Apicoectomy (Endodontic Surgery)

What is an Apicoectomy?

An Apicoectomy, or Root-End Resection, is the removal of the root tip and the surrounding infected tissue of an abscessed tooth. This procedure may be necessary when inflammation and infection persists in the area around the root tip after root canal therapy or root canal retreatment.

Why would I need Endodontic Surgery?

Surgery can help save your tooth in a variety of situations.

•	Surgery may be used in diagnosis. If you have persistent symptoms but no problems appear on your x-ray, your tooth may have a tiny fracture or canal that could not be detected during nonsurgical treatment. In such a case, surgery allows our doctor to examine the root of your tooth, find the problem and provide treatment.
•	Sometimes calcium deposits make a canal too narrow for the cleaning and shaping instruments used in nonsurgical root canal treatment to reach the end of your root. If your tooth has this “calcification,” our surgeon may perform endodontic surgery to clean and seal the remainder of the canal.
•	Usually, a tooth that has undergone a root canal can last the rest of your life and never need further endodontic treatment. However, in a few cases, a tooth not heal or become infected. A tooth may become painful or diseased months or even years after successful treatment. If this is true for you, surgery may help save your tooth.
•	Surgery may also be performed to treat damaged root surfaces or surrounding bone.

Although there are many surgical procedures that can be performed to save a tooth, the most common is called apicoectomy or root-end resection. When inflammation or infection persists in the bony area around the end of your tooth after a root canal procedure, Dr. Segui may have to perform an apicoectomy.

The Apicoectomy Procedure

In this procedure, Dr. Segui opens the gum tissue near the tooth to see the underlying bone and to remove any inflamed or infected tissue. The very end of the root is also removed.

A small filling may be placed to seal the end of the root canal, and a few stitches or sutures are placed in the gingiva (gums) to help the tissue heal properly.

Over a period of months, the bone heals around the end of the root.

Frequently Asked Questions

Local anesthetics make the procedure comfortable. Of course, you may feel some discomfort or experience slight swelling while the incision heals. This is normal for any surgical procedure. Dr. Segui will recommend appropriate pain medication to alleviate your discomfort.

Dr. Segui will give you specific post-operative instructions to follow. If you have questions after your procedure, or if you have pain that does not respond to medication

Often you can, but you should ask Dr. Segui before your appointment so that you can make transportation arrangements if necessary.

Most patients return to work or other routine activities the next day. We will be happy to discuss your expected recovery time with you.

Dr. Segui and her associates is suggesting endodontic surgery because they believe it is the best option for saving your own natural tooth. Of course, there are no guarantees with any surgical procedure. We will discuss your chances for success so that you can make an informed decision.

Often, the only alternative to surgery is extraction of the tooth. The extracted tooth must then be replaced with an implant, bridge, or removable partial denture to restore chewing function and to prevent adjacent teeth from shifting. Because these alternatives require surgery or dental procedures on adjacent healthy teeth, endodontic surgery is usually the most cost-effective option for maintaining your oral health.

No matter how effective modern tooth replacements are – and they can be very effective – nothing is as good as a natural tooth. You’ve already made an investment in saving your tooth. The pay-off for choosing endodontic surgery at Cosmo Dental could be a healthy, functioning natural tooth for the rest of your life.

Following Surgical Endodontics (Apicoectomy):

Try to limit physical activity on the day of your surgery. Going home after procedure is ideal.
Do not lift or pull up on lip. This may tend to loosen the sutures.
Mild discomfort should be expected. Have all prescriptions filled and take as directed.
Slight bleeding during the first day is normal. Increased bleeding should be reported to the office.
Some swelling and discoloration may be expected and should gradually disappear. To minimize swelling, apply an ice bag over the surgical area as soon as possible. Apply and remove at 20 minute intervals for the first four to six hours.
Do not rinse or spit for the remainder of the day. Starting tomorrow, gently rinse mouth with warm salt water, especially after each meal and at bedtime. Mix 1/2 teaspoon salt in a full glass of warm water. Continue until sutures have been removed or as instructed.
Brush and floss your teeth to keep your mouth as clean as possible, BUT not on or near the surgical area.
Maintain a soft nutritious diet. Crusty hard foods should be avoided. Do not chew or bite on or near the surgical area.
Keep your post-operative appointment to have the sutures removed or to have healing assessed.
Should you have any questions or problems, please don’t hesitate to contact Cosmo Dental Office at 8-3765327.

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At COSMO DENTAL, led by Dr. Segui and her skilled team, we provide expert dental care in a warm and welcoming environment.

With clinics in Quezon City and Makati, we offer a full range of services—from routine check-ups and preventive care to advanced cosmetic and restorative treatments.