Infection back after a root canal? A small surgery may save the tooth.
An apicoectomy treats an infection at the very tip of a tooth's root. We make a small opening in the gum, remove the infected tissue and the root tip, and seal the end of the root.
Apicoectomy, or root-end surgery, is used when a root canal or retreatment has not cleared an infection, or when retreatment is not possible. It is done under local anaesthetic.
Examined under a microscope. Options and costs explained before any treatment.
Last updated 17 October 2026
When an apicoectomy may be suggested
- An infection that persists after a root canal and retreatment
- A crown, post or bridge that you want to keep and cannot safely remove
- A canal that is blocked and cannot be cleaned from above
- A cyst or dark area at the root tip that is not healing
What happens, step by step
Look
We examine, take X-rays and often a 3D scan to see the root tip and nearby structures.
Explain
You hear why surgery is advised, what the alternatives are and what recovery looks like.
Treat
Under local anaesthetic and a microscope, we reach the root tip, remove infected tissue and seal the root end.
Heal
Stitches are placed. We review you after a few days and again as the area heals.
What recovery is like
Some swelling, tenderness and mild bruising are normal for a few days. We give you written aftercare and are on WhatsApp if you have questions. Most people return to normal routines quickly, though we advise soft food and avoiding strenuous exercise for the first days.
Healing of the bone takes months, so we review the area with an X-ray later to confirm it is healing.
Questions patients ask
Is an apicoectomy painful?
It is done under local anaesthetic. Afterwards, expect soreness and swelling for a few days, managed with the medication we advise.
How long does it take?
Often under an hour or so, depending on the tooth.
What is the success rate?
It depends on the tooth, the reason for failure and your health. We discuss realistic expectations for your tooth rather than quote a headline figure.
Will I need antibiotics?
Only if your situation calls for it. We decide this at your consultation.
Is it better than extraction and an implant?
Keeping your own tooth is often preferable when it can be done predictably. We will go through both options.
You may also want to read
Root canal retreatment
A root canal that is sore again, infected again or never settled.
Read moreMicroscopic endodontics
Seeing inside the tooth clearly, so nothing is missed.
Read moreDental implants
A fixed replacement for a missing tooth, built in the jawbone.
Read moreExtractions
When a tooth cannot be saved, and how to be sure before it comes out.
Read more


