Apicoectomy or Root-End Surgery in Austin, TX


You’ve had a root canal, but it wasn’t enough to correct your tooth troubles. The infection has returned and you’re still in pain. The next step is a procedure called an apicoectomy, or root-end surgery. This treatment is a final effort to save your tooth; the alternative is usually removal. Preserve the function and aesthetics of your natural teeth with an apicoectomy in Austin, TX. Hill Country Oral Surgery offers this tooth-saving treatment, along with other oral surgery procedures including dental implants, wisdom tooth extraction, and jaw surgery.

What is an Apicoectomy?

To understand the apicoectomy procedure, first, you must understand the anatomy of a tooth. The visible tooth that you see inside of your mouth is only a portion of the actual tooth. We call this visible portion of the tooth the crown. Underneath the gumline, implanted in the jawbone is a portion of the tooth called the root.

Front teeth usually have one root. Teeth in the back, including molars, have two or more roots. At the tip of the root is the apex, the portion of the tooth where blood and nerves enter. A small channel extends from the apex to the pulp chamber of the tooth, essentially the center of the tooth, located in the crown, but not visible as it is covered by your tooth’s enamel.

The purpose of root canal therapy is to clean the diseased or infected tissue from the inside of a tooth and then seal it to prevent further infection. We liken it to a deep clean for the insides of a tooth. This treatment can be complicated by a variety of factors, and the root canal therapy alone may not be successful at clearing the established infection. There may also be extra canals or cracks in teeth that are not visible on x-rays or are not able to be treated by conventional root canal methods.

When infection returns after a root canal, it is often a sign that an apicoectomy or a second root canal is needed. If your dentist has suggested root-end surgery, it means that your tooth cannot be saved with a root canal and requires a more extensive procedure. In these situations, an apicoectomy or root-end surgery is often the only option available to salvage a failing root canal treated tooth.

An apicoectomy is a surgery completed on the tip of the root of a tooth. An incision is made into the gum tissue and the infected root tip is exposed. The diseased tissue is cleaned from the area, and part of the infected root is removed. After the root is removed, the remaining tooth is then sealed to prevent the infection from reestablishing itself. In some instances, a bone graft may be placed, and the area is then closed with sutures.

This procedure is highly effective and saves many teeth each year. Occasionally, the infected tooth can’t withstand the surgery and must be removed. If your apicoectomy fails, the next step is tooth extraction.


What Kind of Recovery Can I Expect After Root-End Surgery?

In general, root-end surgery does not require significant recovery time. Until the incision has healed, you will need to be careful with what you eat. As with any surgery, there will be a recovery period, including potential for tenderness and swelling. You will be prescribed medications to alleviate the discomfort and expedite your recovery. At your consultation appointment, we will discuss the specifics of your recovery and the amount of downtime you can expect. Many of our patients report that recovery after root-end surgery is easier than recovery after their original root canal.

Apicoectomy FAQs

How Long Does Root-End Surgery Take?

Most apicoectomies take between 30-90 minutes. Tooth location and the complexity of the root structure will determine the surgical time. Generally, the procedure is shortest if performed on a front tooth. Lower molars tend to be the most difficult teeth to treat.

What Do I Need to Avoid During Apicoectomy Recovery?

We ask patients to avoid smoking for a few weeks prior to their oral surgery and until completely healed after. Tobacco use can cause dental health problems, so ideally, patients should stop smoking before surgery and not resume the practice. Avoid hard or crunchy foods and chewy, sticky foods. Do not examine the surgical sites. Lifting the lip to see the incisions can disrupt stitches.

We’ll provide detailed instructions as you prepare for surgery.

How Much Does Apicoectomy Surgery Cost in Austin, TX?

You can’t put a value on high-quality dental care and the expertise that our surgeons bring to our practice, but we do realize that paying for dental surgery can require a little pre-planning. We’ll provide a detailed estimate at your consultation and talk with you about insurance and financing options.

What Are the Alternatives to Apicoectomy in Austin, TX?

This is a last-resort procedure, something we try when all other treatments have failed, but saving the tooth is still a possibility. The alternative to root-end surgery is tooth extraction. We can repair function and aesthetics after extraction using dental implants.

What Type of Anesthesia Is Used for Apicoectomy?

At Hill Country Oral Surgery we understand that patients have concerns about both dental surgery and anesthesia. By offering a variety of dental anesthesia options, we ensure each patient gets the pain relief and surgical management tools they need for a successful procedure. Depending on your anxiety levels, pain tolerance, and personal preferences, we’ll create an effective anesthesia plan. Our available options include:

  • Local anesthetic
  • Nitrous oxide (laughing gas)
  • IV sedation
  • General anesthesia

To ensure your comfort after surgery, we may provide a prescription for pain medication. We also offer Exparel®, a non-narcotic, long-lasting pain solution.

If you are experiencing pain and discomfort after a root canal, you may need an apicoectomy. This procedure helps patients to remove decay and damage from the tooth to preserve function and appearance. Call Hill Country Oral Surgery to learn more about apicoectomy treatment in Austin, TX.

Does bone grow back after apicoectomy?

Fortunately, it does. The space left after apicoectomy fills with blood, which becomes dense tissue that calcifies and finally turns into healthy bone. 

Do you need a new crown after apicoectomy?

Not necessarily. You only need apicoectomy after the repeated failure of endodontic treatment, so by the time you get root-end surgery, you already have a crown placed in the tooth. As your oral surgeon will perform this treatment on the tip of the roots and the surrounding tissues, there’s no need to touch the dental crown if it fits correctly. 

Do you need antibiotics after apicoectomy?

Your surgeon might prescribe antibiotic therapy before or after the procedure, based on the severity and type of the infection. When bacteria have affected too much tissue and your body cannot fight the infection on its own, you may need prescription medication. 

Is bone grafting necessary after apicoectomy?

That depends on the amount of bone tissue you had removed during surgery. In most cases, your body replaces the lost tissue, but if it is too much, you might need to have grafting material placed at the surgical site.

Schedule Your Consultation

Schedule a consultation for your Apicoectomy today to determine your best choices. During a consultation, patients meet with their surgeon and the staff to discuss procedure options in more detail. Patients may ask questions about desired outcome as well as view before and after photos of similar procedures.

Call us at 512-327-7233 or
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