What Is an Apicoectomy?
An apicoectomy, also known as root-end surgery, involves removing the tip (or apex) of the tooth’s root along with any surrounding infected or inflamed tissue. This procedure is performed when infection or inflammation persists in the bone around the end of the root, often despite previous root canal treatment.
When Is an Apicoectomy Needed?
Your endodontist may recommend an apicoectomy in the following situations:
- A previous root canal treatment has failed, and retreatment is not feasible
- Ongoing infection or inflammation is present at the root tip
- A tooth has complex anatomy or a root fracture that prevents successful retreatment
- A cyst or other lesion has developed near the root end
- Access through the crown is blocked by a post or restoration
Possible signs that may indicate the need for apicoectomy include:
- Swelling or tenderness in the gums
- Persistent discomfort or pain
- A recurrent pimple-like bump on the gum
- Radiographic evidence of infection, even in the absence of symptoms
What to Expect During the Procedure?
A comprehensive consultation is required prior to scheduling your apicoectomy. During this visit, we will review your medical and dental history, evaluate diagnostic imaging, and discuss treatment options to ensure this procedure is appropriate for your case. Apicoectomy is typically performed under local anesthesia and generally takes about 60 minutes, depending on the location and complexity. Here’s a step-by-step overview:
- Anesthesia and Access
The area is numbed with local anesthesia. A small incision is made in the gum tissue near the affected tooth to expose the underlying bone and root tip. - Removal of Infected Tissue
The inflamed or infected tissue, along with the root tip, is carefully removed. - Root-End Preparation and Filling
The root end is thoroughly cleaned and prepared using ultrasonic instruments. A biocompatible filling is then placed seal the end of the root canal and prevent reinfection. In some cases, the doctor may recommend submitting the removed tissue for a biopsy to further evaluate any underlying pathology. - Suturing and Healing
The gum tissue is sutured back into place. An ice pack will be provided, and the doctor will review detailed post op instructions. Most patients experience mild discomfort and swelling for a few days and can resume normal activities within a day or two.
Recovery and Aftercare
- Mild swelling, tenderness, or bruising is normal and usually subsides within a few days
- Pain can typically be managed with over-the counter or prescribed medication
- Apply a cold compress during the first 24 hours, followed by a warm compress afterward if needed, to minimize swelling or bruise
- Detailed post-operative care instructions and follow-up recommendation will be provided
- Stitches are typically removed within 5 to 7 days. Resorbable sutures may be used and dissolve on their own, eliminating the need for a follow-up suture removal appointment
Is Apicoectomy Successful?
Yes—apicoectomy is a highly successful procedure that can preserve a natural tooth that might otherwise require extraction. With the aid of advanced imaging, microsurgical techniques, and modern micro-instruments, today’s apicoectomies are more precise, effective, and comfortable than ever.
Still have questions?
We’re here to help you feel confident and informed about your care. Contact our office today to learn more about apicoectomy or schedule a consultation with our endodontic team.