Apical Micro-Surgery

Apical Micro-Surgery

Apicoectomy, also known as root-end surgery, is a dental procedure aimed at treating infections and inflammation around the roots of teeth. It involves removing the tip of the tooth's root (apex) along with any infected tissue and sealing it to prevent further infection.

This procedure may be necessary when conventional treatments such as root canal treatment fail or are not feasible. It allows for targeted removal of infected tissue while preserving as much healthy tooth structure as possible.

An apicoectomy offers an effective solution for persistent infections in teeth that have previously undergone root canal treatment. If you're experiencing lingering pain or recurring infections around a treated tooth, consult our endodontist to determine if an apicoectomy might be right for you.

When Is it Necessary to Undergo an Apicoectomy?

There are several situations where a patient may need to undergo an apicoectomy. This specialized dental procedure is typically recommended when other treatments, such as root canal therapy, have failed to effectively treat the root of the tooth.

Here are some specific scenarios where an apicoectomy may be necessary:

  • Persistent infection: If you have a persistent infection in the root tip of your tooth, despite undergoing previous treatments like root canal therapy or re-treatment, an apicoectomy may be needed. This procedure is performed by our endodontist to remove any infected tissue and seal off the affected area.
  • Narrow or curved roots: Some individuals have narrow or curved roots that can make it difficult for traditional root canal treatment to reach and clean out all infected areas. In these cases, an apicoectomy can provide better access for cleaning and sealing off the infected site.
  • Fractured roots: When a tooth has a fractured root that cannot be repaired with standard endodontic techniques, an apicoectomy may be necessary to remove the damaged portion of the root and prevent further complications.
  • Residual cysts or granulomas: Occasionally, after failed conventional treatment, cysts or granulomas can develop at the site of a previously treated tooth. An apicoectomy can help remove these abnormal growths and promote healing in the surrounding tissues.

It's important to note that each case is unique, and our endodontist will carefully evaluate your individual situation before recommending an apicoectomy as part of your treatment plan.

The Process of an Apicoectomy

The process of an apicoectomy, also known as root-end surgery, involves removing the infected tip of a tooth's root and sealing it to prevent further infection. It is typically performed by an endodontist, a specialist in treating problems with the dental pulp.

Local anesthesia will be administered to numb the area around the affected tooth. This ensures that you won't feel any pain during the procedure. Once you're comfortably numb, your endodontist will make a small incision in your gum tissue near the tooth. Next, they will carefully expose the underlying bone and remove any infected or damaged tissue from around the root.  

Using specialized instruments and magnification techniques like microscopes, they will then remove just enough of the affected root tip. After this, your endodontist will clean and shape the remaining portion of the root canal before filling it with a biocompatible material called gutta-percha. This prevents reinfection from occurring in that area. They will then place sutures to close the incision site to promote proper healing.  

In some cases, where necessary for better visualization or access to hard-to-reach areas of teeth roots, your endodontist may use dental lasers during certain steps of an apicoectomy procedure. 
Undergoing an apicoectomy can help save your natural tooth while effectively treating persistent infections at its base. Remember to follow all postoperative instructions provided by our endodontist for optimal recovery! 

Recovery and Aftercare

Recovery and aftercare are crucial aspects of any dental procedure, including an apicoectomy. After undergoing this surgical procedure, it's important to take proper care to ensure a smooth and successful recovery.

  • Immediately following the apicoectomy, you may experience some discomfort or swelling in the affected area. This is normal and can be managed with over-the-counter pain relievers as prescribed by our endodontist. Applying ice packs to the outside of your face can also help alleviate swelling.
  • Follow all postoperative instructions provided by our endodontist. These instructions may include avoiding certain foods that could irritate the surgical site, such as hard or crunchy foods. You should also refrain from smoking or using tobacco products during the healing process.
  • Maintain good oral hygiene for a speedy recovery. Continue brushing your teeth gently twice a day using a soft-bristled toothbrush and non-abrasive toothpaste. Be cautious when flossing around the affected area, taking care not to disturb any sutures.
  • Regularly attend follow-up appointments with our endodontist for monitoring progress and ensuring optimal healing. Our endodontist will assess the healing process and remove any stitches if necessary.

Remember that each person's recovery time may vary, so be patient with yourself during this period. If you have any concerns or notice unusual symptoms like excessive bleeding or severe pain, don't hesitate to contact our endodontist immediately.

By following these aftercare guidelines diligently, you can promote proper healing and reduce the risk of complications after an apicoectomy.


An apicoectomy is a specialized dental procedure that may be necessary in certain cases to maintain the health of your teeth and gums. It is typically recommended when a root canal treatment has failed or when there are persisting issues with the tooth's root.

If you have been experiencing persistent dental problems despite undergoing previous treatments like root canals, it may be time to consult with our endodontist about the possibility of an apicoectomy. They will evaluate your specific situation and determine if this procedure is the best course of action for you.

Wish to learn more? Contact Big Apple Endodontics at (212) 980-7857 or visit our dental office located at 121 East 60th Street, Suite 4A, New York, NY 10022.


121 East 60th Street, Suite 4A,
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