Apicoectomy: Purpose and Procedure 

The root tip, known as the apex is the area through which the nerves and blood vessels enter the tooth structure to provide nutrition to the crown. When the tooth is infected or inflamed extending to the root, it can be treated through root canal treatment (RCT). However, when the infection spreads beyond the root tip, a procedure called apicoectomy is performed. 

New Bern dentist help patients identify the presence of infection and aid in proper treatment to prevent the spread of infection to other teeth. 

Apicoectomy: A minor surgery

Apicoectomy, also known as root end surgery, is a minor endodontic surgical procedure that involves the removal of the infected root tip, and preparation of a root end cavity that is filled with a biocompatible material. 

This procedure helps to curb the infection and prevent its spread to other diseases by sealing the apex. 

Indications of apicoectomy 

When the tooth infection or inflammation persists even after a root canal treatment, an apicoectomy may be required. The purpose of an apicoectomy is the eradication of any residual infection and the ultimate preservation of the function of the affected tooth. 

The reasons why an apicoectomy may be necessary are discussed below. 

  • Small adjoining root branches
  • Most often roots may consist of tiny branches that cannot be sealed by root canal treatment. 
  • Blocked root canals
  • Sometimes your dentist may not be able to completely clean a root canal since it may be blocked due to a fractured file during RCT.
  • Narrow or curved canals
  • Poorly shaped root canals cannot facilitate proper preparation of the canals, and the endodontic files cannot reach the root tip. 

The detailed procedure behind apicoectomy

Your dentist will initially evaluate your affected tooth and take panoramic X-rays to plan the apicoectomy. You will be prescribed antibiotics or anti-inflammatory medications to treat the underlying infection before you are scheduled for surgery. 

An apicoectomy is an outpatient procedure performed under local anesthesia (a numbing agent).

The procedure is as follows:

  • Your dentist will make a small cut (incision) in the gum near the affected tooth.
  • The root will be exposed by lifting the gum flap.
  • A tiny fraction of the jawbone may be removed for clear access to the tooth root. 
  • The edge of the root tip and infected tissue will be removed with special ultrasonic instruments. 
  • The root will be sealed with filling material, and the dentist will close the gum incision through sutures. 
  • Your dentist will instruct you about all the necessary precautions and pain medications will be provided.
  • Your sutures will be removed after about 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.