Note: This article is for general information purposes and does not replace individual dental advice.
An apicoectomy (root-end surgery) is a surgical procedure in which the inflamed root tip of a tooth is removed. It is used when conventional root canal treatment is not sufficient to completely eliminate an inflammation at the root of the tooth. The aim is to preserve the affected tooth and eliminate the inflammation permanently.
When is an apicoectomy necessary?
An apicoectomy is generally only considered when other measures have not been successful:
- Persistent inflammation after root canal treatment: Despite a correct root filling, an inflammation or cyst remains at the root tip
- Inaccessible root canals: Severely curved, narrowed or calcified canals that cannot be fully cleaned and shaped with conventional instruments
- Broken instruments: An instrument that broke off during an earlier treatment is blocking the root canal
- Root fracture: A crack at the root tip that cannot be treated from the inside
The apicoectomy procedure
- Diagnostics
An X-ray or 3D scan (CBCT) shows the exact location and extent of the inflammation. We discuss the findings with you and weigh up whether an apicoectomy makes sense or whether alternatives are an option. - Anaesthesia
The procedure is carried out under local anaesthesia. For patients with dental anxiety, treatment under sedation or general anaesthesia is also possible. - Surgical access
Through a small incision in the gum, the bone is exposed and a small window is created to access the root tip. - Removal of the root tip
The last 2 to 3 mm of the root tip are removed together with the inflamed tissue. - Retrograde filling
The root canal is sealed from below with a biocompatible material to prevent bacteria from entering again. - Wound closure
The gum is stitched. The stitches are removed after about a week.
After the apicoectomy
- Cooling: Cool the cheek from the outside during the first few hours
- Rest: Avoid sport and physical exertion for a few days
- Diet: Prefer soft food and do not chew on the operated side
- Oral hygiene: Carefully avoid the wound, otherwise brush as normal
- Healing time: The swelling usually subsides within a week. Complete healing of the bone takes a few months
- Check-ups: Follow-up check after about a week and an X-ray check after 3 to 6 months
Prospects of success and risks
The prospects of success of a professionally performed apicoectomy are good: in many cases, the tooth can be preserved in the long term. As with any procedure, there is no guarantee.
As with any surgical procedure, there are risks:
- Swelling and post-operative bleeding (usually minor)
- Temporary numbness if nerves run nearby
- Renewed inflammation if infected tissue could not be completely removed
- Loss of the tooth if the resection is not successful
Alternatives to an apicoectomy
- Repeat root canal treatment (retreatment): Sometimes cleaning and shaping the canals again can eliminate the inflammation without the need for surgery
- Tooth extraction and implant: If the tooth can no longer be preserved, a dental implant is a high-quality alternative
- Monitoring: In rare cases, a small, symptom-free change at the root tip can be kept under observation
Apicoectomy at our practice
At the dental practice of Dr. Pantas in Düsseldorf, we perform apicoectomies using modern diagnostics and gentle surgical techniques; for molars that are difficult to access, we refer you to a specialised surgical practice. Digital X-rays and 3D imaging allow us to plan the procedure precisely and reduce risks. If you have any questions, get in touch: 0211 – 497 67 69.
This article is for general information purposes and does not replace professional dental advice. If you have symptoms, please contact your dentist.
