An infection at the root tip does not have to mean losing the tooth. An apicoectomy is a minor surgical procedure that removes the root tip and the inflamed tissue around it — and the tooth is often kept for many more years.
At a glance
- What it is: surgical removal of the tip of a tooth root and the inflamed tissue around it
- When: a chronic infection at the root tip that root canal treatment has not resolved
- Goal: keep your own tooth instead of extracting it
- Anaesthesia: local; the procedure is painless
- Duration: usually 30–60 minutes; sutures removed after a week
- Cost: depends on the tooth and extent; an estimate is given at your consultation
On this page
- What an apicoectomy is
- When it is needed
- The procedure
- Success rates
- Recovery
- Cost
- FAQ
What is an apicoectomy?
An apicoectomy (root-end resection) is a procedure that surgically removes a few millimetres of the root tip, together with the inflamed tissue or cyst around it. The root canal is then sealed from below with a small retrograde filling, so the tooth stays in place and keeps functioning.
When is it needed?
Most often when a chronic infection visible on the X-ray persists at the root tip even after root canal treatment, when infection returns after retreatment, when the canal is not passable to the tip (for example a tooth with a post and crown you do not want to sacrifice), or when a cyst has developed at the apex. An apicoectomy is often the last chance to save a tooth before extraction.
What does the procedure look like?
At ESTERA we perform apicoectomy under local anaesthesia, after analysing the imaging (X-ray or 3D). Through a small access in the gum, the root tip is exposed, a few millimetres of the tip are removed together with the inflamed tissue, the canal is sealed with a special material and the gum is sutured. It takes 30–60 minutes. At ESTERA we perform it with magnification (loupes or microscope) and ultrasonic instruments, which greatly increases precision.
How successful is it?
Meta-analyses show that modern microsurgical technique achieves very high success rates — well above 90% in properly selected cases, while older traditional techniques report lower outcomes. Case selection (imaging, condition of the tooth) and technique are therefore crucial: the realistic prognosis for your tooth is discussed at the consultation, before any decision.
Recovery
Swelling and mild discomfort are normal for the first two to three days and are managed with prescribed medication. Sutures are removed after about a week, and bone healing is followed with a check-up X-ray after several months. Most patients return to work the next day.
Cost
The cost depends on the tooth (front or back), the extent of the procedure and the accompanying diagnostics; an estimate is given at your consultation with the plan. See our dental price list.
Frequently asked questions
Does an apicoectomy hurt?
No — it is performed under local anaesthesia. Swelling and moderate discomfort afterwards are controlled with medication.
Does the tooth stay strong after an apicoectomy?
Yes — only the tip of the root is removed; the tooth keeps most of its root and is used normally.
What if the apicoectomy fails?
The tooth is then usually extracted and replacement with an implant or bridge is considered. This is why the prognosis is assessed honestly before the procedure.
How long does bone healing take?
Soft tissue heals within one to two weeks; bone regeneration is monitored on an X-ray after 6–12 months.
Book a consultation
If you have been told a tooth with an infected root „needs to come out“, a second opinion is worthwhile: the imaging shows whether it can be saved. ESTERA, Bokeljska 7, Vračar, Belgrade — +381 66 378 372.
Book a consultation: +381 66 378 372
Content prepared and medically reviewed by Dr Nenad Stanković, DDS/DMD, specialist in cosmetology, international lecturer and trainer in aesthetic medicine.