Hence a specialist oral and maxillofacial surgeon will expose the root tip within the bone, clear off the infection and seal off the root tip

What is apicectomy

What is “Apicectomy?

It’s the surgical intervention that is undergone to remove the tip of the tooth known as the apex. It’s a minor surgical procedure that is performed under local anesthesia and is mainly done if any infection or cyst persists after root canal treatment or if the dentist is unable to seal the root tip with a normal root filling.


I have not heard about this procedure!!! Can you elaborate?

Whenever a tooth gets decayed the microorganisms will move more deep in towards the pulp chamber of the tooth and thereby through the root canal it move in towards the root and the apex of the tooth.

From the apex of the tooth through the apical foramen these microorganisms will migrate to the bone marrow and other spaces leading to infection. It can be symptomatic or asymptomatic depending upon the duration of the infection or based on the presence of the microorganisms.

microorganisms teeth

As a result the primary management of this will be ROOT CANAL TREATMENT where decay from the tooth is removed and the infected root canal is cleansed with medicaments. As the dentist is unable to remove the infection from the apex of the tooth, hence a specialist oral and maxillofacial surgeon will expose the root tip within the bone, clear off the infection and seal off the root tip with medicaments and then the dentist will fill and complete the root canal procedure.

By this combined teamwork from Root canal specialist and Specialist oral and maxillofacial surgeon the infection from the tooth is removed thereby preserving the tooth without any further spread of infection.

Are there any complications for this procedure?

It’s a routinely practiced normal oral surgical intervention. It aids to eliminate the presence of infection from the tooth apex and helps in preserving the tooth structure rather than removing the tooth.

What to expect afterwards?

You may wish to have someone with you, especially when you leave hospital. You may need to take time off work afterwards because some discomfort and swelling is to be expected for several days. Advice will be given about taking painkillers, and you may need antibiotics. Please complete the course and follow the instructions carefully.

Are there any alternatives for this procedure?

We would not recommend leaving the infected root in-situ as this can be hazardous by allowing Infection to spread. One alternative option is to do re-root canal filling but then it may be impossible since there will be an existing crown or post in the tooth and will be difficult to remove as it will affect the strength of the tooth. Other option is to remove the tooth as that is considered the last treatment option if all the other treatment option to preserve the tooth fails.

Contraindications to Surgical Endodontics

There are few absolute contraindications to endodontic surgery, however, the following should be considered:

  1. Patient factors, including the presence of severe systemic disease and psychological considerations.
  2. Dental factors including:
  • Unusual bony or root configurations
  • Lack of surgical access
  • Possible involvement of neurovascular structures
  • Where the tooth is subsequently unrestorable
  • Where there is poor supporting tissue
  • Poor general oral status.
  1. The skill, training, facilities available, and experience of the operator, should also be considered.

Contraindications to Surgical Endodontics


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