When Is an Apicoectomy Needed?

Certified by the American Board of Oral and Maxillofacial Surgery, Dr. Anup Muduli currently treats patients at his own practice in Oakland, New Jersey. Dr. Anup Muduli performs a wide range of surgical procedures on the teeth, jaws, and face, including apicoectomy.

An apicoectomy is a procedure to remove the tip of a tooth root, which is where the nerves and blood vessels enter the tooth from the jaw. Using microscopic instruments, the oral surgeon removes the root tip and surrounding infected tissues. A tiny filling is then placed at the end of the root.

This procedure is often indicated after an unsuccessful root canal treatment. Root canal treatment involves removing infected tooth nerves and pulp from the root canals and inside the tooth crown, and sometimes causes an infection in the tissues at the root tip. Often, infection occurs because of the complexity of root canals, which can be narrow or curved or contain tiny branches, making it difficult for the dentist or oral surgeon to adequately clean out debris. Sometimes, a second root canal treatment is performed and successfully removes the infection; however, more severe cases require apicoectomy. In addition, if the tooth already has a crown, apicoectomy is the only option, as a repeat root canal treatment would destroy the tooth restoration.