Occasionally, a nonsurgical root canal procedure by itself can’t save your tooth and you will need surgery. The procedure known as an apicoectomy.

During an apicoectomy, the endodontist opens the gum tissue near the tooth to expose the underlying bone and to remove any inflamed or infected tissue. The very end of the root is also removed. A small filling may be placed in the root to seal the end of the root canal, and a few stitches or sutures are placed in the gingiva to help the tissue heal properly.

Over a period of months, the bone heals around the end of the root.