Apicoectomy: A Tooth-Saving Surgery

A tooth inflicted with caries is unpredictable. The infection can be confined to the crown or extend to the roots. However, there could be instances when the infection may spread beyond the apex (root tip where the nerves and blood vessels enter the tooth). Such cases cannot be treated through regular fillings or root canal therapy. Extensive procedures like apicoectomy may be indicated.  

Passaic, NJ oral surgery department comprises a team of skilled surgeons who have expertise in performing apicoectomy with great compassion and precision. 

What is apicoectomy?

Apicoectomy, or root end surgery, is a minimally invasive endodontic procedure that involves the excision of the infected root tip and preparation of a root end cavity that is restored with a biocompatible material. 

This procedure helps to curb the infection and prevent its spread to the surrounding structures by sealing the apex. 

When do dentists recommend apicoectomy? 

Root canal therapy (RCT) is an excellent tooth restoration procedure for pulp exposure and inflammation. However, if the treatment fails and the infection persists, an apicoectomy may be indicated. 

The purpose of an apicoectomy is the eradication of any residual infection and the ultimate preservation of the function of the affected tooth. It also saves your tooth from extraction.

Apicoectomy may be recommended for the following reasons: 

  • Small adjoining root branches
  • Failure to seal tiny root branches through RCT 
  • Blocked root canals
  • Fractured files stuck in a root apex during RCT 
  • Narrow or curved canals
  • Poorly shaped root canals that do not allow the endodontic files to reach the root tip 

How is apicoectomy performed? 

The affected tooth will be evaluated clinically and through panoramic X-rays to design the exact course of action. You will be prescribed antibiotics to treat the underlying infection before you are scheduled for surgery. 

The procedure is as follows:

  • Your dentist will administer local anesthesia to numb the affected tooth
  • A small cut (incision) will be made in the gums near the affected tooth.
  • The root will be exposed by lifting the gum flap.
  • To gain clear access, a tiny fraction of the jawbone will be removed.
  • The edge of the root tip and the infected tissue will be removed with special ultrasonic instruments. 
  • The root(s) will be sealed with a biocompatible material, and the dentist will close the incision through sutures. 

Your dentist will provide all the instructions about the necessary precautions and medications. Ideally, the sutures will be removed after 7 to 10 days. It may take several months for the tissues to heal completely. 


If you experience any pain or discomfort even after an RCT, it is advisable to consult your dentist immediately for further evaluation. 

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