When conventional root canal treatment isn’t enough, apical resection offers a precise surgical solution to eliminate infection and preserve your natural tooth.
Are you experiencing persistent tooth pain or infection after a root canal, or have you been told your tooth can’t be saved? Apical resection might be your solution if you are facing:
Root canal treatment failed to resolve the infection.
Inability to access the root tip during conventional treatment.
Fractured root tip or other anatomical issues.
Ongoing discomfort despite previous dental interventions.
Apical resection, also known as apicoectomy, is a minor surgical procedure performed when an infection or inflammation persists around the tip of a tooth’s root after a root canal treatment. During the procedure, the very end of the tooth’s root is removed, along with any infected tissue. In some cases, a small filling is then placed to seal the end of the root canal, preventing further infection. This precise procedure aims to save your natural tooth, avoiding the need for extraction.
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Comprehensive examination, X-rays, and discussion to confirm the need for apical resection.
Local anesthesia is administered, a small incision is made, the root tip and infected tissue are removed, and the root end is sealed.In some cases, root canal treatment is performed simultaneously with apical resection to remove the infected tissue, devitalize the nerves, and save the tooth.
Post-operative instructions are provided, and follow-up appointments are scheduled to monitor healing.
Common Questions About Apical Resection
Apical resection is usually recommended when:
A root canal treatment has failed, and infection at the root tip persists or recurs.
There is a cyst or lesion at the root apex that cannot be resolved with root canal treatment alone.
The root canal is blocked, curved or contains a broken instrument, making conventional retreatment impossible.
There is persistent pain or swelling around a root-treated tooth despite correct endodontic therapy.
In these situations, apical surgery can often save the tooth from extraction.
apical resection (apicoectomy) typically costs around €250–€350 per tooth (approximately $300–$400), depending on the clinic’s level of experience and the complexity of the case. By comparison, similar procedures in the UK often start from around £650+ per tooth, and in the USA from approximately $600+ per tooth. For this reason, many patients find Turkey significantly more cost-effective for this type of endodontic surgery.
Because some cases may require additional procedures—such as cyst removal or bone grafting—providing a single fixed price can be misleading.
To receive a free online consultation and a personalised apicoectomy treatment plan, please contact us.
The procedure is carried out under local anaesthesia so you do not feel pain. The main steps are:
A small incision is made in the gum to expose the bone over the root tip.
A tiny window is opened in the bone, giving access to the infected area.
The infected root tip (apex) and surrounding inflamed or cystic tissue are removed.
The root end is reshaped and sealed with a root-end filling material to prevent reinfection.
The area is cleaned and the gum is sutured back into place.
The surgery typically takes about 30–60 minutes for a single tooth (sometimes up to 90 minutes in complex cases).
When indications are correct and oral hygiene is good, teeth treated with apical surgery can remain functional for many years. Reviews report endodontic surgery survival ranging from 48% to 93% over different follow-up periods, with microsurgical techniques showing the best results (up to about 94%).
Your individual prognosis depends on factors like root length, bone support, size of the lesion, and quality of the previous root canal.
Apical resection can be performed on many tooth types, including incisors, canines, premolars and selected molars, provided that the root length, bone support and anatomical structures (sinus, nerves) are suitable.
It is most commonly carried out on anterior teeth and premolars, but can also be done on posterior teeth when access to the root tip is safe and predictable.
Yes. Apical resection may not be advisable when:
The tooth has severe periodontal disease or is already very mobile.
The root is too short, so removing the apical third would leave insufficient root for long-term stability (ideally, at least two-thirds of root length should remain).
The root is too close to vital structures such as the maxillary sinus or inferior alveolar nerve, making surgery risky.
There are uncontrolled systemic conditions (e.g. certain heart problems, bleeding disorders, uncontrolled diabetes) that make elective surgery unsafe.
In these cases, extraction and replacement (e.g. with an implant or bridge) might be a better option.
Modern apical microsurgery (using magnification and microsurgical techniques) has very high reported success rates:
Expert consensus papers report success rates over 90% for apical microsurgery when proper techniques and materials are used.
Meta-analyses of root-end surgery show survival rates commonly between 80–94%, with success influenced by factors such as lesion size, periodontal status, and use of magnification.
In other words, in well-selected cases, apical resection is a predictable way to retain a root-treated tooth rather than extract it.
Soft tissues usually heal within 7–14 days, and sutures are often removed after about 1 week.
Swelling peaks in the first 48–72 hours, typically, and then subsides. Bone healing around the root tip continues for several months; radiographic signs of bone fill are usually evaluated at 6–12 month control visits.
No. Apical resection is done under local anaesthesia, so you should only feel pressure or vibration, not pain, during the procedure.
After surgery, it is normal to experience mild to moderate discomfort, swelling and occasional bruising for a few days, which can be managed with prescribed pain medication, cold packs and following the post-operative instructions.
Typical post-operative advice includes:
Use cold packs on the cheek for 10–15 minutes on / 10–15 minutes off during the first 12–24 hours to reduce swelling.
Do not rinse or spit forcefully for the first 24 hours.
From the next day, gently rinse with warm salt water or an antiseptic mouthwash as advised by your dentist.
Eat soft, lukewarm foods and avoid chewing on the operated side until discomfort subsides.
Avoid smoking and alcohol, which can slow healing.
Following instructions carefully reduces complications and speeds recovery.
If the infection persists, it can lead to further bone loss, severe pain, and eventually, the loss of the tooth.
Yes. Apical resection is often considered a tooth-saving alternative when a root-treated tooth has a persistent periapical lesion but is otherwise restorable.
If the tooth has adequate root length and bone support, preserving it with apical surgery may be less invasive and more cost-effective than extracting the tooth and replacing it with an implant, especially when the crown and surrounding structures are otherwise healthy.
Yes. For most single-tooth cases, apical resection can be completed in one short visit to Istanbul, with 1–2 clinical appointments (consultation + surgery, plus an optional follow-up before you fly home). Soft-tissue healing is well underway within a week, so many international patients stay 3–7 days for surgery and initial review, then attend longer-term follow-ups with their local dentist or return later for radiographic controls if needed.
If you have a persistent root-end infection, contact us to learn how apical resection can help preserve your natural tooth.
