Endodontic surgery gets to the root of the problem when other treatments have not worked, and in many cases it can save a tooth that would otherwise need to come out.
- Targets infection at the very tip of the root that cannot be reached from inside the tooth
- Removes damaged tissue and seals the root end to stop infection coming back
- A precise and effective procedure carried out under local anaesthetic
- Can save a tooth even when root canal treatment or retreatment has not been successful
With the right aftercare, most teeth treated with endodontic surgery go on to last for many years.
What Is Endodontic Surgery?
Endodontic surgery is a procedure used to treat infection or damage at the tip of a tooth’s root when standard root canal treatment or retreatment has not been enough to fix the problem. The most common type is called an apicoectomy, which involves making a small cut in the gum to access the root directly.
Once the area is reached, the tip of the root is removed along with any infected tissue. The end of the root is then cleaned and sealed to prevent bacteria from getting back in. The gum is stitched closed and left to heal.
It sounds more involved than it is. The procedure is carried out under local anaesthetic, and most patients find it much more straightforward than they expected. It is typically done by a specialist called an endodontist and usually takes around 30 to 90 minutes depending on the tooth being treated.
What Endodontic Surgery Includes
When you come in for endodontic surgery, here is what you can expect:
- A thorough assessment of the tooth and surrounding area using X-rays or a 3D scan to plan the procedure
- Local anaesthetic to completely numb the area so you do not feel pain during the surgery
- A small cut made in the gum near the affected tooth to expose the tip of the root
- Removal of any infected or damaged tissue surrounding the root tip
- Removal of the very tip of the root, which is often the source of the ongoing problem
- Cleaning and preparation of the root end to make sure no bacteria remain
- Placement of a small filling at the end of the root to seal it off completely
- Stitches to close the gum and allow it to heal properly
- Aftercare guidance to help you recover comfortably at home
Your specialist will talk you through every step before anything begins and will make sure you know what to expect during recovery.
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Why Is Endodontic Surgery Worth It?
When a tooth has not responded to root canal treatment or retreatment, it can feel like there are no options left. Endodontic surgery changes that. It reaches the part of the root that cannot be treated from inside the tooth, giving the tooth a genuine chance of survival.
Surgery removes the source of infection directly, which means the problem is dealt with rather than worked around. It saves your natural tooth, and keeping your natural teeth is almost always better than replacing them with implants or bridges. Natural teeth are stronger, feel more natural, and help keep the surrounding bone and gum tissue healthy. The success rate for endodontic surgery is high when carried out by a trained specialist, and most patients are surprised by how well they feel after recovery.
The alternative is extraction, which costs more in the long run and means dealing with replacement options like implants or dentures. Endodontic surgery is worth considering seriously before giving up on a tooth.
If you are concerned about the cost, speak to your specialist about payment plans. Many practices offer flexible ways to spread the price over time.
Endodontic Surgery FAQs
What is endodontic surgery and when is it needed?
Endodontic surgery is a procedure used to treat infection or damage at the tip of a tooth’s root when standard root canal treatment or retreatment has not resolved the problem. It may also be needed when a cyst or lesion is present at the root tip, when the canal cannot be accessed from inside the tooth, or when a crack near the root tip is causing ongoing issues.
What is an apicoectomy?
An apicoectomy is the most common type of endodontic surgery. It involves removing the tip of the tooth’s root — known as the apex — along with any infected or damaged tissue. The root end is then cleaned and sealed with a small filling to prevent bacteria from re-entering. The gum is stitched closed and allowed to heal.
Is endodontic surgery painful?
The procedure is carried out under local anaesthetic, so you should not feel any pain during the surgery. Afterwards, some soreness and swelling is normal for a few days, with symptoms typically peaking around 24 to 48 hours after treatment. Most patients find the recovery much easier than they anticipated and manage any discomfort with over-the-counter pain relief.
How long does endodontic surgery take?
Most endodontic surgery procedures take between 30 and 90 minutes. The exact time depends on which tooth is being treated and the complexity of the case. Front teeth with a single root are generally quicker to treat, while back teeth with multiple roots can take a little longer.
How successful is endodontic surgery?
Endodontic surgery has a high success rate, particularly when performed by a specialist endodontist using modern techniques and equipment. Studies show success rates of approximately 85 to 97 percent. Your specialist will provide an honest assessment of the likely outcome based on your specific case before treatment begins.
How long does recovery take after endodontic surgery?
Most patients feel back to normal within a few days. Swelling and tenderness usually peak around 24 to 48 hours after the procedure before gradually improving. You should stick to soft foods, avoid brushing directly over the surgical site, and rinse gently with warm salt water. Your specialist will provide full aftercare instructions to support a comfortable recovery.
Why is saving a natural tooth with endodontic surgery better than extraction?
Keeping your natural tooth is almost always preferable to having it removed. Natural teeth are stronger, feel more natural, and help maintain the health of surrounding bone and gum tissue. Extraction also tends to cost more in the long run, as it requires replacement options such as implants or dentures. Endodontic surgery offers a high chance of saving the tooth before extraction becomes necessary.
Will I need a new crown after endodontic surgery?
Not necessarily. If your existing crown or restoration is in good condition, it can usually remain in place. However, if the crown needs to be removed to carry out the surgery, or if it is damaged, a new one may be required. Your specialist at Ayub Endodontics will advise you on this before treatment begins so there are no surprises.