When you're dealing with tooth pain or a failed root canal, your first thought is likely, "What are my options?" At Modern Micro Endodontics, we often help patients navigate between two common treatments—traditional root canals and apicoectomy surgery. While both are designed to save your natural tooth and eliminate infection, they differ in approach and when they’re recommended.

Understanding these procedures can help you make informed decisions about your oral health. If you're experiencing persistent pain after a root canal or have been told you need additional treatment, this blog will walk you through what each procedure involves and how we determine the best course of action.

What Is a Traditional Root Canal?

A traditional root canal is a non-surgical treatment used to remove infected or inflamed pulp from inside a tooth. Once the diseased tissue is cleared out, the canal is cleaned, shaped, filled, and sealed to prevent future infection. This process allows us to preserve your natural tooth structure and eliminate pain from the inside out.

Most root canals are highly successful, especially when performed using modern techniques and advanced imaging tools. At our office, we utilize magnification and digital imaging to ensure precision and patient comfort. Recovery is usually straightforward, and many patients can return to normal activities the next day.

However, there are situations where a root canal may not fully resolve the issue—or where a new infection can develop months or even years later. That’s when we start to consider a different type of treatment.

What Is an Apicoectomy and When Is It Necessary?

An apicoectomy is a form of surgical endodontics used when a root canal alone is not enough. In this procedure, we make a small incision in the gum tissue to access the root tip of the tooth. We then remove the infected root tip and any surrounding inflamed tissue, clean the area, and seal the end of the root with a filling.

This type of surgery is often recommended when:

• Infection persists after a root canal.
• There are hidden canals or anatomical anomalies that can’t be reached non-surgically.
• A fracture or blockage makes it impossible to retreat the root canal.
  
  

Apicoectomy is considered a conservative alternative to extraction. Instead of removing the entire tooth, we address the problem directly at the root’s end, preserving as much of your natural structure as possible. It’s typically performed under local anesthesia and may involve a few days of healing time, but the outcome can be long-lasting.

How Do We Decide Which Procedure You Need?

The decision between a root canal and an apicoectomy depends on several factors, including your dental history, imaging results, the location of the tooth, and whether prior treatments have failed. If this is your first time treating a tooth with infection or decay, we’ll usually recommend a root canal as the first line of defense.

However, if you’ve already had a root canal and symptoms return—or if an infection doesn’t heal properly—an apicoectomy may be the more effective choice. Advanced imaging, such as 3D cone beam CT scans, allows us to get a precise view of the root structure and determine if surgical access is necessary.

We understand that no two patients are the same. That’s why we evaluate every case thoroughly and discuss all available options with you before proceeding. Our goal is to preserve your tooth, relieve your pain, and restore your comfort with the least invasive method possible.

Why It’s Important to Address Persistent Tooth Infections

When infection lingers around a tooth root, it’s not something to ignore. In addition to ongoing pain or swelling, untreated infections can lead to abscesses, bone loss, or the need for tooth extraction. More seriously, oral infections can sometimes spread to other areas of the body, posing risks to overall health.

By addressing the issue early with either a root canal or apicoectomy, we not only protect your tooth but also safeguard your long-term well-being. Both procedures aim to eliminate bacteria, promote healing, and allow your bone to regenerate naturally over time.

If you're noticing signs of infection—like gum tenderness, a recurring pimple on the gums, or sensitivity to pressure—don’t wait. Early treatment gives us the best chance to save your tooth and avoid complications.

Frequently Asked Questions About Surgical Endodontics

How do I know if I need an apicoectomy or a retreatment root canal?

After a root canal, if symptoms persist or imaging reveals an unresolved infection, we’ll assess the tooth to determine the best path forward. If the canal can be retreated without obstruction, we may opt for a non-surgical approach. But if retreatment is not feasible due to previous dental work, complex anatomy, or root tip infection, an apicoectomy may be the most effective solution.

Is an apicoectomy painful?

Apicoectomy surgery is typically performed under local anesthesia, so you shouldn’t feel pain during the procedure. Some post-operative soreness or swelling is normal for a day or two, but it can be managed with over-the-counter medication and cold compresses. Most patients recover quickly and return to normal activities within a few days.

At Modern Micro Endodontics, we combine precision, experience, and compassion to deliver advanced endodontic care. Whether you need a root canal or a surgical solution, we’re here to help you preserve your natural teeth and feel confident in your treatment. Contact us to schedule a consultation.