Apical Surgery (Apicoectomy)


In some cases it may be necessary to surgically remove the infection and repair the roots. This is known as an apical surgery or an apicoectomy.

An Apicoectomy is a minor surgical procedure that allows your endodontist to open the gum tissue over the affected tooth to expose the underlying jaw structures and to remove the inflamed or infected tissue. Typically, they will also remove the end of the affected root(s) and re-seal the canal(s) with a surgical grade material called a retrograde filling. In some cases a bone graft is also placed to allow for advanced bone healing. A few sutures are placed to ensure the gum tissue heals properly. These are normally removed within a week.  This procedure now allows new bone to form and heal around the end of the root. Clinical and radiographic follow-ups over a period of months will confirm the success of this procedure. Most people return to work or normal activities the next day.  

Pre-operative and post-operative instructions (for endodontic surgery can be accessed by clicking in the imbedded link.

Other endodontic surgical procedures are also performed here at our practice. Your endodontist will be happy to discuss these additional procedures if they are more appropriate for your individual case. The procedures include:

  • Exploratory surgical procedures to aid diagnosis
  • Root- resection
  • Repair of a damaged root (root perforations, resorptions)

Endodontic surgery is intended to help save your natural tooth. In some cases this is not possible.  The only alternative to endodontic treatment is an extraction. Modern tooth replacements are very effective, but nothing is as good as your own tooth.  Your endodontist will assist you in making the best possible decision that will lead to a successful long-term prognosis for you and your tooth.

At North Shore & Brookline Endodontics, we take the time to thoroughly assess the risk factors in every case.  When needed, we use 3D imaging CBCT scans to evaluate and determine the best treatment option for your specific case.  

For more information regarding endodontic surgery, please visit the American Association of Endodontists.