Apicoectomy and Retrofilling
An apicoectomy is a microsurgical procedure that removes the infected tip of a tooth root (apex) when root canal treatment alone has not resolved the infection. Retrofilling is the critical final step where a biocompatible material seals the root canal from the bottom, preventing bacteria from re-entering. Together, these procedures save teeth with persistent infections while preserving your natural tooth structure.
At BK Dental, we perform expert apicoectomy and retrofilling procedures using microsurgical techniques and advanced materials like MTA (mineral trioxide aggregate). When standard root canal treatment cannot fully resolve infection due to complex anatomy, calcified canals, or persistent disease at the root tip, this surgical approach provides a second chance to save your natural tooth. Our experienced team has performed hundreds of successful endodontic surgeries at our Scarborough and Richmond Hill clinics.
Book a ConsultationUnderstanding Apicoectomy and Retrofilling
Apicoectomy, also known as root-end surgery, apical surgery, or periradicular surgery, is an endodontic microsurgical procedure designed to eliminate infection that persists at the tip of a tooth root despite previous root canal treatment. During the procedure, the dentist makes a small incision in the gum tissue to directly access the root tip, removes approximately 3 millimeters of the infected root apex along with any surrounding diseased tissue, and then prepares the remaining root end with precision ultrasonic instruments. The retrofilling phase completes the treatment by placing a biocompatible sealing material—typically MTA (mineral trioxide aggregate)—into the prepared root end, creating an impenetrable barrier that prevents bacteria from the canal system from reaching the surrounding bone and tissue. This dual approach addresses infection from the surgical end when conventional treatment through the crown of the tooth has been unsuccessful, offering success rates of 85-95% with modern techniques.
Key Benefits
- Saves natural teeth that would otherwise require extraction
- Eliminates infection that root canal alone could not resolve
- 85-95% success rate with modern microsurgical techniques
- Preserves your natural tooth, root, and surrounding bone
- Often more cost-effective than extraction plus dental implant
- Minimally invasive with small surgical incision
- Quick recovery—most return to normal activities within days
- MTA retrofilling promotes bone healing and provides excellent seal
- Prevents need for tooth replacement with implant or bridge
- Maintains natural chewing function and appearance
How Apicoectomy and Retrofilling Is Performed
Comprehensive Imaging & Surgical Planning
Detailed 3D CBCT scan or digital X-rays precisely locate the infection, map root anatomy, and identify proximity to nerves and sinuses. This imaging guides surgical approach and identifies any anatomical challenges.
Local Anesthesia & Surgical Access
The surgical area is thoroughly numbed with local anesthesia for a comfortable, pain-free procedure. A small incision is made in the gum tissue to create a flap, exposing the root tip and surrounding infected area.
Root-End Resection & Tissue Removal
Using microsurgical instruments and magnification, approximately 3mm of the infected root tip is carefully removed. All surrounding granulation tissue, cysts, or infected material is thoroughly cleaned from the surgical site.
Retrofilling Preparation & Placement
Ultrasonic instruments create a precise preparation in the remaining root end. MTA (mineral trioxide aggregate) or similar biocompatible material is placed to seal the root canal from the bottom, creating a permanent barrier against bacteria.
Site Closure & Healing
The gum tissue is repositioned and secured with sutures. Post-operative instructions are provided. Healing begins immediately as the biocompatible retrofilling material promotes bone regeneration around the surgical site.
Recovery Timeline and Aftercare
Recovery from apicoectomy is typically straightforward with proper care. Swelling and mild discomfort are normal during the first 2-3 days, peaking around 48 hours before gradually subsiding. Ice packs applied during the first 24 hours significantly reduce swelling. Prescribed pain medication and sometimes antibiotics manage symptoms effectively. Most patients describe discomfort as less than expected. Sutures are removed at your follow-up appointment, typically 7-10 days after surgery. Most patients can return to desk work the next day, though physical labor should be avoided for several days. Complete bone healing around the surgical site occurs over 3-6 months, monitored with follow-up X-rays.
Aftercare Tips
- Apply ice packs to the cheek for 20 minutes on, 20 minutes off during the first 24-48 hours
- Take prescribed pain medication before anesthesia wears off for optimal comfort
- Complete the full course of antibiotics if prescribed
- Sleep with head elevated on extra pillows for the first few nights
- Eat soft foods and avoid chewing on the surgical side for one week
- Do not brush or floss directly on the surgical site until cleared by your dentist
- Avoid smoking, alcohol, and straws for at least 72 hours (suction can dislodge the clot)
- Avoid strenuous exercise and heavy lifting for 3-5 days
- Attend your follow-up appointment for suture removal and healing assessment
- Contact us immediately if you experience severe pain, excessive bleeding, or fever
Cost of Apicoectomy and Retrofilling in Toronto
The cost of apicoectomy with retrofilling varies based on several factors including tooth location, complexity of the root anatomy, and extent of infection. Front teeth with single roots are generally less complex than molars with multiple roots. While apicoectomy is a specialized surgical procedure, it is often significantly more cost-effective than the alternative of extraction followed by dental implant placement. Most dental insurance plans provide partial coverage for endodontic surgery. Our team provides detailed treatment estimates and works directly with insurance providers to maximize your benefits. We also offer flexible payment options to make this tooth-saving procedure accessible.
Why Choose BK Dental for Apicoectomy and Retrofilling?
Apicoectomy and Retrofilling in Scarborough & Richmond Hill
BK Dental provides expert apicoectomy and retrofilling services at both our Scarborough (416-490-1264) and Richmond Hill (905-889-4567) clinics. If you have been told your root canal treated tooth still has infection, or you are experiencing persistent pain or swelling around a previously treated tooth, we can evaluate whether apicoectomy is the right option to save your natural tooth. Our team will thoroughly assess your case with advanced imaging, explain all treatment options, and develop a personalized surgical plan. We welcome referrals from other dental offices for complex endodontic surgery cases.
Frequently Asked Questions About Apicoectomy and Retrofilling
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