Dr. Lina Cortes was born and raised in Colombia and attended Autonoma University School of Dentistry in Manizales, where she received her Doctor in Dental Surgery (D.D.S) in 2001. She practiced general dentistry in Colombia for several years. In 2010 Dr. Cortes completed a one year program in Endodontics for International Dentists at New York University and then was accepted into the Post-Doctoral program and there achieved her specialty in Endodontics in 2013. While at NYU, Dr. Cortes completed research in endodontic topics including treatment of immature permanent teeth and participated in outreach programs in Mexico and Ecuador. Dr. Cortes is Board eligible and is well on her way in becoming a Diplomate of the American Association of Endodontists.
She is currently a member of the American Association of Endodontics, American Dental Association, Florida Dental Association, Florida Association of Endodontists, Hispanic Dental Association, Panamerican Dental Association, and Coamed.
If your dentist is recommending an apicoectomy, it means that your tooth cannot be successfully treated with conventional root canal treatment (which will be described below). An apicoectomy is a minor surgical procedure in which the very tip of the tooths root is removed (apico apex or end; ectomy removal) and sealed. It is usually performed by an endodontist (endo inside; dont tooth), a dentist who specializes in the diagnosis and treatment of tooth pain from root canal disease.
As the illustration on this page shows, a space inside the tooth called the pulp chamber houses the pulp the living tissue (nerves, blood vessels and connective tissues) that keeps the tooth alive. A root canal system branches from this chamber. Endodontic treatment, commonly known as root canal treatment, is needed when the pulp becomes inflamed or infected. This can happen for several reasons: deep tooth decay; repeated dental procedures to a tooth (replacing a large filling, for example); or traumatic damage such as a crack, chip or even a fracture. If the pulp dies, the pulp chamber and canals can become infected. That infection can eventually spread into the surrounding bone and other tissues around the tip of the root.
Endodontists use radiographs (x-rays), or sometimes CBCT scans (cone beam-computed tomography) that create three-dimensional views, to examine root canals and diagnose disease that might otherwise go undetected.
Conventional root canal treatment involves drilling a small access hole into the pulp chamber through the biting surface of a back tooth, or from behind a front tooth. Inflamed or infected tissue is removed from the pulp chamber and root canals, and the space is disinfected, shaped with tiny flexible instruments, filled, and sealed. A temporary or permanent filling material will then be placed to cover the access hole. A permanent cap (crown) is often used to replace lost tooth structure and to protect the tooth from biting stresses and further damage.
As you can see, a lot of work goes into treating root canal infection. But root canals may become re-infected for a variety of reasons: new or recurrent decay; previously undetected accessory (extra) canals branching from the primary canal at the root end of the tooth; and, occasionally, calcification (narrowing and hardening) of canals a reaction to trauma or aging that can block the canals and prevent them from being fully cleaned by conventional root canal treatment.
Sometimes, conventional root canal retreatment may not be feasible, or may even jeopardize the tooth. For example, accessing the canals of a tooth that has a crown and a post in place may require taking apart the entire restoration, which could further weaken the tooth. In such cases, a better alternative is to treat infection from the root end of the tooth (instead of the crown end) with an apicoectomy.
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