Apicoectomy:  Endodontic Surgery in Virginia Beach

What is an Apicoectomy?

An apicoectomy, or root-end resection, is a minor surgical procedure performed when inflammation or infection persists at the tip of a tooth’s root after a root canal. Using advanced technology such as digital imaging and operating microscopes, we perform this procedure quickly and comfortably.

After applying local anesthesia, a small incision is made in the gum near the affected tooth to expose the bone and remove inflamed or infected tissue. The very tip of the root is also removed, and a small filling is placed to seal the end of the root canal, preventing reinfection. The gum is then sutured, and over the next few months, the bone naturally heals around the root, restoring full function. Most patients experience only mild discomfort and can resume normal activities the following day.

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Why would I need Endodontic Surgery?

In most cases, a root canal is enough to save a tooth with damaged or infected pulp. However, if the tooth does not heal properly, endodontic surgery may be necessary. This procedure can help locate hidden fractures or canals that do not appear on X-rays but continue to cause pain. It can also be used to treat damaged root surfaces or infection in the surrounding bone.

The most common endodontic surgery is an apicoectomy, or root-end resection, which is performed when inflammation or infection persists in the bony area around the tooth’s root after a root canal. This procedure helps eliminate infection and preserve the natural tooth, preventing the need for extraction.

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What situations would surgery help save your tooth? 
Here are some examples:

• Diagnostic Tool: Surgery can help identify tiny fractures or hidden canals that don’t appear on X-rays but continue to cause symptoms. This allows for proper diagnosis and treatment.
• Treating Calcified Canals: If calcium deposits make a canal too narrow for traditional root canal instruments, surgery may be needed to clean and seal the affected area.
• Addressing Failed Healing: While most root canal-treated teeth last a lifetime, some may fail to heal or develop issues months or years later. Surgery can help resolve these problems and save the tooth.
• Repairing Root and Bone Damage: Surgery may also be performed to treat damage to the root surface or surrounding bone, preserving the natural tooth structure.

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What happens after surgery?

Following the procedure, there may be some discomfort or slight swelling while the incision heals. This is normal for any surgical procedure. Post-surgical discomfort is generally mild.  

Most patients return to their normal activities the next day.  You will return to our office after 3 days to have the sutures removed and to check on the healing.  In the next few months, the bone will heal around the end of the root.

It is rare for endodontic patients to experience complications after routine endodontic treatment or microsurgery. If a problem does occur, however, we are available at all times to respond.

+ After Endodontic Surgery Instructions

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