Apicoectomy – Procedure, Success & Risks
An apicoectomy is a minor oral surgery in which the tip of a tooth root is removed to treat persistent inflammation or infection that cannot be resolved by root canal treatment.
Things worth knowing about "Apicoectomy"
An apicoectomy is a minor oral surgery in which the tip of a tooth root is removed to treat persistent inflammation or infection that cannot be resolved by root canal treatment.
What is an Apicoectomy?
An apicoectomy (also called root-end resection or apicectomy) is a surgical dental procedure in which the tip of a tooth root, together with surrounding inflamed tissue, is removed. The goal is to save a tooth that has a persistent infection or inflammation at the root tip – known as apical periodontitis or an apical cyst – that could not be resolved through conventional root canal treatment. The procedure is a well-established technique in oral and maxillofacial surgery with consistently high success rates when performed using modern methods.
When is an Apicoectomy Needed?
An apicoectomy is indicated when conservative endodontic treatments have failed or are not feasible. Common indications include:
- Chronic apical periodontitis that does not respond to root canal treatment or its retreatment
- Apical cysts that have formed around the root tip
- Fractured instruments within the root canal that cannot be retrieved
- Inadequate apical seal of a root canal filling that cannot be corrected non-surgically
- Anatomical variations of the root that prevent complete canal debridement
How the Procedure Works
The procedure is typically performed under local anesthesia and lasts between 30 and 90 minutes depending on complexity. The standard steps include:
- Incision and flap elevation: The gum tissue near the affected tooth is cut and folded back to expose the underlying bone.
- Bone access: A small opening is made in the bone to expose the root tip.
- Root-end resection: The apical 2–3 millimeters of the root are removed along with all infected or inflamed tissue.
- Retrograde root-end filling: The root canal is sealed from the cut surface using a biocompatible material such as MTA (Mineral Trioxide Aggregate).
- Wound closure: The gum tissue is repositioned and sutured.
Recovery and Healing
After the procedure, patients can expect mild swelling, bruising, and discomfort for a few days. Recommended aftercare includes:
- Applying an ice pack to the cheek in the first few hours after surgery
- Avoiding chewing on the treated area and brushing gently around the surgical site
- Taking prescribed pain relievers or antibiotics as directed
- Attending follow-up appointments to monitor bone healing
Complete bone regeneration may take several months to a year and is monitored through regular dental X-rays.
Success Rates and Risks
When performed using modern techniques – particularly with the aid of a surgical microscope and ultrasonic instruments – the success rate of an apicoectomy exceeds 85 percent. Potential risks and complications include:
- Postoperative bleeding or wound infection
- Temporary numbness due to proximity to nerves (especially in the lower jaw)
- Damage to adjacent teeth or roots
- Perforation of the sinus cavity (in upper back teeth)
- Recurrence of infection requiring tooth extraction
Alternatives to Apicoectomy
In some cases, a root canal retreatment may be attempted before considering surgery. If an apicoectomy is unsuccessful, tooth extraction followed by a prosthetic replacement such as a dental implant or bridge may be the final option.
References
- Setzer FC, Shah SB, Kohli MR et al. - Outcome of Endodontic Surgery: A Meta-Analysis of the Literature. Journal of Endodontics, 2010; 36(11): 1757–1765.
- Kim S, Kratchman S - Modern Endodontic Surgery Concepts and Practice: A Review. Journal of Endodontics, 2006; 32(7): 601–623.
- European Society of Endodontology (ESE) - Quality guidelines for endodontic treatment: consensus report of the European Society of Endodontology. International Endodontic Journal, 2006; 39(12): 921–930.
Most purchased products
For your iron balance
Specially formulated for your iron balance with plant-based curry leaf iron, Lactoferrin CLN®, and natural Vitamin C from rose hips.
For your universal protection
As one of the most valuable proteins in the body, lactoferrin is a natural component of the immune system.
For Healthy Oral Flora & Dental Care
Formulated lozenges with Dentalac®, lactic acid bacteria, and Lactoferrin CLN®The latest entries
3 Posts in this encyclopedia categoryDental braces
Fissure sealant
Pediatric Dentistry
Most read entries
3 Posts in this encyclopedia categoryMagnesiumcarbonat
Calorie content
Cologne list
Related search terms: Apicoectomy