More commonly known as Root End Surgery, Endodontic microsurgery is often done using an operating microscope. This procedure is done on the root tip or apex. It is not the same as a root resection. In a root resection, an entire root is removed, rather than just the tip. This endodontic surgical procedure is done when a root canal and re-treatment by root canal has failed or is not recommended or to repair damaged root surfaces. An apicoectomy can avoid extracting a tooth. Occasionally we may treat surrounding bone with this method as well. This procedure is started by making an incision in the gum which allows us to see the inflamed tissue. We then remove the inflamed tissue along with the last few millimeters of the root tip. Once the area is properly cleaned, we fill the gap to allow healing. If needed, we might take an X-Ray of the area before stitching the tissue back in place. The length of time of the procedure depends on the location of the tooth and the complexity of the root structure. Procedures on front teeth are generally the shortest. Those on lower molars generally take the longest. As typical with most surgical procedures, the discomfort you have while the incision heals can be treated with pain medication. Depending on the extent of the procedure we may recommend an over the counter pain remedy or give you a prescription. If the pain continues (and cannot be controlled with medications) you should advise us immediately.