An Apicoectomy is a dental surgery utilized when root canal treatment fails, and there is an infection in the root of the tooth. The access for this procedure is from the root end of the tooth instead of from the crown end. While this surgery is only performed when conventional root canal retreatment is not practical, an apicoectomy can save the tooth, bone and gum tissues, returning them to health for a good many years. The only alternative and a last resort is to extract the tooth.
In order to understand this surgery, it helps to know the tooth structure. The root canal system is the natural cavity within the center of the tooth that contains the dental pulp, extending from the crown of the tooth to the end of the root. Teeth always have at least one root, and each root always has at least one root canal. The tip or end of each root is called the apex, where nerves and blood vessels enter the tooth. Sometimes there can be many tiny branches off the main canal, and that can make root canal treatment very complex. Even after root canal treatment, healing can be prevented and re-infection occur, because infected tissue can remain in these branches. Disinfecting the root canal system is the primary goal of any endodontic treatment.