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Q. Should I undergo apicoectomy for RCT done shorter than the working length?

Answered by
Dr. Himayoon Majeed Mir
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Dec 30, 2018

Hello doctor,

I got my front (upper 12 probably) tooth RCT done six months ago. The RCT was short because I experienced acute pain beyond that point. RCT is about 1.8 mm short. He then suggested getting apicoectomy because RCT was incomplete. From a second opinion, the other doctor recommended a re-RCT. What should I do? Do I need to get the surgical procedure done? I have no symptoms of pain in the tooth. My teeth are generally weak and hence a little pressure is felt. The tooth area is mildly sensitive, but I suspect it to be from other nearby infected tooth.

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Hello,

Welcome to icliniq.com.

I have been through your query, and I can understand your concern.

Endodontic treatment for any tooth when it is not completely done like in your case it is short. It might be that you cannot feel pain or have any other discomfort. But it is highly susceptible to the secondary infection in the root. I would highly recommend going for the re-RCT treatment as it will not require any major surgical procedure and the tooth will be saved as a whole (in retreatment only minimal tooth material is lost). However, sometimes if space is some mm short, then if the root canal is properly sealed, it might not lead to further secondary infection. But that is just one such case. So if you wanna wait for the symptoms, you can but I would suggest you go for re-RCT.

Apicoectomy is more invasive and will remove a small unfilled lower portion of the tooth and then accordingly seal the apex of the root. This also is a way to seal off the apex for underfilled root canals in RCT. But re-RCT is more desirable for me if you would have been my patient. Also, maintain good oral hygiene and brush your teeth twice daily and floss regularly.


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