Apicoectomy

When a root canal is not enough, endodontic surgery can save your tooth and restore full function.
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What is an apicoectomy?

In many cases, a root canal is enough to treat an injured or infected tooth and help prevent the need for extraction. Occasionally, however, a tooth may not heal as expected after a root canal. When this happens, your endodontist may recommend endodontic surgery to address the underlying issue and give the tooth the best chance of being saved.

Endodontic surgery may be recommended to identify small fractures or additional canals that cannot be seen on traditional X-rays but may be contributing to ongoing symptoms. It can also be used to treat infection or damage affecting the tip of the root and surrounding bone.

One of the most common endodontic surgical procedures is an apicoectomy, also known as a root-end resection. During the procedure, a small opening is made in the gum to access the area around the root. The inflamed or infected tissue and a small portion of the root tip are carefully removed. A small filling is then placed at the end of the root to help prevent further infection, and the gum is gently sutured closed.

Some tenderness, swelling, or sensitivity is normal as the area heals. We will provide you with detailed aftercare instructions and recommend appropriate medication to help keep you comfortable during recovery. If you experience significant pain or discomfort that is not relieved with the recommended medication, please contact our office so we can assist you.

Signs you may need treatment

Persistent Tooth Pain

Hidden Canals/Fracture

Swelling Or Tenderness

Bone Infection

What to expect

1

Diagnose

We examine whether non-surgical treatment is sufficient. If infection or inflammation remains after root canal, or if there are hidden canals, fractures, or damaged root surfaces and surrounding bone, we recommend apicoectomy.

2

Treat

An incision is made in the gum tissue to expose the bone and surrounding inflamed tissue. The damaged tissue is removed along with the end of the root tip. A root-end filling is placed to prevent reinfection of the root and the gum is sutured.

3

Restore

The bone naturally heals around the root over a period of months restoring full function. Following the procedure, there may be some discomfort or slight swelling while the incision heals. This is normal and an appropriate pain medication will be recommended.

Common questions

How painful is an apicoectomy?
Most patients report only mild to moderate discomfort after an apicoectomy. Local anesthesia is used during treatment to keep you comfortable, and any soreness afterward is typically manageable with prescribed or over-the-counter pain medication.
A root canal is usually the first and preferred treatment for saving an infected tooth. However, if infection persists after a root canal, an apicoectomy surgery may be the best option to preserve the natural tooth and avoid extraction.
As with any surgical procedure, there are potential risks including swelling, discomfort, infection, or delayed healing. In some cases, the tooth may not heal as expected and additional treatment could be necessary. However, apicoectomy procedures are generally considered safe and effective.
A patient may need an apicoectomy if infection or inflammation remains after root canal, if there are hidden canals or fractures that cannot be treated non-surgically, or if the root tip and surrounding bone have become damaged and need treatment.
Apicoectomy cost can vary depending on location of the tooth, complexity of the case, and whether advanced imaging or sedation is required. In many cases, dental insurance may cover a portion if it is medically necessary. During your consultation, we will review your plan and discuss pricing.