What Is an Apicoectomy and Who Needs One?
An apicoectomy — also called root end surgery — is a precise microsurgical procedure that removes the very tip of a tooth's root (the apex) along with any infected tissue. It is typically recommended when a standard root canal or root canal retreatment has not fully resolved an infection, or when scar tissue or a narrow root canal prevents conventional treatment from reaching the source of the problem.
Signs Your Tooth May Need Root End Surgery
You might be a candidate for an apicoectomy if you experience persistent pain, swelling, or a pimple-like bump on your gum near a tooth that has already had root canal therapy. Other signs include ongoing discomfort when chewing, tenderness to touch, or a sinus tract (a small channel of infection draining through the gum). These symptoms suggest that bacteria remain sealed at the root tip, and root end surgery can often save the tooth when other options have failed.
Apicoectomy vs. Root Canal Therapy — What's the Difference?
A root canal therapy cleans and seals the inside of the tooth — the pulp chamber and canals — from the crown down to the root tip. An apicoectomy, by contrast, approaches the problem from outside the tooth through the gum tissue, removing the infected root tip and sealing the end of the root directly. Think of root canal therapy as working from the top down, and an apicoectomy as working from the bottom up. When infection persists after a root canal, an apicoectomy is often the best way to save the tooth from extraction.
Benefits of Choosing In-House Endodontic Surgery in Los Angeles
Choosing San Jose Dental Clinic for your apicoectomy means you stay in one familiar, trusted practice. Dr. Molina performs the procedure using an operating microscope for exceptional precision — a level of detail not available in every dental office. You avoid the hassle of a separate referral to a specialist across town. We offer sedation options including nitrous oxide and oral sedation to keep you relaxed throughout the procedure. And our team is fully bilingual — hablamos español — so you can communicate comfortably in English or Spanish. We also accept a broad range of insurance, including Denti-Cal and most PPO plans, to help make this care financially manageable.
What to Expect During Your Apicoectomy at San Jose Dental Clinic
Before, During, and After the Procedure
Before surgery, Dr. Molina will take a digital X-ray or 3D image of your tooth to plan the exact approach. On the day of the procedure, local anesthesia numbs the area completely — sedation is available if you feel anxious. Dr. Molina makes a small incision in your gum near the root tip, removes the infected tissue and the last few millimeters of the root, cleans the area, and places a tiny filling to seal the root end. The gum is sutured closed. The entire appointment typically takes 60 to 90 minutes.
Recovery and What's Normal
After your apicoectomy, you can expect mild soreness and slight swelling around the surgical site for a few days. Over-the-counter pain relievers and an ice pack are usually enough to manage discomfort. You will be able to return to work or normal activities the next day. Dr. Molina will give you specific aftercare instructions, including gentle rinsing and avoiding hard or chewy foods on the treated side for about a week. Most patients feel back to normal quickly, and the bone heals fully over the following months.
What Happens If an Apicoectomy Is Left Untreated
When an infection at the root tip is not addressed, it does not go away on its own. The infection can spread to the surrounding bone, leading to bone loss and weakening the jaw structure in that area. Over time, the tooth may become loose and require extraction. In some cases, the infection can spread to nearby teeth or, in rare instances, to other parts of the body. Treating the problem promptly with an apicoectomy gives your tooth the best chance of long-term survival and helps protect your overall oral health.