Sometimes root canal therapy alone cannot save an infected tooth. In such cases, the doctor may recommend apicoectomy surgery.

Surgery is indicated in a variety of instances including:

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.