Endodontic surgery, often referred to as apicectomy or apicoectomy in the US, is a procedure performed by an endodontist to treat infections or issues within the root canal system that have not responded well to non-surgical root canal treatment. It involves accessing the tip of the tooth's root (apex) to remove infected tissue and sealing off the root canal to prevent further infection.

The procedure would involve:

Assessment: Before the surgery, the dentist will typically conduct a thorough examination, which may include X-rays, to assess the extent of the problem and determine if surgery is necessary.

Anaesthesia: Local anaesthesia is administered to numb the area around the tooth to ensure the patient's comfort during the procedure.

Incision: The dentist makes a small incision in the gum tissue near the affected tooth to access the root tip.

Root Tip Removal: Using precise instruments, the dentist carefully removes the infected or damaged tissue at the tip of the tooth's root.

Sealing: Having removed the infected tissue, the dentist will seal the end of the root canal with a filling material to prevent bacteria from re-entering and causing further infection.

Sutures: The incision in the gum tissue is then closed with sutures, removed within a week. Follow-up appointments will typically be scheduled to monitor healing progress and ensure the effectiveness of the treatment.

Healing: Over the following weeks, the surrounding bone and tissues heal around the treated tooth.

The outcome of endodontic surgery can vary depending on factors such as the severity of the infection, the location of the affected tooth, and the patient's overall oral health. In many cases, the procedure is very successful in eliminating infection over 90% and preserving the tooth, avoiding the need for extraction. However, like any medical procedure, there are risks or potential complications and success cannot be guaranteed in every case.

After the surgery, patients may experience some discomfort and swelling, which can usually be managed with over-the-counter pain medications and cold compresses. It is important for patients to follow post-operative instructions provided and not to undertake strenuous exercise for 3 days to promote proper healing and minimise the risk of complications.