What Is an Apicoectomy?
An apicoectomy is a minor surgical procedure that removes the very tip of a tooth’s root along with any surrounding infected tissue. It is typically recommended when a standard root canal or retreatment has not fully resolved an infection at the root apex. Rather than extracting the tooth, an apicoectomy allows the tooth to be preserved by directly addressing the problem at its source.
Apicoectomy (Root End Surgery): Quick Facts
| Quick fact | Typical answer |
|---|---|
| Number of visits | 1 procedure, plus stitch removal |
| Time needed | 30 to 90 minutes |
| Anesthesia | Local anesthesia |
| Recovery time | A few days of swelling; bone heals over months |
| How long it lasts | Long term in most cases |
These are typical ranges. Your own plan is confirmed after an examination.
When an Apicoectomy Is Recommended
Sometimes infection persists at the tip of a root even though the root canal is well filled, or the canal cannot be reached from the top of the tooth. Treating the root tip directly can save the tooth.
- Infection that persists after root canal treatment or retreatment
- A post or crown that makes retreatment risky
- A blocked or calcified canal
- A persistent gum pimple over the root
- A small fracture or extra canal near the root tip
Apicoectomy (Root End Surgery) at Bensonhurst Dental Care
At Bensonhurst Dental Care, apicoectomies are performed by Dr. Alex Rubinshtein, who combines surgical precision with advanced imaging to plan and execute each case. The procedure involves making a small incision in the gum tissue near the root tip, removing a small amount of bone to access the apex, excising the infected tissue and the tip of the root, and placing a small biocompatible seal at the end of the root canal. The gum tissue is then sutured closed and the area heals over the following weeks.
What to Expect, Step by Step
- Imaging. 3D imaging locates the root tip and nearby structures.
- Numbing. Local anesthesia is given.
- Access. A small opening is made in the gum over the root.
- Removal. The root tip and infected tissue are removed.
- Seal. A small filling seals the end of the root.
- Closure. The gum is stitched; bone refills the area over several months.
Options when a root canal has not healed
| Option | Approach | Chosen when |
|---|---|---|
| Retreatment | Through the top of the tooth | Canals are accessible |
| Apicoectomy | Through the gum at the root tip | Retreatment is not possible or has not worked |
| Extraction | The tooth is removed and replaced | The tooth cannot be saved |
An apicoectomy treats a few millimeters of root. For the right tooth, those few millimeters are all that stands between keeping it and losing it.
Recovery and Aftercare
After your visit
The first 24 hours
- Use cold packs on the cheek
- Do not lift your lip to look at the stitches
- Eat soft foods and avoid the area
The following days and weeks
- Rinse gently as directed
- Return for stitch removal
- Attend the follow-up X-ray to confirm bone healing
When to Call Us
Call the office on (718) 234-3434 if you notice any of the following:
- Bleeding that will not stop
- Swelling that increases after the third day
- Numbness that persists
Where Apicoectomy Fits
Apicoectomy is a targeted procedure with a specific purpose. It is not a substitute for root canal therapy but rather a complement to it when non-surgical treatment has not achieved complete healing. The procedure preserves the natural tooth and avoids the need for extraction and the more involved process of replacement with an implant or bridge.
Cost and Insurance
The fee for root canal care depends mainly on which tooth is involved, because back teeth have more canals than front teeth. You receive an estimate before treatment starts.
What affects the cost
- The tooth being treated: front tooth, premolar or molar
- Whether it is a first treatment or a retreatment
- The restoration needed afterward, usually a core and crown
- 3D imaging, if required
Most dental plans contribute to root canal treatment and to the crown that follows. Our team can check your benefits and explain your options before treatment begins.
