What is an Apicoectomy?
Some infections refuse to give up a tooth quietly. When a root canal treated tooth continues to harbor infection at the tip of its root, an apicoectomy performed at our Manhattan office removes the disease surgically while keeping the tooth firmly in place. It is the procedure that stands between a stubborn infection and an unnecessary extraction.
The apex, the last few millimeters of a tooth root, is the most anatomically complicated part of the tooth. Canals branch, curve, and split into deltas too fine for any instrument to clean from inside. In most teeth this never causes a problem, but occasionally bacteria persist in these branches or in the bone surrounding the apex, producing chronic inflammation, a cyst, or an abscess that no amount of treatment from the crown downward can resolve.
An apicoectomy approaches the problem from the outside. Through a small opening in the gum, our endodontist removes the infected tissue and the apex itself, then seals the freshly trimmed root end with a biocompatible filling. The gum is closed with fine sutures and the surrounding bone regenerates over the following months, restoring solid, healthy support around the root.
What can you expect during an apicoectomy at our Flatiron office?
Everything about the modern procedure is built around precision. At 37 West 17th Street we perform apicoectomies under an operating microscope with ultrasonic instruments, which allows an access point measured in millimeters. Local anesthesia keeps you fully comfortable, the appointment typically runs under 90 minutes, and Manhattan patients routinely return to work the following day.
Recovery is straightforward for most people: some swelling and tenderness for a few days, managed with cold compresses and over the counter medication. We schedule a short follow up to remove sutures and then track bone healing with imaging over subsequent months. You will leave with clear aftercare instructions and a direct line to our team with any questions.
We also believe in honest case selection. If imaging shows that surgery is unlikely to succeed, we will tell you plainly and walk you through the alternatives. Recommending only the care you truly need is a founding commitment of this practice.
What are the benefits of an Apicoectomy?
For the right tooth, an apicoectomy delivers outcomes that neither retreatment nor extraction can offer.
It is the last, best defense of your natural tooth
An apicoectomy exists for exactly one purpose: keeping a functional tooth in your mouth when every nonsurgical option has been exhausted. Success means retaining your tooth, your crown, and your natural bite, and avoiding the surgical placement, expense, and healing time of an implant.
It treats what imaging can see but files cannot reach
Cysts, persistent apical infections, and sealed off canal branches live beyond the reach of conventional root canal instruments. Surgical access lets us remove the diseased tissue directly and inspect the root end under magnification, resolving problems that would otherwise smolder indefinitely.
Precision surgery means a gentle recovery
Microsurgical technique has rewritten what patients should expect from this procedure. Smaller incisions heal faster, magnification protects healthy tissue, and modern root end filling materials integrate beautifully with bone. Most patients tell us the recovery was far easier than the word surgery led them to expect.
If a root canal treated tooth will not heal, do not assume extraction is inevitable. Our Manhattan office is located at 37 West 17th Street, Suite 7W in the Flatiron District, steps from Union Square and the 14th Street subway hub. We welcome patients from Flatiron, Chelsea, Greenwich Village, Gramercy, and across Manhattan. Book your consultation online today.
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