Most teeth heal well after root canal treatment, but occasionally infection persists at the very tip of the root. When retreatment is not possible or has not resolved the problem, an apicoectomy, also called root end surgery, may be recommended to save the tooth.
An apicoectomy may be suggested when infection persists after root canal treatment, when a crown or post makes retreatment difficult, or when the root has an unusual shape or extra branches near the tip.
Under local anaesthetic, a small incision is made in the gum near the root tip. The infected tissue and the tip of the root are removed, and the end of the root is sealed with a small filling. The gum is then stitched.
Mild swelling and discomfort for a few days are common. Cold compresses, pain relief and a soft diet help. Stitches are usually removed after about a week.
Apicoectomy has good success rates in suitable cases. Alternatives include retreatment, extraction and replacement with an implant or bridge. Your dentist will discuss the pros and cons.
X-rays at follow-up visits monitor bone healing around the root tip, which may take several months.
Before an apicoectomy, your dentist will review your medical history and medications and may take a 3D scan to assess the root and surrounding structures. Eat a light meal beforehand unless advised otherwise, and arrange to rest for the remainder of the day. If you are anxious, discuss options with your dentist. You may be prescribed medication to take before or after the procedure. Following pre-operative instructions carefully helps the procedure go smoothly and supports healing. Having soft foods and cold compresses ready at home makes recovery more comfortable.
After an apicoectomy, avoid brushing directly on the surgical site for the first few days, but continue cleaning the rest of your mouth. Rinse gently with warm salt water or a prescribed mouthwash as advised. Eat soft foods and avoid chewing on the treated side. Avoid smoking, as it slows healing and increases the risk of complications. Do not lift your lip to look at the stitches, as this can disturb healing. If you notice increasing pain, swelling, fever or bleeding that does not stop, contact your dentist promptly.
Many teeth treated with apicoectomy heal well and remain functional for years. Bone healing around the root tip is checked with X-rays at follow-up appointments, typically several months after the procedure. Factors that affect success include the quality of the root seal, the health of the surrounding bone and gum, and the overall condition of the tooth. Keeping up excellent oral hygiene and attending regular check-ups help protect the tooth. If the tooth does not heal, your dentist will discuss other options, such as extraction and replacement with an implant or bridge.
It is done under local anaesthetic, and discomfort afterwards is usually manageable.
Typically around an hour, depending on the tooth.
When successful, saving the natural tooth is often preferable. Your dentist will advise.
Discuss your options if a root canal has not healed. Learn more about root canal treatment in Al Ain.
Call 03 751 0245 WhatsApp 056 536 4536 Email Us