Apicoectomy: Cost, Procedure, & Recovery

What is an Apicoectomy?

An apicoectomy is a minor dental surgery that removes the tip of a tooth's root, called the apex. It’s often a follow-up procedure after a failed root canal when you still have tooth pain.

Your dentist may recommend an apicoectomy if you have:¹

• Failed previous root canal
• Fracture of the tooth not disclosed in an x-ray
• Infected root or surrounding root tissue
• Hidden canals not previously root canaled
• Damaged root surface 
• Trauma to a previously root-canaled tooth

Apicoectomies are highly effective procedures, with around an 81% success rate after three years.²

Apicoectomy vs. Root Canal

A traditional root canal treats the infected tooth from the top of the tooth, whereas an apicoectomy is a small surgical procedure at the tip of the root, or apex, of the tooth.

A root canal will treat a tooth with deep tooth decay or trauma. The dentist will clean and disinfect the canals and seal the tooth from bacteria. 

An apicoectomy will remove a small piece of the root tip and clean any infected root tissue. It’s typically a follow-up procedure to a failed root canal.

Apicoectomy Procedure Steps

A typical apicoectomy procedure follows the following steps:

• Imaging — Your endodontist will take an x-ray or possibly a 3-D ConeBeam to get an accurate look at the tooth’s apex and all surrounding structures.
• Anesthetic — Your doctor will use a local anesthetic to numb the area around the tooth.
• Tissue and apex removal — A small incision will be made at the root's tip to remove any infected tissue and 3 to 4 millimeters of infected root tip structure.
• Sealing the area — The surgeon will use a small piece of biocompatible filling to seal the area and replace the few millimeters of the root tip.
• Stitching and possible bone graft — Lastly, your endodontist will suture your gums with stitches. If the infection was severe and a significant amount of bone was removed, they may use a bone graft, which can help bone regenerate.³

Typically an apicoectomy should take 30 to 90 minutes, depending on the severity of the infection and the tooth treated.

What to Expect After an Apicoectomy

It’s normal and expected to experience mild pain, swelling, bleeding, or numbness after an apicoectomy. Most people can resume regular activities the next day.

You can typically manage any pain with over-the-counter or prescription pain medication. You can also use ice packs on the surgical site for up to 12 hours to minimize swelling. Some endodontists will give an antibiotic if there was a significant infection.

You should follow your dentist’s post-surgical instructions and avoid the following to prevent infection at the surgical site:

• Smoking cigarettes or any type of nicotine products
• Brushing with pressure at the surgical site for several days 
• Vigorous rinsing, which can irritate the suture site
• Eating hard or crunchy foods until the site is healed
• Strenuous physical activity

What to Eat After an Apicoectomy

Your diet following an apicoectomy should consist of softer foods for the first few days to avoid disturbance of the surgical site.

Good food options include:

• Pasta and rice
• Yogurt
• Mashed potatoes
• Eggs
• Soft chicken or fish

Avoid eating hard or crunchy foods or drinking any hot beverage that may cause discomfort. 

How Much Does an Apicoectomy Cost?

The cost of an apicoectomy varies depending on the tooth being treated, the endodontist treating you, your location, and your dental insurance coverage.

Typically, the procedure will cost $1,000 to $,1500 without dental insurance.

An apicoectomy procedure is costly, but compared to a dental extraction and tooth replacement, it is an exceptional solution to restore your dental health. 

Summary

An apicoectomy is a minor dental surgery that removes the tip of the root, or apex, of the tooth. It’s often a follow-up procedure when a root canal fails to resolve a toothache or infection.

The cost of an apicoectomy depends on several factors but usually ranges between $1,000 and $1,500 without insurance. The procedure takes between 30 and 90 minutes and shouldn’t be more painful than a root canal.

During recovery from an apicoectomy, you should eat softer foods and avoid vigorous brushing and rinsing. You may have minor pain, swelling, or bleeding after the procedure, but most people resume full activity the following day.