What Is an Apicoectomy?
An apicoectomy (root‑end surgery) is a minor procedure that removes the very tip (apex) of a tooth’s root along with any infected tissue. It’s performed when a standard root canal or retreatment doesn’t completely eliminate infection. Hidden canals or anatomical complexities may harbor bacteria that conventional instruments cannot reach.
When You Need Apicoectomy
Most root canals save teeth, but sometimes infection persists at the root tip. You may need an apicoectomy if:
Failed root canal: A previous root canal didn’t heal the infection. Bacteria can linger at the apex (root tip) and form an abscess.
Persistent infection: Ongoing pain or swelling at the root tip after treatment.
Blocked or curved canal: Some canals are blocked or sharply curved, so traditional tools can’t reach the infection.
Fractured root tip: A tiny crack or broken file at the root tip that causes trouble. An apicoectomy lets the dentist access and remove it.
Cyst or lesion: A cyst or granuloma at the root’s end that won’t resolve without surgery.
In short, if another root canal (retreatment) is not possible or hasn’t fixed the issue, an apicoectomy may be the best way to save your tooth
The Apicoectomy Procedure
Exam and X‑rays: First, the dentist reviews your history and takes X‑rays or 3D scans to pinpoint the problem.
Local anesthesia: The area is numbed with local anesthetic so you feel no pain. Modern endodontists may also use sedation for comfort.
Gum incision: A tiny cut in the gum exposes the bone at the tooth root.
Remove infected tissue: Any inflamed tissue or bone around the root tip is gently cleaned away.
Root tip removal: About 3 mm of the root tip is trimmed off to ensure all infection is removed.
Clean and seal: The very end of the root canal is cleaned and sealed with a biocompatible filling (often mineral trioxide aggregate) to prevent reinfection.
Stitches: The gum is stitched back with a few tiny sutures. The cut is very small, so healing is fast.
Recovery: The procedure usually takes less than an hour, and you can go home the same day. Mild swelling or soreness is expected for a few days. Most patients return to normal activities (work/school) the next day.
Generally no special hardware (like braces) is needed after the surgery – your dentist will explain any extra care.
Benefits of Apicoectomy
Save your natural tooth: You keep your own tooth instead of losing it. Preserving the natural root maintains jaw strength and bite.
Avoid implants: Removing the tooth means needing an implant, bridge or denture. Apicoectomy is often more biologic and cost-effective than extraction and replacement.
Remove stubborn infection: It eliminates chronic infection that a root canal alone couldn’t clear.
Long-term fix: It’s a reliable, lasting solution. With proper care, the treated tooth can function for many years.
High success rate: Endodontists report about 85–90% success, especially with modern techniques. In fact, skilled surgeons using microscopes often see success above 90%.
Because you preserve the natural tooth, patients often find apicoectomy more convenient and satisfying than starting over with a new tooth.
Apicoectomy vs. Retreatment
When to choose apicoectomy: It’s done after one (or more) root canal treatments have failed or aren’t possible. For example, if a tooth has a crown or post that blocks simple retreatment, an apicoectomy lets you clean and seal the canal tip from the root side.
When retreatment is better: If the canal can be reopened (no crown blockage), dentists usually try another root canal first. Retreatment means redoing the canal filling without surgery. It’s often less invasive and usually costs a bit less.
Cost comparison: A retreatment (redoing a root canal) typically involves just the canal work, so it may be cheaper. Apicoectomy is a minor surgery, but at VR Dental it starts around ₹5,000 (similar to retreatment pricing). More complex cases (multi-root teeth, advanced imaging, etc.) can raise the price.
Success rates: Both procedures have high success (around 80–90%). Retreatment can fail if hidden canals remain; apicoectomy is often more definitive in those cases. Overall, apicoectomy often succeeds when retreatment alone does not.
Your dentist will consider factors like anatomy, restorations and cost. If retreatment won’t fix the issue (e.g. a failed canal under a crown), we’ll recommend apicoectomy.
Recovery and Aftercare
After an apicoectomy, follow these guidelines to heal quickly:
Follow instructions: Take prescribed painkillers or anti-inflammatories as directed. Over-the-counter pain meds also work. Mild swelling or bruising is normal. Applying ice packs for the first 12–24 hours can help.
Diet: Stick to soft foods (soups, yogurt, smoothies) for a few days. Avoid hot, spicy or hard foods that could irritate the site. Do not chew on the treated side until it feels normal.
Oral hygiene: Gently clean your teeth but avoid the surgical area. Your dentist may recommend salt-water rinses. Do not smoke, as it can slow healing.
Activity: Rest for a day, but you can usually go back to a desk job or light activities the next day. Avoid heavy exercise or lifting for 2–3 days.
Follow-up: Attend any scheduled follow-up or suture removal (often 1–2 weeks after). The gum stitches typically dissolve or are removed in this time.
Warning signs: It’s rare, but if you get severe pain that isn’t controlled by meds, fever, or foul discharge, call us. Any high fever or heavy bleeding should prompt an immediate check-up.
Healing is generally quick. Sutures are out by about 2 weeks, and the bone fully heals over several months
Cost
Apicoectomy costs in India range from ₹3,000 to ₹15,000 per tooth, depending on complexity and location. Because it’s a surgical procedure, it generally costs more than a standard root canal.
Our endodontist has advanced training in microsurgery. We use digital imaging and microscopes to precisely locate infection and minimize tissue removal. By offering both conventional root canals and surgical options, we can often save teeth that might otherwise be extracted.
Frequently Asked Questions
What is an apicoectomy and when might I need one?
An apicoectomy, or root tip surgery, is a minor endodontic procedure performed when a standard root canal cannot completely eliminate infection. If bacteria persist at the tip of the root due to hidden canals, curved roots or a failed previous treatment, your dentist may recommend an apicoectomy to save the tooth.Is an apicoectomy painful?
No. The surgery is done under local anesthesia, so you won’t feel pain during the procedure. Sedation may be used if you are anxious. Some mild swelling or soreness afterward is normal and can be managed with medication.How does an apicoectomy differ from a root canal?
A root canal treats the tooth from the crown by removing infected pulp and filling the canals. An apicoectomy addresses infection from the root end. The dentist removes a small portion of the root tip and seals it to prevent reinfection. It’s usually recommended only after conventional root canal therapy has failed.What is recovery like after a root tip surgery?
Recovery is generally quick. You may experience minor swelling or discomfort for a few days, which responds well to ice packs and prescribed medication. Stitches are removed after about a week, and most patients return to normal activities within a day or two.How much does an apicoectomy cost in Kukatpally?
In India, an apicoectomy typically costs between ₹3,000 and ₹15,000 per tooth. The price depends on the tooth’s location and the complexity of the case. It’s higher than a standard root canal because of the surgical component, but it still costs less than extraction and replacement.
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Internal Resources: For more on related treatments, see our Root Canal Treatment understanding, Retreatment of Failed RCT, and if extraction is needed, consider our Dental Implants or Dental Crowns.