Endodontic microsurgery · Pearland, TX
Apicoectomy — Endodontic Surgery
An apicoectomy treats infection at the very tip of a root when it cannot be resolved through the crown of the tooth. It is a small, precise procedure performed under magnification, and it is frequently the last step that keeps a tooth that would otherwise be extracted.
- Typical duration
- 30–90 minutes
- Anaesthetic
- Local; sedation available
- Stitches
- Usually removed in about a week
When surgery is the right route
The canal system inside a tooth is not a simple tube. It branches, and the finest branches near the root tip can be impossible to clean completely from above. When infection persists in that region despite a technically sound root filling, treating it directly is more predictable than repeating the work through the crown.
Surgery is also the sensible route when the tooth carries a well-fitting post and crown that would be damaged or destroyed by re-entering from above, when a canal is blocked or calcified, or when a small fracture at the root tip needs to be seen to be assessed.
It is a considered decision, not a fallback. The alternative is usually extraction.
What happens
The procedure
-
01
Anaesthetic and access
The area is numbed and a small opening is made in the gum tissue to expose the bone over the root tip.
-
02
Removing infected tissue
The inflamed tissue around the root end is removed along with a few millimetres of the root tip itself.
-
03
Inspecting under magnification
The cut root surface is examined under the microscope, which is how additional canals or a fine fracture become visible.
-
04
Sealing the root end
A small filling is placed in the end of the canal to seal it against bacteria.
-
05
Closing
The gum is repositioned and a few stitches are placed. Bone around the root tip heals over the following months.
Afterwards
Recovery
Discomfort and swelling are normal for the first two to three days and then settle.
- Apply a cold compress to the outside of the face for the first several hours as directed.
- Take pain relief as advised, starting before the anaesthetic fully wears off.
- Eat soft food and avoid chewing on the surgical side.
- Do not lift the lip to inspect the area — it disturbs the stitches.
- Keep the rest of your mouth clean as normal, and follow the specific rinsing instructions you are given.
- Call the practice if bleeding does not settle, if swelling worsens after the third day, or if you develop a fever.
Common questions
Apicoectomy FAQs
Is an apicoectomy painful?
The procedure itself is performed under local anaesthetic and should not be painful. Afterwards, most patients describe soreness and some swelling for two to three days, managed with over-the-counter pain relief and a cold compress.
How long does recovery take?
Most people return to normal activities the following day. Stitches are usually removed after about a week, and the bone at the root tip continues to heal over several months, which is followed up with periodic X-rays.
Will I lose the crown on my tooth?
No — that is one of the main reasons this route is chosen. Surgery reaches the root tip from the side, leaving an existing post and crown undisturbed.
What if the apicoectomy does not work?
No procedure has a guaranteed outcome. If infection persists, the remaining options are repeating the surgery in selected cases, or extracting the tooth and replacing it. You will be told realistically beforehand how favourable your particular tooth looks.
Discuss whether surgery can save your tooth
Bring any recent X-rays and your referral letter if you have one.