Precision Endodontic Microsurgery for Optimal Outcomes
Endodontic microsurgery (apicoectomy) is a precise, microscope-guided surgical procedure that removes infection at the very tip of a tooth root. It is the right choice when conventional retreatment is not feasible, when there is a cyst at the root apex, or when access through the crown is blocked by a post or crown that cannot be safely removed.
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 previous root canal and retreatment
- A cyst or granuloma at the root tip seen on CBCT
- A post-and-core build-up that cannot be safely removed for retreatment
- A separated instrument or other obstruction in the canal
- Anatomical complexity at the apex that conventional treatment cannot reach
How apicoectomy works at Hope Endodontics
- 1
CBCT planning
3D imaging maps the tooth root, the bone around it, and the relationship to nearby anatomy (sinus, nerve).
- 2
Anesthesia
Local anesthesia plus comfort measures. The procedure is virtually painless during.
- 3
Microscope-guided incision
A small, precise gum incision is made directly over the root tip.
- 4
Apex preparation
The infected tip of the root 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 & follow-up
Sutures are typically removed at one week. Most patients return to normal activity in 24–48 hours.
The technology behind every appointment
- CBCT 3D imaging is essential 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 microsurgery painful?
- No. The procedure itself is performed under local anesthesia and is comparable in comfort to a routine filling. Mild soreness afterward is typical for 24–48 hours and managed with over-the-counter analgesics.
- How long is recovery?
- Most patients return to normal activity within a day or two. 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?
- Modern microsurgery, with microscope and bioceramic materials, has a published success rate around 90%, far higher than older surgical techniques.
- When is microsurgery preferred over retreatment?
- When the canal cannot be safely re-accessed through the crown, when there is a post that cannot be removed, or when the issue is at the root tip itself. CBCT imaging guides this decision.
- How is this different from extraction?
- Microsurgery saves the natural tooth. Extraction removes it and typically requires an implant or bridge, which is significantly more expensive and time-consuming.
Explore other endodontic services
Root Canal Therapy
Relieve pain and save your natural tooth with microscope-guided root canal therapy.
Apicoectomy
Microscope-guided surgical removal of infected tissue at the root tip when conventional retreatment is not an option.
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.
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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