What Is an Apicoectomy?
An apicoectomy — also called root end surgery — is a minor surgical procedure designed to treat persistent infection at the very tip (apex) of a tooth root. During the procedure, your endodontist removes a small portion of the root tip along with any surrounding infected tissue, then places a tiny filling to seal the end of the root canal.
This helps prevent reinfection and is intended to preserve your natural tooth when standard root canal therapy or retreatment alone may not be enough.
Why Choose Molina Endodontics for Your Apicoectomy
Specialist Experience & Technology
Dr. Molina has performed over 20,000 endodontic procedures since 1992, including complex surgical cases. Our Downey office is equipped with 3D CT/CBCT scanning and surgical microscopes for precise visualization of the root tip and surrounding bone — supporting accurate diagnosis and more predictable outcomes. Explore all of our endodontic treatments.
Sedation for a Comfortable Procedure
We understand that the idea of a surgical procedure can feel overwhelming. That's why we offer nitrous oxide, oral sedation, IV sedation, and general anesthesia — all monitored by a board-certified dental anesthesiologist on our team. Dr. Molina and our staff are committed to making your experience as gentle as possible.
When Is an Apicoectomy Needed?
Your dentist or endodontist may recommend this procedure when:
- A previous root canal has not fully healed or an infection has returned.
- The root tip has a fracture, unusual anatomy, or a blockage that prevents conventional retreatment.
- A biopsy of the tissue around the root tip is needed for diagnosis.
Apicoectomy vs. Endodontic Retreatment
If your initial root canal hasn't resolved the problem, the first step is usually endodontic retreatment, which involves reopening the tooth to clean and reseal the canals. However, when retreatment isn't possible — due to a post, crown, or complex root anatomy — or when retreatment has already been attempted, root end surgery becomes the recommended path. Dr. Molina will evaluate your specific situation using 3D imaging and recommend the approach most likely to save your tooth.
What to Expect During Your Apicoectomy
Before the Procedure
Your visit begins with a thorough examination, including 3D CT imaging to map the root structure and surrounding bone. Dr. Molina will explain the procedure in detail, answer your questions, and discuss which sedation option is right for you.
During the Procedure
After numbing the area (and administering your chosen sedation), Dr. Molina makes a small opening in the gum tissue near the affected tooth. The infected root tip is carefully removed, the end of the root canal is cleaned and sealed, and the gum tissue is closed with a few small sutures. Most procedures are completed in about 30 to 90 minutes.
Recovery and Aftercare
You may experience mild swelling and tenderness for a few days following your procedure. Ice packs and prescribed medication help manage any discomfort. Most patients return to daily activities within two to three days. We provide detailed aftercare instructions and schedule a follow-up visit to monitor your healing.
Apicoectomy Cost and Insurance
The cost of an apicoectomy varies based on the tooth location and complexity of your case. Molina Endodontics participates with a wide range of PPO insurance plans — including Aetna, Delta Dental, Cigna, MetLife, and many others — and our team will help verify your coverage before your appointment. CareCredit financing is also available. Visit our Insurance & Financing page for more details.
Frequently Asked Questions
Most patients report little to no pain during the procedure thanks to local anesthesia and available sedation options, including IV sedation with a board-certified dental anesthesiologist. Post-operative discomfort is typically mild and manageable with prescribed or over-the-counter medication for a few days.
Most patients return to normal activities within two to three days. Mild swelling and tenderness near the surgical site may last up to a week. Full healing of the bone and tissue around the root tip typically occurs over several months.
When performed by an endodontic specialist using modern microsurgical techniques and advanced imaging, this procedure has a high success rate. The use of 3D CT scanning and surgical microscopes helps improve precision and long-term outcomes.
Delaying a recommended root end surgery may allow infection to spread, potentially leading to increased pain, bone loss, or the eventual need for tooth extraction. Early treatment gives you the best chance of saving your natural tooth and avoiding more extensive procedures.
