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This is the next line of treatment after root canal treatment has failed. This means the root canal treatment has been carried out on the tooth in the past but there is persistent infection at the base of the tooth root. The procedure involves removing the end of the root, where infection is contained. A small filling is then put in the root end of the tooth; this is called a retrograde root filling.


This procedure will be performed under local anaesthetic. Anaesthetic will be administered to the area, so this area will feel numb and swollen after the procedure. An incision (cut) will be made in the gum overlying the troublesome tooth. A small amount of bone will be removed with a drill, exposing the root tip of the tooth. The area of infection will be cleaned and the end of the root removed. A small filling is then placed in the end of the root to seal the root -filling. The gum will be repositioned over the tooth and secured with stitches.


After you operation your mouth is likely to feel sore and tender for a few days and you will be advised to take painkillers e.g. Paracetamol. The area will swell for a few days after the operation. It is important to keep cleaning your teeth as usual but obviously take care around the operation site. You will be advised to rinse your mouth with hot saltwater, 3-4 times per day. You will be given an appointment to attend the clinic 4-5 days after the procedure, to ensure that everything has healed well and to have the stitches removed.


  • Surgery can help save your tooth in a variety of situations
  • Surgery may be used in diagnosis. If you have persistent symptoms but no problems appear on your x-ray, your tooth may have a tiny fracture or canal that could not be detected during nonsurgical treatment. In such a case, surgery allows your endodontist to examine the entire root of your tooth, find the problem, and provide treatment.
  • 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 your tooth has this “calcification,” your endodontist may perform endodontic surgery to clean and seal the remainder of the canal.
  • Usually, a tooth that has undergone a root canal can last the rest of your life and never need further endodontic treatment. However, in a few cases, a tooth may not heal or become infected. A tooth may become painful or diseased months or even years after successful treatment. If this is true for you, surgery may help save your tooth.
  • Surgery may also be performed to treat damaged root surfaces or surrounding bone.

Although there are many surgical procedures that can be performed to save a tooth, the most common is called apicectomy or root-end resection. When inflammation or infection persists in the bony area around the end of your tooth after a root canal procedure, your endodontist may have to perform an apicectomy.



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