Apicoectomy
An apicoectomy is a microscope-guided surgical procedure that removes the infected tip of a tooth root and the surrounding inflamed tissue, then seals the canal from the outside. It is the right choice when conventional root canal retreatment is not feasible — typically because of a post-and-core build-up, a separated instrument, or a cyst at the root apex.
Medically reviewed by Dr. Hope Feldman · Diplomate, American Board of Endodontics
Last reviewed May 5, 2026 · NPI 1275089088
When you need apicoectomy
These are the most common reasons apicoectomy is recommended. If you recognize any of these signs, call the office. We hold time daily for urgent endodontic care.
- Persistent infection after a root canal and a retreatment
- A cyst or granuloma at the root tip on CBCT 3D imaging
- A post or crown that cannot be safely removed for retreatment
- A separated file or other obstruction in the canal
- Anatomic complexity at the root apex that conventional treatment cannot reach
How apicoectomy works at Hope Endodontics
- 1
CBCT 3D planning
3D imaging maps the root, surrounding bone, and adjacent anatomy (sinus, nerve).
- 2
Local anesthesia
Numbing the area; the procedure itself is virtually painless.
- 3
Microscope-guided incision
A small, precise gum incision directly over the root tip.
- 4
Apex preparation
The infected root tip and surrounding tissue are removed under high magnification.
- 5
Bioceramic seal
A small biocompatible filling is placed at the apex to seal the canal from the outside.
- 6
Closure
The gum tissue is repositioned with very fine sutures.
- 7
Recovery
Sutures removed at one week; most patients return to normal activity in 24–48 hours.
The technology behind every appointment
- CBCT 3D imaging for surgical planning
- Surgical operating microscope at every step
- Ultrasonic root-end preparation tips
- Bioceramic root-end filling materials
Typical cost
Estimates only. Actual fees depend on your insurance plan, the complexity of the tooth, and any additional restoration work. We provide a written estimate before treatment so there are no surprises.
| Item | Estimated range | Notes |
|---|---|---|
| Anterior apicoectomy | $1,400–$1,800 | — |
| Premolar apicoectomy | $1,600–$2,000 | — |
| Molar apicoectomy | $1,800–$2,500 | Posterior access is more complex |
Frequently Asked Questions
- Is an apicoectomy painful?
- No. The procedure is performed under local anesthesia and is comparable in comfort to a routine filling. Mild soreness for 24–48 hours afterward is typical and is managed with over-the-counter analgesics.
- How long is recovery from an apicoectomy?
- Most patients return to normal activity within 24–48 hours. Sutures come out at about a week. Bone healing continues for several months and is monitored on follow-up imaging.
- What is the success rate of a modern apicoectomy?
- Modern microsurgical apicoectomy with a microscope and bioceramic root-end filling has a published success rate of approximately 90% — far higher than older surgical techniques.
- When is an apicoectomy preferred over retreatment?
- When the canal cannot be safely re-accessed through the crown — usually because of a post that cannot be removed, a separated instrument, or pathology at the root tip itself. CBCT 3D imaging guides the decision.
- Is an apicoectomy better than extraction?
- For a tooth that is otherwise restorable, yes. The apicoectomy preserves your natural tooth and avoids the cost and timeline of an implant + crown that would otherwise follow extraction.
Explore other endodontic services
Root Canal Therapy
Relieve pain and save your natural tooth with microscope-guided root canal therapy.
Sedation Endodontics
Nitrous oxide, oral sedation, and IV sedation options for anxious patients and longer treatments.
Pediatric Endodontics
Pulpotomy, pulpectomy, and vital pulp therapy for children and teens, with age-appropriate behavioral guidance.
Regenerative Endodontics
Pulp-tissue regeneration for immature permanent teeth — preserving long-term root development.
Dental Trauma Care
Same-day evaluation and treatment for knocked-out, fractured, displaced, or split teeth — minutes matter.
Endodontic Retreatment
When a prior root canal hasn't healed, CBCT-guided retreatment gives your tooth a second chance.
Endodontic Microsurgery
Apicoectomy removes persistent infection at the root tip and preserves your natural tooth.
Cracked Tooth Care
Specialist diagnosis and treatment for cracked, fractured, or split teeth before they worsen.
CBCT 3D Imaging
High-resolution 3D scans for precise diagnosis and conservative treatment planning.
Emergency Endodontist
Same-day appointments for severe tooth pain, infection, and dental trauma.
Endodontic Second Opinions
Independent specialist review before you commit to a root canal or extraction.
References
- American Association of Endodontists. aae.org
- American Board of Endodontics. aae.org/about/abe
- NIH National Library of Medicine. ncbi.nlm.nih.gov
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