Surgical Precision When It Matters Most
What Is Endodontic Microsurgery?
Endodontic microsurgery, also known as an apicoectomy or root-end surgery, is a specialized procedure used to treat infection or inflammation at the tip of a tooth’s root when non-surgical root canal treatment or retreatment has not fully resolved the problem. Using a surgical microscope and microsurgical instruments, we access the root tip directly through a small incision in the gum tissue, remove the affected tissue, and seal the root end to prevent reinfection.
At Escondido Endodontics, every microsurgical procedure is performed under high-powered magnification with 3D CBCT imaging guiding the process from diagnosis through treatment planning. This level of detail allows us to address even the most complex cases with precision. Patients from Escondido, San Marcos, Vista, Poway, and throughout North County San Diego are welcome.
When Is Endodontic Microsurgery Recommended?
Microsurgery may be recommended when:
- Infection or inflammation persists at the root tip after root canal treatment or retreatment
- A post, crown, or blocked canal makes non-surgical retreatment difficult or not possible
- A fracture or hidden canal is suspected but cannot be fully evaluated without direct access
- There is a cyst or lesion near the root tip that requires removal
- Persistent symptoms exist but cannot be explained by standard imaging alone
Steps of Endodontic Microsurgery
Microsurgery or Extraction?
For many patients, endodontic microsurgery represents the last opportunity to save a natural tooth before extraction becomes necessary. Preserving the natural tooth supports long-term bone health, bite function, and the stability of surrounding teeth. Our team will discuss all available options with you so you can make an informed decision about your care.
After Endodontic Microsurgery
Most patients return to normal activities within a few days following surgery. Some swelling and mild soreness in the area is expected and can typically be managed with over-the-counter pain relief. We will provide detailed post-operative instructions and schedule a follow-up visit to monitor healing. Bone and tissue healing around the root tip continues over several months.
In most cases, the existing crown or restoration does not need to be replaced following microsurgery, since the procedure is performed through the gum tissue rather than through the top of the tooth.
Yes. An apicoectomy is the most frequently performed endodontic surgical procedure and has a well-established record in saving teeth that cannot be successfully treated through non-surgical means alone.
Most patients feel well enough to return to normal activity within two to three days. Full bone healing around the treated area takes several months, though most people experience little to no disruption to their daily routine after the first few days.
A root canal treats the inside of the tooth from the crown down through the canals. An apicoectomy approaches the root from the outside, through the gum tissue, to address infection at the root tip that cannot be reached non-surgically.
