What is an apicoectomy?

Sometimes, a conventional root canal treatment is not enough to eliminate a dental infection. In these cases, an apicoectomy may be required — a precise surgical procedure focused on removing the tip of the tooth’s root to preserve the natural tooth.

This type of intervention brings together advanced knowledge of oral surgery, radiology and prosthetics, all of which are developed in programmes such as the degree in Dentistry in Madrid of the degree in Dentistry in Malaga. If you are considering a future in advanced dentistry and want to master complex surgical techniques, this procedure is a clear example of the skills demanded in high-level postgraduate training.

In this post, we explain what a dental apicoectomy is, when it should be performed, and the main stages of the procedure, from a clinical and educational perspective.

Definition of a dental apicoectomy

A dental apicoectomy is a surgical procedure that involves removing the apex (tip) of a tooth’s root, along with the surrounding infected tissue. Its main objective is to eliminate a persistent infection that has not responded to conventional endodontic treatment, such as a root canal.

Unlike non-surgical treatments, an apicoectomy allows direct access to the affected area through the gum and bone. Although it is considered a minor surgical intervention, it requires a high level of technical precision, detailed anatomical knowledge, and strict sterilisation protocols.

For this reason, apicoectomies are usually performed by specialists in endodontics, one of the specialities of dentistry, or oral surgery with advanced clinical training — a competence typically developed during specialised postgraduate studies in dentistry.

Step-by-step procedure of a dental apicoectomy

While it is a routine intervention for trained specialists, an apicoectomy is one of the most technically demanding procedures in conservative dentistry, as it combines surgical, diagnostic and restorative expertise.

The procedure usually lasts between 30 and 90 minutes and follows these main stages:

1. Diagnosis and planning: The process begins with detailed imaging, such as periapical X-rays or a dental CT scan. These tools allow the dentist to locate the lesion precisely, assess nearby anatomical structures, and plan the surgical approach safely.
2. Local anaesthesia: Local anaesthesia is applied to the affected area. The patient remains awake but experiences no pain during the procedure.
3. Incision and access to the root apex: A small incision is made in the gum tissue, and the underlying bone is gently accessed to expose the tip of the tooth’s root.
4. Removal of infected tissue: The infected root tip is carefully removed, along with any inflamed or cystic tissue. The area is thoroughly cleaned to prevent reinfection.
5. Sealing and suturing: Finally, the root canal is sealed with a biocompatible material, and the gum tissue is sutured to promote proper healing.

Postoperative care and recovery after an apicoectomy

Recovery after an apicoectomy is usually straightforward and well tolerated by patients. Most discomfort is mild and temporary, especially when postoperative instructions are followed correctly.

Common recommendations include:

• Applying cold packs during the first few hours to reduce swelling
• Avoiding chewing on the treated side for several days
• Maintaining good oral hygiene while avoiding direct brushing over the surgical site
• Taking prescribed pain relief or antibiotics if indicated
• Attending a follow-up appointment after 7–10 days to remove stitches

Thanks to local anaesthesia and minimally invasive techniques, most patients can return to their normal routine the next day.

Risks and possible complications of a dental apicoectomy

Although apicoectomies have a high success rate, they are still surgical procedures and therefore carry some risks. These may include:

• Temporary swelling or bruising
• Mild to moderate postoperative pain
• Infection or delayed healing
• Accidental damage to nearby roots or nerves (rare)

Proper case selection, accurate radiographic planning and surgical precision are essential to minimise complications — key competencies emphasised in advanced dental training programmes.

When should an apicoectomy be performed?

An apicoectomy is not a first-line treatment. It is typically recommended when other options have failed or are not feasible. Common indications include:

• Persistent infection after root canal treatment
• Obstructed, curved or fractured root canals that cannot be re-treated
• Cystic lesions or granulomas at the root apex
• Extruded filling material beyond the root tip
• Teeth with crowns or posts that prevent conventional access

In these situations, an apicoectomy allows dentists to preserve the natural tooth and avoid extraction, aligning with modern dentistry’s conservative approach.

Conclusion: why apicoectomy matters in modern dentistry

Apicoectomy is a clear example of how advanced surgical techniques contribute to tooth preservation and patient wellbeing. It reflects the growing importance of specialised training in oral surgery and implantology by completing programmes such as the degree in Dentistry in Valencia or the degree in Dentistry in Alicante.

Key takeaways:

• An apicoectomy is used when root canal treatment is not sufficient
• It removes the root tip and infected tissue to save the natural tooth
• The procedure requires advanced surgical and diagnostic skills
• Recovery is usually quick with minimal discomfort

For those interested in specialising in this area, programmes within the portfolio of degrees in biomedicine and health at Universidad Europea provide the clinical, theoretical and practical foundation needed to perform complex procedures safely and effectively. Exploring postgraduate education in dentistry is a crucial step towards a career at the forefront of modern oral healthcare.