Root end surgery (also known as an apicoectomy) is a specialist microsurgical procedure to save your tooth when a persistent infection cannot be resolved by a traditional root canal.
When a non-surgical root canal cannot resolve a persistent infection at your tooth’s root tip, an apicoectomy is the recommended procedure to save your tooth.
Performed by a specialist endodontist under a surgical microscope.
The procedure accesses the infection from the root tip, meaning your existing crown or bridge is not removed or damaged.
Most patients return to work in 1-2 days, with discomfort managed by over-the-counter pain relief.
Root end surgery (or apicoectomy) is a minor surgical procedure that removes the tip of a tooth root and the surrounding infected tissue.
While a traditional root canal accesses the tooth from the crown (top), an apicoectomy accesses the root from the gum side. This allows us to treat persistent infections that cannot be resolved through non-surgical approaches.
Root end surgery becomes the recommended treatment in specific situations where non-surgical approaches are not feasible or have not succeeded.
Modern apicoectomy is a precise microsurgical procedure performed under a dental operating microscope with minimal tissue trauma. Understanding each phase helps patients feel prepared and confident.
Surgical microscopes provide 8-25x magnification, enabling us to:
If you have been told you need root end surgery, or if persistent infection remains after root canal treatment, a specialist evaluation will determine if microsurgical treatment can save your tooth.
Immediate Post-Surgical Care (First 48 Hours)
Understanding recovery expectations helps patients heal optimally.
| Treatment Option | Outcome |
|---|---|
| Root End Surgery | Saves your natural tooth. Preserves your existing crown. |
| Root Canal Retreatment + New Crown | Non-surgical alternative, but requires destroying and replacing the crown. |
| Extraction + Dental Implant | Loses your tooth. Higher cost and a 6-12 month treatment timeline. |
An apicoectomy (or root end surgery) is a minor surgical procedure that removes the infected tip (apex) of a tooth root and seals the end of the root canal from the bottom. It is performed when conventional root canal treatment cannot resolve a persistent infection.
The area is numbed with local anaesthetic before surgery starts. After surgery, expect mild to moderate discomfort for 2-4 days, which is well-managed with over-the-counter pain relievers.
Most patients return to work within 1-2 days and light physical activity in 3-5 days. Sutures are typically removed after 7-10 days. The bone will continue to heal internally for 6-12 months.
For many patients, yes. It can save a tooth that would otherwise need extraction. The cost is significantly less than an extraction and dental implant replacement.
It depends on the tooth, the bone around it and whether there is a crack. Your endodontist will explain the likely outcome for your case at consultation.
For further reading on the research, learn more at “Clinical case study: periapical healing.”
Eat cold, soft foods only for the first 24 hours (e.g., yoghurt, smoothies). Do not have hot foods or drinks. Chew on the opposite side of your mouth for the first week.
The procedure typically takes 60-90 minutes, depending on the tooth’s location and complexity. It is a single-visit procedure.
A root canal is non-surgical and cleans the canals from the inside of the tooth (through the crown). An apicoectomy is surgical and accesses the root tip from the outside (through the gum) to seal it.
Yes, some can. This is most commonly due to an undetected root crack or poor healing. If it fails, the next step is usually extraction.
Yes, most Australian private health insurance policies provide partial coverage under “Major Dental” or “Specialist Endodontics,” subject to your policy’s waiting periods and annual limits.
Yes, if you only had a local anaesthetic, you can drive home. If you had any form of sedation, you cannot drive and must have a responsible adult escort you home.
An apicoectomy is recommended if: (1) a blockage (like a post or broken file) prevents retreatment, (2) previous retreatment has already failed, or (3) you have an expensive crown you want to preserve.
This is rare, but is a possibility for lower back teeth near the main jaw nerve. We use a pre-surgical 3D (CBCT) scan to precisely map the nerve’s location and plan the surgery safely to minimise this risk.
Yes. This is a major advantage of the procedure. The apicoectomy is performed at the root tip, leaving your existing crown completely intact.
Root Canal Retreatment Root canal retreatment is a specialist procedure to fix a failed root canal, providing a second chance to save your natural tooth.
A cracked tooth is when damage causes a small break or fracture in the tooth, which can range from small craze lines in the enamel to a split that runs below the gum line.
If you are in pain, we can usually see you for an assessment within 48 hours. That appointment covers diagnosis, pain relief and a clear plan for treatment, with treatment scheduled from there.