An Apicoectomy, sometimes referred to as root end surgery, is a surgical procedure whereby the tooth’s root tip is explored. The bony tissue around the root tip (periapical area) is debrided of infectious or inflammatory tissue and the root tip is removed. The root tip is sealed by one of several methods. An apicoectomy is performed when conventional endodontic treatment has failed and endodontic re-treatment was unsuccessful or not advised. After a thorough clinical and radiographic evaluation by our doctors, the tooth may not be considered a candidate for an apicoectomy but rather best treated by an extraction. Most patients choose to undergo the apicoectomy procedure with IV anesthesia.