Generally, root canal treatment is all that is needed to repair your injured tooth.  Occasionally, the root canal procedure will not be sufficient to completely eliminate the problem.  If the tooth is not healing, we may suggest a surgical treatment.  Endodontic surgery can be used to remove persistent infections, locate fractures or treat hidden canals that do not appear on x-rays but cause pain in the tooth.  Damaged root surfaces or the surrounding bone may also be treated with this procedure.  The most common surgery used to save damaged teeth is an apicoectomy or root-end resection.

Endodontic surgery, known as Apicoectomy, starts with an incision in the gum tissue to expose the damaged tooth and/or bone.  The damaged portion of bone or root is removed and the surrounding areas are cleaned.  Sometimes a root-end filling is placed at the end of the root to prevent re-infection.  The gum is sutured back in place.  The bone will heal naturally over the next few months.  We will closely monitor you and your tooth during this time.

Following this procedure, you may expect some discomfort, swelling and possibly bruising of the surrounding area.  This is normal after any surgical treatment.  We will guide you through the postoperative healing with specific instructions and medications as needed.  We are only a phone-call away if you have any questions after your surgery.


Yes, you will be awake.  For the procedure, you will be given local anesthetic, similar to what you would experience with any other type of dental procedure, such as a crown or filling.  If oral sedation is requested, please feel free to let us know when you make your appointment.

Endodontic surgery may not always be the best option in your situation.  We will not hesitate to recommend other treatment options when they are more appropriate.  Dr. Reff's priority is helping you understand all of your options to reach the best possible long-term oral health.  At your consultation, we will discuss all options including endodontic surgery, removal of the tooth and dental implants.