Occasionally, a nonsurgical root canal procedure alone cannot save your tooth and surgical procedure may be needed.  Endodontic surgery may help in the following situations:

  • Sometimes calcium deposits make a canal too narrow for the instruments used in nonsurgical root canal treatment to reach the end of the root. If the tooth has this “calcification,” endodontic surgery may be performed to clean and seal the remainder of the canal.
  • Surgery may also be performed to treat damaged root surfaces or surrounding bone.
  • If the tooth has complex anatomy such as hidden canals or small branches of the canal that cannot be treated non-surgically, surgical treatment may be needed to remove the portion of the root with complex anatomy.
  • Sometimes surgery is used to explore for possible fracture in the root that cannot be detected on the x-ray or the scan.

The most common type of surgical procedure is called apicoectomy.  In this procedure, the gum tissue near the tooth is opened to see the underlying bone and to remove any inflamed or infected tissue. The very end of the root is also removed.

Endodontic Surgery One
Endodontic Surgery Two

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

Endodontics Surgery Three

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

Endodontics Surgery Four

The content was reproduced with permission from the American Association of Endodontists