An apicoectomy is performed if a root canal fails and can’t be retreated. When an infection will not go away or returns after a root canal has been performed this procedure is usually necessary. During an apicoectomy, the tip of the root of the tooth is removed and sealed with a filling.
In most cases a second root canal is considered before an apicoectomy, since it is a simpler, less invasive procedure. Before the apicoectomy begins you will be given a local anesthetic to anesthetize the area. Access to the infected root tip will begin by making an incision in your gum to expose the root tip. Any inflamed tissue will be removed to clean out the area. The surgery takes place in a very small area, and only a few millimeters are removed from the root. For this reason, the doctor will use magnification and small precision instruments to perform the surgery. The precise nature of the surgery gives it a high rate of success. After the root tip is removed, a filling is placed in the root tip and the tissues are sutured. Depending on the type of sutures you may have to return in a week or more to have them removed, or dissolving sutures may be used instead. Over the course of the next few months the bone will heal around the root.