When a tooth continues to cause problems after root canal treatment, losing it is not necessarily the next step. Modern endodontic microsurgery can address persistent problems at the very tip of the root while giving the natural tooth another chance to heal. In fact, a 2025 study found a pooled success rate of 89% for endodontic microsurgery.

A microscopic apicoectomy is a type of endodontic surgery that removes infected or inflamed tissue around the root tip, along with a small portion of the root itself. The end of the root canal is then prepared and sealed to help prevent bacteria from reentering the area. If you’re looking for the best microscopic apicoectomy specialist in Mountain View, understanding the process ahead of time can make treatment feel much less unfamiliar.

Keep reading to learn why a microscopic apicoectomy procedure may be recommended and what you can expect before, during, and after surgery.

Why Do I Need an Apicoectomy?

An apicoectomy is typically recommended when a tooth has already had root canal treatment, but infection or inflammation persists around the tip of the root. Rather than removing the entire tooth, an apicoectomy gives your endodontist another way to treat the problem and potentially preserve your natural tooth.

In some cases, the issue is related to the anatomy at the root tip. The source of the infection may be difficult or impossible to reach through another root canal procedure, making it necessary to approach the affected area from outside the tooth instead.

During an apicoectomy, your endodontist can access the root tip directly, remove the affected tissue and a small portion of the root, and seal the end of the canal. This addresses the problem at its source while avoiding tooth extraction when the tooth can still be saved.

What Should You Expect Before, During, and After a Microscopic Apicoectomy?

A microscopic apicoectomy is a carefully planned procedure that allows your endodontist to treat a problem at the root tip with a high level of precision. Here is what you can expect at each stage, from your initial evaluation through recovery.

What Happens Before an Apicoectomy?

Before your apicoectomy, your endodontist will examine the affected tooth and use diagnostic imaging to thoroughly evaluate the root and surrounding area. This endodontic evaluation helps pinpoint the problem and map out your treatment before the procedure begins.

As part of your apicoectomy preparation, your endodontist will review your medical history and any medications you currently take. In some cases, you may receive instructions about temporarily stopping or adjusting medications that can increase bleeding, such as aspirin, before treatment. You should only make these changes if specifically directed by your healthcare team. Your endodontist will explain any necessary precautions and make sure you know how to prepare for the day of your procedure.

What Happens During an Apicoectomy?

A microscopic apicoectomy procedure typically takes about 30 to 90 minutes, although the location of the tooth and complexity of its root structure can affect the length of treatment. Local anesthesia is used to numb the area around the affected tooth before the procedure begins.

From there, your endodontist will complete several precise steps:

  • Access the root tip: Your endodontist makes a small incision in the gum and gently moves the soft tissue aside to reach the affected root. Using an endodontic microscope for magnification and enhanced visibility, they remove a few millimeters of the root tip along with the infected or inflamed tissue surrounding it.
  • Clean and seal the root end: After removing the root tip, your endodontist cleans and prepares the end of the root canal before sealing it with a small filling. This root-end filling helps prevent bacteria from reentering the canal.
  • Close the treatment area: After the root-end surgery is complete, your endodontist repositions the gum tissue and closes the area with sutures. As you heal, new bone gradually fills in around the treated root.

Because the area is numbed with local anesthesia, you should not feel pain during the procedure, although you may notice pressure or movement while your endodontist works.

What Is Recovery Like After a Microscopic Apicoectomy?

Once the local anesthesia wears off, you may notice some discomfort and mild swelling around the surgical area. However, apicoectomy recovery is typically relatively quick. According to the American Association of Endodontists, most patients can return to their normal activities the following day.

Your endodontist will give you specific instructions for caring for the surgical site after an apicoectomy. During the first few days, you may need to:

  • Clean carefully around the sutures as directed.
  • Avoid hard or crunchy foods that could irritate the treatment area.
  • Stay away from spicy or very hot foods while the area begins to heal.
  • Use any recommended medications as directed to manage discomfort or swelling.

Depending on your individual needs, your endodontist may prescribe antibiotics to treat or reduce the risk of infection. You will typically return for a follow-up visit so your endodontist can examine the surgical site, address the sutures as needed, and make sure healing is progressing as expected.

The Microscopic Apicoectomy Process: A Snapshot

Stage What Happens Why It Matters
Evaluation Your endodontist examines the tooth and reviews diagnostic imaging Identifies the location and extent of the problem
Preparation Your medical history and medications are reviewed Identifies any precautions or instructions you may need before treatment
Microsurgery Your endodontist removes the affected tissue and root tip Removes the source of persistent infection or inflammation
Root-End Sealing Your endodontist cleans and seals the root end, then closes the gum with sutures Helps prevent bacteria from reentering the canal
Early Recovery The surgical site begins to heal Swelling and discomfort should gradually improve
Follow-Up Your endodontist checks the surgical site and addresses the sutures as needed Confirms that healing is progressing as expected

Find the Best Microscopic Apicoectomy Specialist in Mountain View

When a problem persists at the root tip after a root canal, the right treatment may give you another opportunity to preserve your natural tooth.

The team at The Modern Endodontist provides specialized endodontic and microsurgical care in Mountain View. Dr. Yarah Beddawi has practiced dentistry since 2005 and completed specialty training in endodontics and microsurgery at Boston University after earning her dental degree from UCSF. Dr. Dominic Do completed advanced graduate training in endodontics at Boston University and specializes in root canal treatment, retreatment, and apicoectomies.

The practice also operates as a carbon-neutral dental office to reduce the environmental impact of the dental care it provides.

Searching for the best endodontist in Mountain View for your needs? Schedule a consultation with The Modern Endodontist to find out whether a microscopic apicoectomy can help preserve your tooth.