in London

Apicectomy is a way of saving unhealthy teeth in cases where root canal re-treatment is unsuccessful.

What is an apicectomy?

If you have undergone root canal, and potentially additional root canal re-treatment and yet inflammation has returned to the affected tooth you may be concerned about what happens next. Rest assured that our experienced dental professionals here at Wimpole Street Dental Clinic have a clear and confident clinical dental care resolution to safeguard your smile if this issue arises for you.

On these occasions, an apicectomy (a minor dental surgery) can be performed if deemed the next necessary step in your optimum dental care and treatment.

The medical definition of an apicectomy (sometimes called ‘root end surgery’) is the surgical removal of an anatomical apex (the end of the root of the tooth). An apicectomy usually involves minor surgery if cysts or infection continue to cause problems after root canal treatment or re-treatment and if our dentists are not able to disinfect and to apply a root canal filling to seal the root tip.

A flap of gum is lifted to expose the tip of the root whilst under local anaesthetic. The infected area (including bone and tissue) is then carefully removed, cleaned and the tip of the root is reduced in size. If possible, our dentist/endodontist may be able to apply a filling with a biological cement to seal the end of the tip of the root.

Once the surgery is complete the gum is stitched back to seal it completely using dissolvable stitches.

Who is suitable for an apicectomy?

After your initial consultation, our experienced dental team will be in the best position to determine whether you present as a suitable case for an apicectomy procedure as we seek to provide the highest quality care to look after your long term oral health and teeth.

Apicectomy is usually considered the next necessary step if both the original root canal treatment and root canal re-treatment have not been fully successful. Patients who have had a root canal treatment and re-treatment fail, usually have an apicectomy recommended to them in order to try reduce pain from root inflammation and to avoid an extraction. This continuation of discomfort and infection at the root can sometimes be caused not just by treatment failure but by other factors such as new tooth decay or damage/trauma to the canal area. However, the most common cause for a residual infection is the failure the clean and to disinfect the tip of the root.

It is important to rectify the root canal treatment and continuous infection as to avoid the infection from spreading further from the root to other areas of the mouth or the body and cause further complication.

If you’re still feeling pain and have an obvious inflammation or infection surrounding the root canal, our endodontist will examine the area and assess whether you’re suitable for an apicectomy as supposed to an extraction.

Root canal treatment fees

Front tooth

from £600
Premolarfrom £900
Molarfrom £1,200
Emergency root canal treatment£250
Front tooth retreatmentfrom £800
Premolar retreatmentfrom £1,100
Molar retreatmentfrom £1,400
Review X-ray£120
Medication change£100

Are you ready to restore your smile?

The full amount you pay for your root canal treatment varies depending on your personal needs.

However, the following amounts should give you a sense of what to expect for the cost of a root canal at Wimpole Street Dental Clinic in London:

What happens during an apicectomy?

First of all, to alleviate any concerns you may have regarding potential pain or discomfort, know that you would receive a local anaesthesia to numb the entire root canal area. One of our dentists, using a microscope or high magnifying glasses, will begin the dental procedure by making a tiny incision into the gum (or cyst if one is present) so that the inflammation can be removed in addition to the last three millimetres of the root.

The tip of the infected root is then sealed using biological cement (MTA) and in some cases larger cavities are refilled with artificial bone or filling. The entrance of the root canal area is then sealed with a membrane or gum transplant to avoid unwanted bacterium from getting into the area and festering into a potential abscess or infection. 

Rest assured that each case as presented is different and so in micro-surgical apicectomies we remove no more than the tip of the root through a tiny passage and bone augmentation and sealing are not required. After most endodontic surgery, our dental patients will not be significantly affected in their daily routine though they may feel a little discomfort or swelling in the hours after surgery.

Our endodontics team will recommend aftercare guidance for you to follow regarding chewing, brushing your teeth and pain relief. It might be necessary for you to be prescribed antibiotics following the treatment. We advise all our patients that they complete the full course and following the instructions carefully to guarantee the very best chance of recovery. Patients who smoke will be stronger advised not to in order to avoid slowing down the recovery period and to allow the gum tissue to properly heal.

Your dentist may advise that you avoid certain activities due to receiving intravenous sedation such as driving or operating machinery, undertaking exercise, competing in contact sports (as to avoid direct contact, damage or trauma to your teeth), smoking, taking sleeping tablets and/or drinking alcohol in excess.

Why is Wimpole Street Dental Clinic best for an apicectomy in London?

Whenever you need to take care of your smile – in an emergency, during routine care or when booking cosmetic dentistry – you naturally seek a qualified, skilled and experienced dental professional whom you can trust to deliver the premium dental treatment you expect at every appointment.

We would like you to consider placing your trust in Wimpole Street Dental Clinic because:

  • We are internationally renowned within the dental profession.
  • We have extensive experience in endodontics (assessing dental pain and specialising in root canal treatment) and apical surgery with an in-house endodontist and oral surgeons available to consult.
  • If we have undertaken your initial root canal treatment or root canal re-treatment, we will already have extensive knowledge of your oral health, the original treatment plan and be best placed to perform your root treatment.
  • We have undertaken hundreds of apicectomy and surgical endodontic procedures with great success.
  • We pride ourselves on offering evidence-based dentistry with a person-centred approach.
  • We offer a new standard in modern dentistry in our clinical methodology  – leveraging the optimal combination of the finest handcraft, magnifying technology and the newest machinery to deliver excellence in both patient care and dental treatment success.

