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You have had your root canal completed. For some reason, you are still having pain when you bite on that tooth, even though the nerve has been taken out of tooth. Now, Dr. Smith tells you that you have to have yet another procedure performed on your tooth, as to save it. It is called an apicoectomy.

Why do I need an apicoectomy?

On occasion, the infection that has invaded the pulp of tooth, does not respond adequately and appropriately following root canal therapy. The infection will continue to expand at the end of the root of the tooth. This causes pain, inflammation and bony destruction. This small infection that remains can be alleviated several different ways, but the most effective way is an apicoectomy.

What is an apicoectomy?

During an apicoectomy, the end of the root or roots are accessed that are still infected. The infection is removed surgically. The root canal that was relatively recently performed will be cleaned out from the root end of the tooth.

Once the root canal is cleaned out, it is then refilled from the root end. Most times, a small bone graft will then need to be placed. The bone graft is necessary due to a small space being left from the infection being removed.

After the bone graft is placed, oftentimes a synthetic membrane may need to be placed over the graft to aid in healing. This is not always necessary and Dr. Smith will determine this at the time of surgery.

What is the recovery time for an apicoectomy?

After an apicoectomy, you will be sore initially for the first couple of days. Most of this discomfort will be able to be relieved with over the counter medications such as Ibuprofen or Tylenol. Dr. Smith will discuss this with you during your treatment planning session and after your surgery.

Total recovery time happens in stages. You should notice no noticeable discomfort or any visual differences to your mouth after approximately two weeks. After this time, your underlying bone is still healing.

Total bone healing should completed in approximately six months. There should be no marked radiographic differences to the bone after this time. You should have, also, no marked differences to your function.


If your primary goal is to maintain your natural tooth and not use a replacement, many times an apicoectomy is the best treatment to choose. This treatment will oftentimes extend the life of your natural tooth many years, sometimes for the rest of your life.

The apicoectomy is a procedure that has been around for many years and is tried and true. Sometimes, you have to go to an old standby to get the job done. This is the apicoectomy. It is but one of many tools in Dr. Smith’s toolbox to get your dental job done.

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