Online Dental Education Library

Dr. Goldman and his staff strive to improve the overall health of our patients by focusing on preventing, diagnosing and treating conditions associated with your teeth and gums. Please use our dental library to learn more about dental problems and treatments available. If you have questions, please contact us.

Oral and maxillofacial surgeons are unique among dentists in that they all have completed an additional four years of hospital-based training alongside medical residents, and can administer all types of anesthesia. If you have a diseased or impacted tooth that needs to come out, implants to be placed, a suspicious lesion that needs a biopsy, or any other oral health condition requiring surgical diagnosis or treatment, we can help. Learn more about Oral Surgery.

Snoring & Sleep Apnea

Chronic loud snoring is a common symptom of Obstructive Sleep Apnea (OSA), which occurs when the upper airway is blocked to the point of causing significant airflow disruption, or even no airflow whatsoever for 10 seconds or more. This can be a dangerous situation. Learn more about Snoring & Sleep Apnea.

Tooth Extractions

There are times when it is in your best interest to have a tooth extracted (removed). This could be the case for a variety of reasons, including: damage or trauma to the tooth; an impacted wisdom tooth that may cause trouble for you later on; or overcrowding. Learn more about Tooth Extractions.

Implant Dentistry

Dental Implant Video

If you are missing one or more teeth, dental implants offer the comfort and security of a permanent replacement that looks and functions just like your natural teeth. Dental implants also help preserve the tooth-supporting bone in your jaw that deteriorates when even one tooth is lost.

Oral Diagnosis & Biopsies

When it comes to detecting certain oral or systemic (whole-body) diseases, a thorough dental exam may be your first line of defense. Learn more about Oral Diagnosis & Biopsies.

Bone Grafting

Bone grafting, a minor in-office surgical procedure, is commonly used in dentistry to correct deficiencies in bone quality and to build support for teeth or dental implants. Learn more about Bone Grafting.

Sedation Dentistry & Anesthesia

We want you to have the most comfortable dental treatment experience possible. That's why we offer sedation, to help you relax, and/or anesthesia, to block your sensations of pain. Learn more about Sedation Dentistry.

Facial Trauma & Reconstructive Surgery

Oral and maxillofacial surgeons are capable of treating the full scope of injuries to the structures of the face, mouth or jaws — including the teeth, the bones of the jaws and face, and the tissue of the skin and gums. We can also treat congenital defects such as cleft palate.

TMJ Disorders

If you have chronic pain in or around your jaw, or find the movement of your jaw is restricted, you may be suffering from a temporomandibular joint (TMJ) disorder. Learn more about TMJ Disorders.

Treating Dental Emergencies

We can treat a variety of traumatic dental injuries, including teeth that have been moved or knocked out entirely. Please call our office for assistance, or click here to learn more about what to do in a dental emergency.

Occasionally, root canal treatment proves unsuccessful at resolving an infection in the tissues near a tooth's roots. That's when a minor surgical procedure called an apicoectomy may be recommended. Because this procedure is often performed with the aid of a microscope and other small specialized tools, it's considered a type of endodontic microsurgery. Probably the most common type of root canal surgery, an apicoectomy involves removing a small portion of the apex (tip) of the tooth's root, along with any surrounding hard or soft tissue that may be infected.

What would cause you to need an apicoectomy? There could be several reasons, including a canal that is blocked or inaccessible, an anatomical irregularity, or a fracture or crack in the tooth's roots. The procedure is normally only recommended after one or more root canal treatments have been attempted, and have failed. Since this type of problem generally occurs near the apex of the root, the procedure is often an effective way to treat a persistent infection.

Root canal surgery apicoectomy.Before an apicoectomy procedure, diagnostic images (such as X-rays) of the affected tooth and surrounding bone, a careful review of your medical history including medications you take (both prescription and non-prescription), and other factors are reviewed. If an apicoectomy is recommended, the reasons for it will be explained to you.

The Apicoectomy Procedure

Root canal surgery is usually performed under local anesthesia such as a numbing shot, so you won't feel any pain. To begin the procedure, a small incision is made in the gum, and the infection at the end of the tooth's roots is exposed. The infected tissue is then removed, along with a few millimeters of the root tip itself. A dye may be used to help make cracks or fractures easy to see; if we discover that the tooth is fractured, it may be better to extract (remove) it at this time instead of completing the apicoectomy.

Next, a microscope and light are used to examine the tiny canals. They will be cleaned with an ultrasonic instrument, then filled with an inert material and sealed up with a small filling. To finish the procedure, a small bone graft may be placed at the affected site, and then the gum tissue covering the tooth's root will be sutured (sewn) closed. X-rays may also be taken as the procedure nears completion. Afterwards, instructions on postoperative care will be given, and you'll go home. Most apicoectomies take about 30 to 90 minutes to complete.

Following the procedure, you may experience some swelling and soreness in the area that was treated. Over-the-counter non-steroidal anti-inflammatory medications (such as ibuprofen) are usually all that's needed to control any discomfort. You can probably return to normal activities the following day, but you may want to avoid eating hard or crunchy foods or brushing vigorously for a few days afterwards. If your sutures aren't self-dissolving, you will be asked to return in about a week to have them removed.

The Goal: Saving Your Tooth

Although apicoectomy is typically a safe and effective procedure, there are slight risks with any type of minor surgery. That's why apicoectomies are not recommended unless further root canal treatment won't be effective. An alternative treatment in most cases would be extraction of the tooth. However, our goal as dentists is to help you preserve your natural teeth for as long as possible.

While there are excellent methods of tooth replacement (such as dental implants), these involve further and more complex treatments, and they can be costly. An apicoectomy is generally a permanent and cost-effective solution which can help the tooth last for the rest of your life.

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Common Concerns About Root Canal Treatment The term “root canal” can send shivers down many a spine. However, preconceived notions that root canal treatment is filled with pain and discomfort are nothing more than outdated myths. In fact, root canal treatment doesn't cause pain but actually relieves it... Read Article


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