Apicoectomy
A precise microsurgical procedure used to treat persistent infection and help save a tooth when conventional root canal treatment isn’t enough.
Specialized care to help save your tooth
When Root Canal Treatment Isn’t Enough
Most root canal treatments are highly effective, but sometimes infection can persist around the tip of the tooth’s root.
An apicoectomy allows our endodontists to access the affected area directly, remove the root tip and infected tissue, and seal the end of the canal to help preserve the natural tooth.
Treat Infection
Remove infection around the root tip.
Save Your Tooth
Preserve the natural tooth whenever possible.
Target the Source
Treat the affected area directly.
Support Healing
Help surrounding tissues recover.
The Right Treatment Starts With the Right Diagnosis
Persistent pain or infection after root canal treatment doesn’t always mean the tooth needs to be removed.
Our specialists carefully evaluate the tooth and surrounding tissues to determine the source of the problem and whether an apicoectomy is the appropriate next step.
Advanced imaging helps us plan treatment with greater precision before the procedure begins.
Clear answers before treatment
Your Apicoectomy, Step by Step
Evaluation & Planning
We evaluate the tooth and surrounding area before treatment.
Access the Root
A small opening is made to reach the affected root tip.
Remove the Infection
Infected tissue and the root tip are carefully removed.
Seal & Heal
The root end is sealed to support healing and protect the tooth.
Advanced Technology. Better Treatment Experience.
The GentleWave® System cleans and disinfects the root canal more thoroughly, helping preserve healthy tooth structure for predictable results.
Advanced Technology. Better Treatment Experience.
Small field high resolution 3D imaging helps our specialists see fine details for more precise diagnosis and treatment planning.
Frequently Asked Questions
Ask a Question
Why can a tooth hurt again after it has already had a root canal?
A previously treated tooth can develop symptoms for several reasons.
There may be persistent or new infection, untreated anatomy, leakage around a restoration, a crack, a problem with the surrounding tissues, or pain coming from another source.
The first step is determining why the tooth is symptomatic before deciding whether additional treatment is appropriate.
Can a root canal-treated tooth become infected again?
Yes.
Bacteria can sometimes persist within complex anatomy or re-enter a tooth later through decay, leakage, cracks, or problems with the restoration.
A new problem does not automatically mean the tooth must be removed. An endodontic evaluation can determine whether retreatment or another option is reasonable.
What is root canal retreatment?
Root canal retreatment means treating a tooth again after a previous root canal.
The endodontist accesses the root canal system, removes prior filling materials as needed, evaluates the anatomy, cleans and disinfects the canals again, and reseals the tooth.
The goal is to address the reason the previous treatment is no longer successful while preserving the natural tooth when possible.
Can an endodontist save a tooth when a previous root canal has failed?
Sometimes.
A previously treated tooth may be a candidate for nonsurgical retreatment, endodontic surgery, or another tooth-saving approach.
Whether saving it is predictable depends on the cause of the problem, remaining tooth structure, cracks, periodontal support, prior treatment, and restorability.
How do you decide whether a tooth needs retreatment, surgery, or extraction?
The decision starts with the diagnosis.
Your endodontist evaluates why the previous treatment is failing, the anatomy of the tooth, existing restorations, remaining tooth structure, infection, possible cracks, and the likelihood that another procedure can provide a predictable result.
The advantages and limitations of the reasonable options can then be discussed with you.
What is an apicoectomy?
An apicoectomy is an endodontic surgical procedure performed near the tip of a tooth’s root.
The endodontist accesses the root through the gum and surrounding bone, removes diseased tissue and a small portion of the root tip, and seals the end of the root when appropriate.
When might an apicoectomy be recommended instead of retreatment?
Endodontic surgery may be considered when disease persists around the root and nonsurgical retreatment is impractical, unlikely to address the problem, or has already been attempted.
The best option depends on the cause of the problem, the anatomy of the tooth, existing dental work, and the overall prognosis.
Can a root canal be retreated through an existing crown?
Sometimes.
In certain cases the endodontist can access the root canal system through an existing crown.
In other situations, the crown may need to be removed or replaced because of its condition, the type of restoration, decay, leakage, or the treatment plan.
Does a crown always have to be removed for root canal retreatment?
No.
Whether a crown can remain in place depends on its condition, the anatomy beneath it, the access needed for retreatment, and whether there is concern about decay or leakage.
Your endodontist evaluates this as part of treatment planning.
How does CBCT help evaluate a tooth that already had a root canal?
Three-dimensional imaging can provide additional information about root anatomy, areas of bone change, previously treated or untreated canal spaces, resorption, treatment complications, and nearby structures.
This information can help determine why a tooth is having problems and whether retreatment, surgery, or another option is reasonable.
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