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An apicoectomy (also called root-end surgery or “root-tip resection”) is a dental surgical procedure done to treat persistent infections or inflammation at the tip (apex) of a tooth’s root, especially when a conventional root canal has failed or is insufficient.
The term “apico-” refers to the apex (tip) of the root, and “-ectomy” means removal. In an apicoectomy, the tip of the root is removed, plus any infected or inflamed tissue around it.
After removing the root tip and cleaning the area, a small filling is placed at the end of the root (root-end filling) to seal it and prevent reinfection.
The gum is then sutured, and over time, the bone around the root can regenerate and heal.
It is a type of periradicular (around-the-root) surgery.
An apicoectomy is usually considered when:
A prior root canal treatment has failed to fully eliminate infection, or new infection recurs at the root tip.
Retreatment of the root canal is not feasible (for example, because of difficult anatomy, blocked canals, or existing structure that prevents re-access).
There are anatomical complexities such as small accessory canals or root curvatures near the apex that were not cleaned in the original root canal.
There is a persistent lesion, cyst, or bone involvement around the root tip.
The tooth is still restorable, and preserving it is preferred over extraction + replacement (implant/bridge).
In short: when conventional endodontic (root canal) therapy fails or is not possible to correct the problem, an apicoectomy may be the “last option” to save the tooth.
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