Apical surgery, also known as apicoectomy or root-end surgery, is a surgical procedure performed on a tooth that has had root canal treatment but still has an infection or inflammation in the tip of the tooth root. The procedure is typically performed by an endodontist or an oral surgeon.

During apical surgery, the endodontist or oral surgeon makes a small incision in the gum tissue to access the underlying bone and the root tip of the affected tooth. The endodontist or oral surgeon then removes the infected or inflamed tissue and the tip of the root. The root is then sealed with a filling material to prevent future infection and promote healing.

Apical surgery is usually recommended when nonsurgical root canal treatment has failed to resolve the infection or inflammation. It may also be performed to treat a cracked tooth, a tooth with a blocked canal, or a tooth with a calcium deposit at the tip of the root that prevents normal healing.

After the procedure, the patient may experience some discomfort and swelling, which can usually be managed with pain medication and ice packs. The patient will need to follow specific post-operative instructions, including avoiding certain foods and beverages and practicing good oral hygiene. Follow-up appointments will be scheduled to monitor healing and ensure the success of the procedure.