Endodontic Surgical Treatment

On rare occasions, a relatively small number of teeth will not respond to conventional endodontic or re-treatment therapy. When this occurs, an endodontic surgical procedure called apicoectomy becomes necessary.

Endodontic Surgical Therapy

endosurgery Remember, nothing is as good as your natural tooth!

Apicoectomy means removal of the apex or root tip of the tooth. This is performed under local anesthesia, by making a small incision in the gum tissue near the tooth. Once the inflammatory or infected tissue is removed from around the root end, the root tip itself is then removed.

A permanent, cement material called MTA is placed in the root to seal the apex. Dissolvable stitches or sutures are placed to help the gum tissue heal appropriately.

Since the procedure is done under local anesthesia the patient may drive him or herself to and from our office. Under most circumstances the patient can return to normal activities the next day. Discomfort is controlled routinely with over-the-counter medications. Swelling will likely occur and can last from three-five days after the surgery. This is a normal component of the healing process.

Most often the only alternative to endodontic surgery is extraction. Since replacement of an extracted tooth necessitates either implant surgery or bridge placement, which requires a procedure on adjacent, healthy teeth, endodontic surgery is frequently the most biologic and cost effective option for maintaining oral health.


The perception of root canal therapy being painful began many years ago. In fact, most people's perception is related to the pain that brought them to the dentist and not the pain associated with the procedure itself. With today's modern techniques, anesthetics and the special training and skill of the endodontist, your endodontic therapy should be no more uncomfortable than having a filling placed.


There is no need to alter your routine prior to endodontic therapy. We encourage you to get a good nights rest and to eat normally before your appointment. Be sure to take any medications you routinely take. It may be advantageous to take 2 Advil or Aleve prior to your visit. This will help to minimize any post-operative inflammation.

Under certain circumstances, prior to a surgical visit, we may recommend that you alter your medications and may also prescribe additional medications for you to start before your appointment. We will advise you of this, at your consultation appointment if necessary.