Apicoectomy - City Clinic Marbella

Dentistry▸Endodontics

Apicoectomy

An apicoectomy (also known as root-end surgery) is a minor surgical procedure that removes the tip (apex) of a tooth’s root and any infected tissue around it, sealing the root end to preserve the tooth.

Doctors & Specialists:

Dr.Álvaro Díaz de Alda
Said Ramazani

When a previous root canal has failed or infection persists near the root tip, an apicoectomy becomes necessary. The procedure involves making an incision in the gum to expose the root, removing a few millimeters of the root tip along with infected tissue, then sealing the canal from the end. Over time, bone and tissue heal around the treated root tip, preserving the tooth’s function and structure. Modern techniques often use microscopes and microsurgical tools to maximize precision and success.

Indications

Persistent infection after root canal

Pain or swelling near root tip

Apical lesion or cyst on X-ray

Complex roots not treatable conventionally

Tooth worth preserving functionally

Causes

Incomplete prior root canal cleaning

Hidden or accessory canals with bacteria

Leakage from faulty restoration

Calcified or obstructed canals

Treatment Details

Procedure Steps

1

Examination & Preparation – Imaging (X-ray or CBCT) and local anaesthesia to plan and ensure comfort.

2

Root-End Surgery – A small gum incision is made, the root tip and infected tissue are removed, and the area is cleaned and sealed.

3

Closure & Aftercare – The gum is sutured, and detailed recovery instructions and follow-up visits are provided.

Duration:

60–90 minutes (depending on complexity)

Number of Sessions:

Usually a single surgical visit; sometimes additional follow-up visits

Recovery / Downtime:

Mild swelling and tenderness for several days; general activities resume quickly

Pain Level:

Moderate — managed with local anaesthesia during surgery and pain control afterward

Pre-Treatment:

Share full medical and dental history, including medications
Avoid smoking and maintain good oral hygiene prior to surgery
Arrange transportation or rest time if sedation or discomfort anticipated

Post-Treatment:

Apply ice packs first 24 hours to reduce swelling
Eat soft, non irritant foods and avoid chewing near surgical site
Maintain gentle oral hygiene — avoid disturbing sutures
Use prescribed analgesics or anti-inflammatories
Attend follow-up visits to monitor healing and remove sutures

Results

Expected Outcome

Short-term: Relief of symptoms like pain and infection. Over time, healthy bone regrows around the treated root tip, resolving lesions and stabilizing the tooth.
Long-term: The apicoectomy helps maintain the tooth in place and prevent further infection.

How Long
Results Last? 

When successful, results are long-lasting. Many treated teeth remain functional for many years with proper restoration and care.

Risks & Considerations

Possible Side Effects 

• Swelling, mild bleeding, or bruising in the area • Temporary sensitivity or discomfort • Risk of failure to heal completely or reinfection • Possible damage to adjacent structures (e.g. nerves) in rare cases

Contraindications (who should avoid it)

• Poor general health or uncontrolled systemic conditions
• Teeth with insufficient structure to restore or support
• Inadequate periodontal support or compromised bone
• Active infection elsewhere that has not been treated

Safety Notes

City Clinic uses microsurgical techniques, sterilised instruments, and imaging guidance to minimize risks. Every case is individually planned and monitored for safety and optimal outcome.

Pricing

Price Range (approximate)

Factors Affecting Price

• Number of roots or complexity of anatomy
• Need for guided surgery, bone grafting or magnification tools
• Accessibility (e.g. front vs molar region)
• Follow-up visits and restoration afterward

Insurance Coverage

Apicoectomy is not covered by insurance.

FAQs

Is the procedure painful?

No — local anaesthesia ensures comfort during the procedure; mild post-operative discomfort is normal.

How long is recovery?

Most patients recover within a few days; full bone healing takes weeks to months.

Will I need a new restoration afterward?

Yes — the tooth usually needs a final restoration (e.g. crown) to protect it.

Can an apicoectomy fail?

Yes — reinfection or inadequate sealing can lead to failure, though success rates are generally high with modern techniques.

Is this better than extracting the tooth?

Yes — when feasible, preserving your natural tooth is often the preferred option compared to extraction and replacement.

Related Treatments

Root Canal

Root canal treatment is a dental procedure that removes infected or inflamed pulp (the inner soft tissue) from a tooth’s root canals, thoroughly cleans and disinfects the internal spaces, then seals and restores the tooth to preserve its function and prevent further infection.

Retreatment

Retreatment is a secondary endodontic procedure performed on a tooth that has already undergone root canal therapy but has developed new symptoms or failed to heal properly. At City Clinic, retreatment offers a second chance to resolve persistent infection and salvage the natural tooth.

Pulp Capping

Pulp capping is a conservative dental procedure aimed at protecting and preserving the vitality of the tooth’s pulp when it is exposed (or nearly exposed) due to decay or mechanical trauma. Instead of removing the pulp entirely, a medicated dressing is placed directly or indirectly over it, promoting healing and avoiding a root canal.

Dental Fillings

Dental fillings are a restorative procedure used to repair teeth damaged by decay, wear, or minor fractures. At City Clinic, we use advanced, tooth-colored composite materials that blend seamlessly with your natural enamel — restoring strength, function, and aesthetics with minimal invasiveness.