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What Is an Apicoectomy?

An apicoectomy—also called root-end surgery or root-end resection—is the most common form of endodontic microsurgery. It treats persistent inflammation or infection around the tip of a tooth’s root when a nonsurgical approach is not appropriate or has not resolved the problem.

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Why Might Endodontic Surgery Be Recommended?

• Disease persists near the root tip after root canal treatment

• Calcification or an obstruction prevents nonsurgical access to the end of a canal

• A post or restoration makes retreatment from inside the tooth impractical

• A root surface, surrounding bone, resorptive defect, or suspected fracture needs direct evaluation

• A biopsy or direct visualization is needed to clarify the diagnosis

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Surgery is not automatically the next step for every previously treated tooth. Your endodontist compares retreatment, surgery, continued observation, and extraction based on the cause of disease and the prognosis of the tooth.

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What Happens During an Apicoectomy?

• The area is completely numbed with local anesthesia.

• A small opening is made in the gum tissue near the tooth to access the root end and surrounding bone.

• Inflamed or infected tissue is removed, and the root end is carefully inspected under magnification.

• A small portion of the root tip is removed.

• The end of the canal is prepared and sealed with a biocompatible root-end filling material.

• A few sutures are placed while the gum tissue heals. Over time, bone can heal around the root end.

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What Is Recovery Like?

Most patients return to ordinary activities the next day, although swelling, bruising, and tenderness vary. Follow the written postoperative instructions regarding medication, oral hygiene, food, cold compresses, and activity. Sutures may need to be removed at a follow-up visit. Bone healing occurs over the following months and is evaluated clinically and radiographically.

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When Should I Call?

Call for severe or worsening pain, increasing swelling, persistent bleeding, fever, a medication reaction, or anything that does not follow the expected recovery described by your doctor. Difficulty breathing or swallowing or rapidly increasing facial or neck swelling requires immediate emergency evaluation.

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Frequently Asked Questions

Will I be asleep?

Apicoectomy is generally performed with local anesthesia. Advanced Endodontics does not advertise oral or IV sedation. Nitrous oxide may be available for relaxation when clinically appropriate.

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Is the entire root removed?

No. Only a small portion at the end of the root is removed. The tooth remains in place.

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What are the alternatives?

Depending on the tooth, alternatives can include nonsurgical retreatment, monitoring, or extraction followed by a replacement option. Your endodontist will explain which choices are reasonable in your situation.

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Schedule an Evaluation

If you have tooth pain, swelling, a cracked tooth, dental trauma, or questions about a previous root canal, our endodontists can evaluate the problem and explain your treatment options. Same-day emergency appointments are often available.

South County: (314) 894-5600   |   Festus: (636) 931-4020

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Clinically reviewed by the endodontists of Advanced Endodontics. This information is educational and does not replace an individual examination or diagnosis.