The tip of a tooth’s root is called the apex. An apicoectomy, also known as root-end resection, removes that tip along with the infected tissue around it, then seals the end of the root. It is one of the most common forms of endodontic surgery.
Why an apicoectomy may be needed
Root canal treatment cleans out the inside of the tooth. Occasionally, though, infection persists or returns near the root tip. That can happen when:
- The root has tiny side branches or curves that are very difficult to clean from inside the tooth
- A small crack or fracture lets bacteria back in
- The tooth already has a crown or post that would be damaged by redoing the root canal
Signs that something isn’t right can include tenderness when biting, swelling of the gum near the tooth, a small pimple-like bump on the gum, or an area that shows up on an X-ray.
What happens during the procedure
An apicoectomy is done under local anesthetic, so the area is numb. The dentist or endodontist makes a small opening in the gum to reach the end of the root, removes the inflamed tissue and a few millimeters of the root tip, and places a small filling to seal the end of the canal. A few stitches help the gum heal. The procedure usually takes about an hour, depending on the tooth.
Recovery
Most people return to normal activities the next day. Some swelling and soreness for a few days is common. To stay comfortable:
- Use a cold compress on the cheek for the first day
- Take pain relievers or antibiotics exactly as prescribed or directed
- Eat soft foods and chew on the other side
- Avoid brushing directly on the stitches until your dentist says it’s fine
Over the following months, the bone around the root tip heals. A follow-up X-ray confirms that healing is on track.
What are the alternatives?
Depending on the tooth, options may include redoing the root canal or removing the tooth and replacing it with a dental implant or bridge. Keeping your natural tooth is usually the first choice when it can be done predictably, and your dentist will explain which option makes the most sense for you.
Questions about your own teeth? Call Shrewsbury Dental Group at (732) 741-8707 or book a visit online (opens in a new tab). This article is general information and isn't a substitute for an exam.