Occasionally, root canal therapy is not enough to save a tooth. In such cases, you may need an apicoectomy. This is a form of endodontic microsurgery that serves to help you avoid the pain and trouble of tooth extraction. With one of our doctors’ expert hands at Apex Endodontics and the technology we use, you can rest assured that you will have quality treatment if you need this type of surgery.

What is an Apicoectomy?


An apicoectomy is a microsurgical procedure that removes the apex, or very tip, of the tooth's root. In order to access this area, a small, temporary opening is made in the gum tissue by an endodontist.   After the opening is created in the gums, the apex of the root is removed along with any infection that surrounds the root.  Usually, a filling is placed in the end of the root to seal the root canal space. A few sutures (stitches) are placed in the gum tissue to make sure the area heals well.

Apicoectomies typically only occur in teeth that have already undergone root canal treatment. Sometimes, an endodontist may do a second root canal treatment (retreatment) before recommending an apicoectomy. In all cases, consult with your endodontist to determine the best course of action for your tooth.

Why Would I Need Apicoectomy?

If you have had root canal therapy and the tooth became infected after the procedure, you may need an apicoectomy to allow the doctor to clean out portions of the tooth unreached during the root canal.  For example, sometimes canals can become calcified, meaning deposits in the tooth make the canals smaller. If a tooth becomes too calcified, sometimes root canal treatment cannot access portions of the canal space.  An apicoectomy can sometimes be indicated in these cases.

What Happens During an Apicoectomy?

During an apicoectomy, you will first receive a numbing agent on your gums. Then, the doctor will create a small opening in the gum below the infected tooth. This small incision allows them access to the tip of the tooth.

Next, they will remove the root tip to access the canal from the bottom. The doctor will clean out the infected material from inside the root canal and seal the treated area. You should have small stitches to hold the incision closed. You might need imaging of the tooth during the procedure so the endodontist can see if other areas need treatment.

What Is Recovery Like?

After you complete the procedure, which may take up to an hour and a half, you will return home. Generally, some discomfort will set in after the local numbing agent wears off. However, you should only need over-the-counter pain medication to control the discomfort for the first few days.

The endodontist will provide you with post-operative instructions, including if you need to come back for a follow-up visit. Adhere to these instructions carefully to minimize your discomfort and speed your healing.

If you feel severe pain after the procedure or discomfort that lasts more than 4-5 days, please contact our office. Apicoectomy procedures have a high rate of success, and complications are rare.

Contact Apex Endodontics for Professional Care and Expert Endodontic Surgery

If your dentist recommends endodontic surgery, such as an apicoectomy, or retreatment, schedule a consultation with Apex Endodontics by calling us or using our online contact form. We strive to always provide our patients with the best care we can. Comfort, precision, and technology are what you will find when you have your apicoectomy with us at Apex Endodontics.