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Endodontic Surgery

In some cases, root canal therapy is insufficient to save your tooth. In such a situation, your endodontist may recommend alternative strategies, which may include endodontic surgery. There are several situations in which endodontic surgery can help save your tooth where normal root canal therapy would be lacking:

  • Surgery may be used for extensive diagnosis. Some patients have recurring symptoms, but no visible problems on their X-rays. These cases can sometimes indicate a tiny fracture or break in the tooth structure or root. Endodontic surgery can give your endodontist a chance to thoroughly examine the tooth’s structure without relying on X-rays.
  • In some cases, tooth roots are too narrow to fully operate in because of mineral deposits referred to as “calcification”. If this is the case, endodontic surgery would be needed for your tooth to be completely cleaned and healed.
  • In some rare cases, normal root canal therapy may be considered successful, but symptoms or problems may persist, or reoccur later – possibly months or even years after the original procedure. In these cases, endodontic surgery can still be an option in order to save the remaining tooth.
  • If the tooth disease has spread to the surface of the tooth root or if an infection has spread into the surrounding bone material, endodontic surgery may be required to treat these areas.

The most common type of endodontic surgery is called an apicoectomy, or “root-end resection”. When the tooth’s infection or inflammation spreads to the bone material around the tip of the tooth’s root after a root canal, your endodontist may need to perform an apicoectomy.


Your endodontist will open your gum tissue near your tooth to examine and diagnose the surrounding bone and to remove any inflamed or infected tissue. After this, the endodontist will fill the end of the tooth’s root to prevent it from attracting more infection, and will close and suture the gum tissue back together to encourage proper healing. Over the course of the next few months, the existing bone tissue will gradually grow back in to replace the removed infected tissue. Most patients are able to return to their normal routine as early as the day after their surgery. Before committing to the surgery, often your endodontist will inform you of the specifics of your case, and the pros and cons of endodontic surgery, as well as how to properly prepare for the procedure and steps to be taken after the procedure is finished. As with any medical procedure, success is not guaranteed, so it is important that you take your endodontist’s evaluation and estimated chances of success seriously. In many cases, the only alternative to endodontic surgery is the removal (or extraction) of the tooth. After this procedure, the tooth must be replaced with an artificial replacement – an implant, bridge or denture – to restore the tooth’s function and to prevent the surrounding teeth from moving. These alternatives usually require surgery or procedures on adjacent healthy teeth, which means that endodontic surgery is not only cost-effective, it is the most natural treatment for maintaining your oral health. Of course, nothing is as preferable as your natural tooth. You’ve already made an investment in preserving your teeth and the rewards for choosing endodontic surgery far outweigh the costs: a chance for a healthy, functioning natural tooth for the rest of your life.