment of the root (Reendo)** In many cases, root canal treatment is recommended instead of surgery. This procedure involves opening the tooth, re-cleaning the canals and filling them. If there are no anatomical problems, this method can be more effective and less expensive. #### **Tooth extraction and replacement** If epichoectomy is not possible or not successful, the next option is to extract the tooth and replace it with a **dental implant**, **bridge** or **prosthetic tooth**. However, implants are expensive and require a separate surgery. #### **conservative treatments** In some cases, the use of antibiotics or anti-inflammatory treatments may temporarily control the infection, but these methods are usually not a permanent solution. ### **Steps of performing dental epic surgery** #### **Preparation** Before the surgery, the dentist checks the condition of the root by taking radiographic images (CBCT or OPG). The patient should report any drug sensitivity or underlying disease. #### **surgical process** - **Local anesthesia:** The target area becomes numb. - **Gum cutting:** The gum is cut and pushed aside to expose the root. - ** Removal of the root tip: ** The inflamed or infected part of the root is cut. - **Tissue cleaning:** Cysts or infected tissues are removed. - **Canal filling:** The end of the root is filled with biocompatible materials. - **Suture:** The gum is sutured and prepared for healing. ### **Post-surgery care** - **Cold compress:** To reduce swelling, put a cold compress on the area for 20 minutes. - **Drugs:** Taking antibiotics and painkillers as prescribed by the dentist. **Avoid pressure:** Avoid chewing with the operated tooth. - **Oral hygiene:** Rinse the mouth with salt water solution. ### **Exercises and care tips** #### **soft diet** After Epico surgery, it is recommended to eat soft foods such as soup, mashed potatoes, and yogurt. Avoid hard, hot or spicy foods. #### **Avoid heavy activities** Avoid strenuous exercise or heavy lifting for a few days to avoid putting pressure on the surgical area. #### **gentle wash** Avoid brushing directly on the surgical area. Gently washing with salt water helps to heal. ### **Conclusion: Is Epico Surgery Right For You?** Epicodental surgery is an effective option to save teeth that cannot be treated with conventional methods. By removing infection and root inflammation, this method helps to preserve natural teeth and prevent the need for implants or prostheses. By following prevention tips such as oral hygiene and regular checkups, you can reduce the possibility of needing this surgery. If your dentist recommends this method, you can get the best result with careful consultation and choosing an experienced specialist. For more information or to book an appointment, contact a reputable dental clinic and protect your oral health. ### **