An apicoectomy is also known as a root-end resection, and consists of the removal of a tooth’s root tip (also called the apex) and the accompanying infected tissue when you have an abscessed tooth. A filling seals the end of the root after the procedure. If you’ve had a root canal and the area becomes infected or inflammation does not subside, your dentist may recommend a second root canal or an apicoectomy to fix the problem so you don’t have to have the tooth removed.

During a root canal, the canals are cleaned and infected tissue is removed; however, these canals have many small branches off the main canal and infected debris can remain. Sometimes an apicoectomy is called endodontic microsurgery as it’s done under an operating microscope.

Procedure information
During an apicoectomy, the gum is lifted to reveal the underlying bone and the root-end, or apex, of the tooth. The root-end is then removed along with all of the surrounding infected tissue. A root-end filling seals the end of the root canal and then the gum is repositioned. Dissolvable sutures are placed to hold the gum tissue in place while it heals. Most apicoectomies last from 30 minutes up to 1 hour, 30 minutes, depending on the complexity of the root structure; procedures on lower molars take the longest.

Recovery time
It takes a few months for the bone around the root-end to heal and for all symptoms of the apicoectomy to subside. Immediately after surgery, you will have to use ice on the area for 10 to 12 hours and rest. Pain is typically controlled with over-the-counter medications such as ibuprofen or prescription medication.

Healing will be facilitated if you do not brush or vigorously rinse the area, smoke or eat hard foods. You should avoid lifting the lip to view the area as it will interrupt blood-clot formation and loosen the stitches. The whole area may be numb for days or weeks from the trauma, and stitches can be taken out 2 to 7 days after the surgery. Soreness and swelling are usually gone in 2 weeks.