Surgical Information


You have been referred to an Endodontist for Surgical Root Canal Therapy

It has been determined that surgical root canal therapy is the treatment of choice to treat the problem with your tooth.

There are several reasons why surgical root canal therapy may be necessary.

These include:

  1. A need to institute drainage, which cannot be achieved through the tooth.
  2. Inabilities to seal the root end by normal means due to calcification, obstructions, resorption or previous treatments.
  3. Persistent post-procedural discomfort.
  4. The presence of infection, which will not heal in the normal manner.

No tooth will be treated unless we feel there is an excellent chance of success.

While there is not absolute certainty about healing anywhere in the body, studies indicate that treatment is successful in 80 to 90% of cases. It is possible that your chances of success may fall below this expectancy, or that your tooth may not be amenable to surgical root canal therapy at all. You will be advised of this at the time of your consultation and informed of your treatment alternatives.

It is our policy that no treatment be rendered until our patients are completely comfortable with all aspects of their care.

The procedure involves making an incision in the gum tissue around your tooth. This tissue is then carefully lifted away so that the bone overlying the area can be examined. The soft tissue infection is cleaned from inside to the bone and the end of the root is prepared to receive a root end filling in order to arrest the infection. There are number of filling materials that can be used. We recommend IRM or Super EBA cement. Please discuss the choice of filling materal with us.

The surgical procedure involves the use of microsurgical techniques. The area is examined under high-powered magnification for structural defects and fractures in the tooth or root. If the infection is severe, then it is often necessary to place a bone graft in the area to optimize the healing potential. If this applies to your specific case, you will be informed of this. Once the procedure has been completed, the gum tissue will be repositioned and stitches place to hold it in place.

The procedure is performed after the area is well anaesthetized with local anesthetic. In some cases, sedation is also recommended.

If you would like to have sedation, for your surgical procedure, please advise us so that we can discuss this with you.

Schedule your time so you do not have to resume any activity for the remainder of the day of your procedure. Depending on your individiual situation, you should be able to resume normal activity the next day.

Call us if you have any concerns. Remember that you have stitches in your mouth. If not the dissolving type, these will be remove at your next appointment. If you have any questions, stop before proceeding, and call our office.

Follow up visits and radiographs are part of your care in our office. These are necessary to evaluate the healing process as this can take 6 to 18 months. A notice will be mailed to you at the appropriate time for your re-examination.

It is important to note that we all heal differently. Successful surgical root canal therapy means that there is an absence of pain, swelling, no discharge and normal gum contour and colour.

Radiographically, we expect to see the regeneration of bone around the root of the tooth.

Following all surgical endodontic procedures, vague feeling, occasional twinges, or the sense that the tooth is different from other teeth are all possible outcomes. This is merely part of the healing response. Please notify us if you have any concerns.

As an endodontist, I solely perform root canal treatment, and corrective surgery when failures occur. Please feel free to discuss any aspect of treatment with me.

Possible Causes for Endodontic Surgery

  1. Anatomic complications of the root canal system resulting in symptoms and or pathology. For example: Calcified canals, severely curved canals, root resorption, additional canals, and incomplete canal formation.
  2. Problems associated with symptoms and/or pathology where non-surgical re-treatment is not possible. Such as: Irretrievable root filling material, crowned teeth with a post and core, ledged canals, perforated canals, blocked canals, separated instruments or foreign bodies in the canals.
  3. Known trauma associated with symptoms and pathology. Horizontal root fracture near the apex often necessitates a surgical intervention.
  4. Expediency of treatment. Surgical treatment speeds the relief of pain and swelling, the ability to disinfect the canal or control exudates, accelerates healing by removing pathology.
  5. Treatment of failure of previous endodontics. Where there is no apparent cause of problems, filling and seal appear adequate, direct inspection and treatment are necessary.
  6. The prime alternative to treatment is extraction.

NOTE: Should you experience any difficulty with your tooth after treatment in our office, we would ask you to please contact me prior to having any further treatment undertaken elsewhere. I would appreciate seeing you again for follow-up and assessment.

It is our commitment to provide the latest in microsurgical equipment and techniques available to perform endodontic surgery. For your safety and protection, all instruments used during the procedure, including the dental handpieces, are stem sterilized in an autoclave.

Dr. Irwin Golosky graduated from the University of Toronto, Faculty of Dentistry in 1988. He then practiced general dentistry in Toronto for three years. He received his specialty Certificate in Endodontics @ Temple University, Philadelphia Pennsylvania, which he completed in 1993.