Plan
3D CBCT imaging maps the root tip, the infection, and nearby structures so the surgery is precise before it begins.
Endodontic Care
Apicoectomy in The Woodlands, TX
A precise microsurgical procedure that removes infection at the root tip when a conventional root canal can't resolve it, saving teeth that would otherwise be lost.
Treatment Explained
Apicoectomy, Explained
This treatment addresses infection, inflammation, or damage inside a tooth. At Woodlands Endodontics, our specialists focus on preserving your natural tooth whenever possible, using advanced imaging and gentle technique to keep care comfortable and predictable.
- By caseVisits to complete
- HighLong-term success rate
- LastingResults you can rely on
Looking for an Apicoectomy in The Woodlands, TX? An apicoectomy, sometimes called root-end surgery or endodontic microsurgery, is a procedure that treats persistent infection at the very tip of a tooth's root. It is typically recommended when a root canal or retreatment hasn't fully resolved the problem, or when retreatment isn't possible because of a post, crown, or blocked canal. At Woodlands Endodontics, apicoectomy is a routine microsurgical procedure that saves teeth other options can't reach.
During the procedure, a small opening is made in the gum near the tip of the affected root. The infected tissue is removed along with the last few millimeters of the root tip, and the end of the canal is sealed with a small biocompatible filling. Performed under the surgical operating microscope with ultrasonic instruments, modern apicoectomy is far more precise than the versions of this surgery performed decades ago, and healing outcomes have improved dramatically as a result. The procedure is done under local anesthesia and usually takes 30 to 90 minutes.
Recovery is typically easier than patients expect. Most people return to work or normal activities the next day, with some mild swelling or tenderness near the surgical site for a few days. The bone around the root tip regenerates over the following months, and we confirm complete healing with follow-up imaging. For the right cases, apicoectomy offers success rates comparable to retreatment and keeps a natural tooth that would otherwise need extraction and replacement.
Our Approach
Surgery on a tooth sounds intimidating, so we spend time making sure you understand exactly what will happen and why it is the right option for your tooth. Apicoectomy is only recommended after microscope examination and 3D imaging confirm that the problem lives at the root tip and can't be addressed less invasively. If a simpler option would serve you better, that is what we will recommend.
The procedure itself is performed with microsurgical techniques: high magnification, tiny precision instruments, and minimal incisions that heal quickly. We use profound local anesthesia and take our time. Afterward, you leave with clear written aftercare instructions, and we schedule follow-up imaging to confirm the bone is regenerating. Your referring dentist stays informed at every step.
The Process
How Treatment Works
Access
Under local anesthesia, a small opening in the gum exposes the root tip while protecting the surrounding tissue.
Remove
The infected tissue and the last few millimeters of the root tip are removed under the surgical microscope.
Seal
The root end is sealed with a biocompatible filling and the gum is closed with fine sutures for fast healing.
Common Questions
Frequently
Asked Questions
Straight answers to the questions we hear most. Don’t see yours? Give our team a call — we’re always happy to help.
01 Why do I need an apicoectomy instead of another root canal?
Retreatment through the top of the tooth is usually the first choice, but it isn't always possible or sufficient. If your tooth has a post and crown that can't be removed safely, if a canal is blocked, or if infection persists at the root tip despite good root canal treatment, an apicoectomy treats the problem directly at its source. We confirm which approach fits your tooth with microscope examination and 3D imaging first.
02 Is an apicoectomy painful?
The procedure is performed under local anesthesia and you should feel no pain while it is done. Afterward, mild swelling and tenderness near the site are normal for a few days and usually respond well to over-the-counter pain relievers and cold compresses. Most patients are surprised by how manageable recovery is.
03 How long does the procedure take?
Most apicoectomies take between 30 and 90 minutes depending on the tooth. Front teeth are usually faster; molars with multiple roots take longer. You will be comfortable the entire time, and you can drive yourself home afterward if only local anesthesia was used.
04 What is recovery like?
Plan on taking the rest of the day easy. Most patients return to work and normal routines the next day. Mild swelling peaks around the second day and fades over the week. Sutures are typically removed or dissolve within a week, and we will give you simple instructions for keeping the area clean while it heals.
05 How successful is apicoectomy?
Modern microsurgical apicoectomy has high success rates, with most studies reporting that the large majority of treated teeth heal fully and remain functional for years. Precision equipment matters here: outcomes with the operating microscope and ultrasonic instruments are significantly better than with older surgical techniques.
06 Will people be able to tell I had surgery?
The incision is small and hidden along the gum near the affected tooth, and visible swelling is usually minor and short-lived. Most patients feel comfortable in social and work settings within a day or two.
07 What happens if I choose not to treat it?
Persistent infection at a root tip does not resolve on its own. Left untreated, it can grow, damage the surrounding bone, cause painful flare-ups, and eventually cost you the tooth. Treating it while the infection is contained keeps your options open and your outcomes better.
08 Does the tooth need a new crown after an apicoectomy?
Usually not. Because the procedure reaches the root from the side rather than through the crown, your existing restoration typically stays untouched. That is one of the advantages of this approach when a good crown is already in place.
09 How do you confirm the surgery worked?
We schedule follow-up visits and imaging over the months after surgery to watch the bone regenerate around the root tip. You will typically feel fine long before then; the imaging is how we verify complete healing underneath. Your referring dentist receives those findings as well.
We Save Teeth™
Whether you’re a patient in pain or a dentist referring a case, we’re ready to help. Reach out and our team will take great care of you.
Schedule an Appointment