Apicoectomy: What is it and when is it used

In this article, Oral Surgeon Simón Pardiñas López, a specialist in dental treatments, tells us about apicoectomy, a treatment used in dentistry to treat infections in the root of teeth that cannot be addressed with a root canal.

When a tooth has suffered trauma and changes color, it indicates that it has lost its vitality in the internal part and is known as having a dead nerve. When this happens, the area of the tooth becomes infected extending to the tip of the root, usually a cyst or a granuloma. The cyst can emerge through the gum and can be detected by an x-ray. This can also happen when a deep caries infects the nerve or if the tooth suffers any type of trauma.

The main treatment when these things happen is endodontics, which serves to “kill” the nerve, although in this case it is already dead, and thus be able to remove the necrotic remains to cure the infection. When endodontics does not solve the process, what is done is apicoectomy.

What is an apicoectomy?

An apicoectomy is a dental treatment to eliminate an infection in the root of a tooth and adjacent tissues, when endodontics has not had any effect or when it cannot be accessed by that procedure.

The first thing that is done is an x-ray to know the current situation of the root of the tooth and tissues. Next, an incision is made in the gum and the bone necessary to access the apex of the root is removed. In this area, the infectious cyst is removed and the area is cleaned. Then, a beveled cut is made at the tip of the affected tooth and the root is sealed. Finally, the area is sutured and will regenerate until it heals.

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Better than a tooth extraction?

In the face of such an infection, sometimes the idea of proceeding with a dental extraction can be considered. However, it is better to opt for an apicoectomy, as it is a much simpler process and usually gives better results. If the root only presents a fissure or a small fracture, then it is better to opt for an extraction.


For the days following the intervention, a series of recommendations can be followed:

  • Keep the area sanitized to avoid infection.
  • Brush your teeth after meals, avoiding the operated area.
  • Maintain an adequate diet: soft and eminently cold avoiding chewing with the operated area.
  • Do not consume tobacco or alcohol that damage the healing.
  • Control physical activity.
  • Anti-inflammatory drugs or analgesics may be taken to relieve pain in the operated area.