A specialist procedure for selected teeth that remain diseased after root canal treatment.

An apicoectomy treats the root from outside the tooth.

Root canal treatment cleans and seals the canal system from inside the tooth. If inflammation or infection persists in the bone around the root tip, endodontic surgery may be considered to identify a hidden problem, remove diseased tissue, and seal the root end.

The most common root-end surgery is an apicoectomy. It is generally performed by an endodontist, a dentist with advanced specialty training in diagnosing tooth pain and treating the inside and roots of teeth.

Why root-end surgery may be discussed

• Persistent disease around the root tip after earlier root canal treatment
• A canal that cannot be fully reached because it is calcified, blocked, or unusually shaped
• A small fracture or root-surface problem that requires direct examination
• A condition where retreating through the crown would not predictably address the source

What the procedure involves

After local anesthetic, the specialist opens the gum near the root, removes inflamed or infected tissue and a small portion of the root tip, then places a root-end filling. The gum is repositioned and sutured.

Eastland Family Dental can evaluate symptoms and the existing restoration, then discuss whether endodontic retreatment, specialist surgery, extraction, or monitoring fits the diagnosis.