An apicoectomy is a dental procedure where the end of a tooth root is cut off. Apico- comes from apex and -ectomy means to cut off. It’s done on a failed root canal and is a minor surgical procedure done in the dental office. Fortunately, most insurance companies help with the cost. The end of a tooth root can be very complex and sometimes there’s unfilled spaces in this area after a root canal. The unfilled spaces can harbor bacteria and cause a dental abscess. Fortunately, this is not common with modern techniques, however, there are many older root canals performed with irritating root canal filling materials.

During the apicoectomy the patient is thoroughly numbed and an opening is made through the bone where the end of the offending tooth root is located. The end of the root is cut off and a root end filling is placed. Some dentists like to place donor bone into the surgical hole made around the removed root to improve bone growth after this dental surgery. A new material, called mineral trioxide aggregate, is promising. The gums on top of the surgical area are then sutured closed and the surgery patient returns in a week to have the sutures removed.

Because an apicoectomy is usually done on a root canal failure, there is a chance that the root canal surgery will not work since this tooth already had serious problems. Many dentists are not comfortable doing it because of the higher failure rate and the fact that another dentist usually performed the failed root canal. There is about a 5% failure rate with all root canals, even if performed correctly. However, when needed, it is an important alternative for some patients rather than having an offending tooth removed.