Apicoectomy

What is an Apicoectomy?

An apicoectomy is a surgical procedure that attempts to remove infection from the tip of the tooth root (apex), where nerves and blood vessels enter the tooth.

An apicoectomy, sometimes called endodontic microsurgery because the procedure is performed under an operating microscope, is usually performed only after a tooth has had at least one root canal procedure and usually a second root canal treatment.

Endodontic surgery can be used to locate fractures or hidden canals that do not appear on X-rays but still manifest pain in the tooth. Damaged root surfaces or the surrounding bone may also be treated with this procedure. The most common surgery used to save damaged teeth is an apicoectomy, or root-end resection.


Overall, an apicoectomy is a safe and effective procedure that can help save a tooth that would otherwise need to be extracted. If you are experiencing persistent pain or swelling after a root canal procedure, you may want to speak with your dentist or endodontist to determine if an apicoectomy is the best course of action for your specific case.

Apicoectomy FAQs

  • What is an apicoectomy?

    Endodontic retreatment is a procedure performed on a tooth that has previously received root canal therapy but has not healed properly or has developed new problems. During retreatment, the old filling materials are removed, the canals are cleaned and disinfected again, and the space is refilled and sealed to promote renewed healing.

  • Why would I need an apicoectomy?

    This will vary depending on the procedure and tooth. 

  • How is an apicoectomy different from a root canal or retreatment?

    Retreatment revisits an already treated tooth. The process involves removing existing filling material (gutta-percha), carefully re-cleaning and reshaping the canals, and resealing them — often with the aid of advanced magnification and imaging to locate previously missed anatomy.

  • How do I know if I need an apicoectomy?

    Unless specifically told by our office, you can drive on your own.

  • What happens during the procedure?

    While no treatment offers a 100% guarantee, retreatment success rates are high — typically above 85–90%. Proper restoration, hygiene, and follow-up greatly improve long-term outcomes.

  • How long does an apicoectomy take?

    Unless specifically told by our office, there are no restrictions on the day of your appointment.  Much like a filling, you should be very careful with hot liquids or with biting/chewing until the numbness subsides.

  • Is an apicoectomy painful?

    No. The procedure is done under local anesthesia, ensuring your comfort throughout. Most patients report that retreatment feels similar to having a standard root canal.

  • What can I expect after surgery?

    The price will vary depending on the procedure and tooth. 

  • How long does it take to heal?

    Yes, in many cases. A new crown or restoration helps protect the tooth and prevent reinfection. Your endodontist and restorative dentist will coordinate to ensure a proper seal and natural appearance.

  • Will I have stitches?

    Yes, small sutures are placed to help the gum heal. These are typically removed within a week at a follow-up appointment.

  • What are the benefits of an apicoectomy?

    Most patients return to work or school the same day or the next. You should follow any specific post-operative instructions provided by your endodontist.

  • What are the risks?

    Maintain good oral hygiene — brushing, flossing, and attending regular checkups. If you experience swelling, discomfort beyond a few days, or new symptoms, contact your endodontist promptly.

  • What if the apicoectomy doesn’t work?

    If retreatment cannot resolve the issue, your endodontist may recommend an apicoectomy (a minor surgical procedure to clean the root tip) or extraction followed by an implant or bridge. However, preserving your natural tooth is usually the best option when possible.

  • How successful is an apicoectomy?

    With modern technology and proper care, retreatment outcomes are excellent — most patients keep their retreated tooth for many years, often for life.

  • Will my tooth look or feel different afterward?

    No. The tooth remains functional and natural-looking. Once healed, you should not notice any difference in comfort or appearance.

  • How do I care for my tooth after an apicoectomy?

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