An apicoectomy is another option for endodontic re-treatment. During the procedure, an incision is made in the gum tissue surrounding the tooth and the gum is retracted to create a window of access into the root system. The infected or inflamed tissue is removed, along with the tip of the root. A root-end filling may also be placed to seal the end of the root canal. Finally, a few stitches will be placed in the gum tissue to close off the treated area. Approximately one week after surgery, the patient will come back to have the stitches removed and have the area checked to ensure healing is progressing properly.
During an intentional replant, the tooth is extracted and treated endodontically while the tooth is outside of the mouth. Similar to an apicoectomy, the root tips are resected and filled with a root end filling. Once endodontic treatment is complete, the tooth is placed back in the mouth and stitches help keep it in place while the connections between the tooth and socket reform. Approximately one week after surgery, the patient will come back to have these stitches removed and have the area checked to ensure the tooth is resting firmly in the socket. An intentional replant is used instead of an apicoectomy in order to more closely look for cracks which may explain why the tooth failed to heal after initial treatment.