Specifically, for an apicectomy, rest assured that we prioritise saving teeth as our optimum clinical outcome for our dental patients. We have a clear and confident step by step dental care resolution in place for this kind of treatment plan as it is required on a case-by-case basis as presented to us.


The staging of the treatment is as follows: If you have pain and the tooth has not been root canal treated the first option is a regular root canal treatment. The pain of a tooth with a dying nerve is always sharp and irradiating to the back of the head. During a first root canal it is important that the pulp and the nerve canals are mechanically and chemically cleaned properly.

Sometimes even after years of a successful root canal treatment a root can become infected again. Very often these teeth don’t cause any pain at all. The removal of the reinfection is very important as the infection increases the risk for heart attacks, unmanageable diabetes, kidney failure and many more. If you have pain it presents itself as a dull ache and hurts when you press the area in your mouth where the tip of the root is located. The first option for this problem is always a root canal re-treatment.

If the re-treatment is not successful either an apicectomy has to be weighed against an extraction. An extraction can be the wiser choice, if the tooth is heavily decayed or vertically cracked. If the tooth is carrying a restoration and is in a good condition otherwise a removal of the tip of the root might be an option.

The dental literature places success rates of dental root apicectomies between 25% and 85%. It is common to suggest a success rate of around 50%. After evaluating our data at Wimpole Street Dental Clinic we can provide a success rate of so far around 70%. Front teeth have a better chance of a successful endodontic surgery than molars. It is vital that the infected tip of the canal is additionally filled during surgery.

If you have developed an abscess or if the surgery failed to remove the inflammation you might need an extraction and a tooth replacement. Implants are a fantastic option to replace failing teeth without damaging the neighbouring teeth for a dental bridge. Contrary to common understanding an extraction and the implant placement can be performed in the same session as inflammations do not play a role.

Tooth preservation, rather than tooth removal, is always our top clinical priority at Wimpole Street Dental Clinic. Should you require an extraction for the affected tooth or a different tooth, after initial consultation, your experienced dental professional will be in the best position to determine if it is the next necessary step for your optimum dental care.

The NHS defines dry socket as occurring where a blood clot fails to develop in the tooth socket, or if the blood clot becomes dislodged. This is a common complication arising after wisdom teeth removal. An apicectomy does not generally involve tooth removal as it is primarily concerned with removing inflammation and/or dental cyst, refilling and sealing of the affected area. The most important part of an apicectomy is to clean the infection thoroughly and to prevent bacteria from re-entering.

If you have any concerns which arise post-treatment regarding the healing process, please contact us for further guidance. In some circumstances we may ask you to revisit our London clinic so we can re-examine the affected area and ensure that the infection hasn’t spread further.

Be sure to follow the detailed advice you will receive from your experienced dental professional for your aftercare plan following treatment, so you are confident about what to expect as you recover. You are likely to feel some discomfort around the treated root canal area as well as some swelling. You should also be careful to not accidentally bite a numb area of your mouth.

Your dentist will be able to recommend pain relief options as well as advice on what to do regarding daily activities like eating, chewing, drinking and brushing your teeth following the endodontic microsurgery.

After most surgeries and endodontic treatments, our dental patients will not be significantly affected in their daily routine. An apicectomy is usually performed at our Wimpole Street Dental Clinic under the expert care of a root canal specialist or endodontist, so an overnight stay in hospital is not required.

We will always make sure that every patient receives suitable aftercare guidance and advice to help give them the very best chance for a full recovery.

After your initial consultation with us, your experienced dental professional will be in the best position to inform and advise on how long your individual apicectomy procedure is likely to take.

The duration of the procedure depends on the severity of the infection in the root canal and the patient’s own oral health and teeth. Your dentist will be able to make an estimate following the initial consultation.

After treatment, your experienced dental professional will provide you with an aftercare plan detailing all the information and advice you will need to guide you through your recovery. Ensuring that you follow this guidance thoroughly will likely help speed up your recovery process. Your dentist may advise against activities that prolong or hamper recovery such as smoking or chewing sticky or hard foods.

You may be prescribed a course of antibiotic medication to help address the infection if required. You should complete the full course of antibiotics as recommended in the instructions.

Your dentist will be able to monitor the success of the apicectomy providing your continue to attend regular dental check-ups.

Apicectomy patients receive local anaesthetic to numb the entire area before the procedure begins at our central London dental clinic. This sedation means that during the surgery you will feel no pain, though in the hours afterwards you may start to feel some discomfort as the local anaesthesia starts to wear off. You may experience some mild bruising on the inside and outside of your mouth following the endodontic microsurgery, though this should usually disappear after the first three days.

If you have undergone root canal treatment, required root canal re-treatment and yet inflammation has returned to the affected tooth or root canal area you may need an apicectomy to remove the infected area and root tip.

Our dental team may recommend an apicectomy if we feel that this is the best option to remove the infection and preserve the tooth (without requiring an extraction of the entire root or tooth).

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