Apicoectomy: The Step beyond Root Canal Surgery

young blond woman with bad tooth ache

In general, root canal therapy is a highly successful form of oral surgery. In most cases, the procedure is extremely effective at treating infection, relieving pain, and preserving as much of the natural structure of a tooth as possible. Sometimes, a second root canal procedure may be necessary to remove additional infected material. Rarely are further procedures called for beyond that.

However, there are instances in which infection lingers in the tissues near the apex, or tip, of the root of a tooth. In such cases, a procedure called an apicoectomy may be necessary. Dr. Allan Libunao, Dr. Richard H. Kim, and Dr. Jeffrey Hawkins are pleased to offer apicoectomy at their Bolingbrook, IL practice, Suburban Oral Surgery & Implant Center. Our experienced oral surgeons are able to diagnose instances in which apicoectomy is the best course of action and perform the procedure with exceptional care.


Apicoectomy is a microsurgical endodontic procedure in which a small piece of the apex of a tooth’s root is removed. Any surrounding tissues that are also infected are also removed at the same time. Apicoectomy is generally recommended only after a second root canal procedure has been attempted, and the infection has continued to persist. It may also be recommended if root canal surgery was unsuccessful and a second root canal procedure cannot be performed.


Usually, apicoectomy is performed while patients are under local anesthesia. Whichever of our oral surgeons is performing the procedure will make an incision in the gum in order to expose the infection at the apex of the tooth’s root. This infection is carefully removed, along with a tiny portion of the apex. At this point, it will be determined whether the tooth is structurally sound enough to remain in place or whether extraction of the tooth is preferable.

If the tooth is structurally sound enough to salvage, the root canals will be cleaned and disinfected. A filler material will be placed in the empty canals, and the exposed area will be sealed off. If necessary, a bone graft will be placed at the site of damage, and the gums will be sutured closed. The entire procedure takes approximately an hour to complete from beginning to end, though more complex apicoectomy procedures can take up to 90 minutes.

After the procedure, patients may experience some swelling and soreness, but over-the-counter pain relievers are usually sufficient to controlling any discomfort. Most patients are able to return to their normal routines the very next day. The majority of apicoectomy procedures are successful in relieving pain, restoring oral health, and allowing patients to salvage their natural teeth. With proper oral hygiene habits and regular dental visits, the restored tooth should last for a lifetime.


If you would like to learn more about apicoectomy, or if you would like to schedule your initial consultation with one of our esteemed oral surgeons, please contact Suburban Oral Surgery & Implant Center today.