Apicoectomy

When Root Canal Isn't Enough — Microsurgery Can Help

An apicoectomy is a minor surgical procedure that removes the root tip and surrounding infected tissue. It's often the last option before extraction — and it works.

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What is an Apicoectomy?

An apicoectomy (also called root end resection or periradicular surgery) is an endodontic surgical procedure where the tip (apex) of a tooth's root is removed along with any infected tissue. A small filling is then placed to seal the root end.

It is typically recommended when:

  • A root canal or retreatment has not resolved the infection
  • Persistent symptoms remain after conventional treatment
  • A crown or post makes retreatment through the crown impractical
  • Anatomy of the root makes the apex inaccessible with files

The Procedure

1. Local Anesthesia

The area is fully numbed. You will feel pressure but not pain.

2. Incision & Access

A small incision is made in the gum to expose the bone and root tip.

3. Root Tip Removal

A few millimeters of the root end is removed along with infected tissue.

4. Sealing & Closure

The root end is sealed with a biocompatible filling and the gum is sutured closed.

FAQ

Frequently Asked Questions

Is an apicoectomy painful?

The procedure is done under local anesthesia and is generally well-tolerated. Some swelling and tenderness for 2–3 days after is expected.

What is the success rate of apicoectomy?

Studies report 85–95% success rates when performed by an experienced endodontist. Success is defined as healing of the bone and resolution of symptoms at a follow-up x-ray after 1 year.

How long is recovery?

Most patients return to work and normal activities the next day. We recommend a soft diet and limited physical activity for a few days. Sutures are removed after about a week.

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