Apicoectomy is the most common endodontic surgical procedure. When inflammation or infection persists in the bony area around the end of your tooth after root canal therapy, your endodontics may suggest an apicoectomy. In this procedure, the endodontist or surgeon opens the gum tissue near the tooth to expose the underlying bone and the infected tissue is removed. The very end of the root is also removed and a small filling may be placed to seal the root canal.  Local anesthetics make the procedure comfortable and most patients return to their normal activities the next day. 

When is an Apicoectomy Necessary?

Surgery may be necessary for diagnosis. If you have persistent symptoms but no problems appear on your x-ray, your tooth may have a small fracture or an additional canal that could not be detected during nonsurgical treatment. In such a case, surgery may allow the doctor to examine the root of your tooth. In most cases they can find the problem and provide effective treatment.

Sometimes calcium deposits make a canal too narrow for the cleaning and shaping instruments used in nonsurgical root canal treatment to reach the end of the root. The endodontist may then fill the tip of the root through a small window in the gum.

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