Apicoectomy (Root-End Surgery)

This operation may be used for a tooth with persistent infection after root canal treatment, particularly when repeat root treatment cannot improve the existing filling or a metal post cannot be removed safely.

Apical surgery is usually performed under local anaesthetic while you are awake, so the tooth area is numbed for the procedure.

Root-end surgery can leave temporary numbness in the gum, and gum healing can occasionally expose the edge of an existing crown. Infection can also return months or years later.

An apicoectomy cannot be guaranteed to succeed permanently: infection may return months or years later, when repeat surgery or removal of the tooth may be needed.

The gum is cut and lifted from the bone, a small amount of bone is removed to reach the infected area, infected tissue and part of the root tip are removed, and the root end is sealed with a small filling. Dissolving stitches close the gum.

You can go home immediately after apical surgery and many people do not need time away from work. Dissolving stitches usually disappear in about two weeks.

Repeating the root canal filling is the usual alternative considered before apical surgery. Removal of the tooth, followed by a denture, bridge, or dental implant, may also be considered.

The whole operation may take up to an hour. Bleeding afterwards is unusual; pressure over the area for at least 10 minutes can usually stop it.

Whether a tooth can be retreated depends on the existing root filling and whether a metal post can be removed without breaking the root.