
Endodontics involve the inside of the tooth, typically treating the tooth pulp and the roots, which can easily become infected due to trauma and/or decay. A root canal is typically the first step in treating damage to the tooth pulp and the canals, but sometimes, certain types of damage cannot be fixed with a simple root canal. In these cases, endodontic surgery might be an alternative to extraction, allowing an endodontic specialist to save the tooth. If our doctors feel that you need endodontic surgery, we will help you find a Miami Endodontist to go over your options.
What is Endodontic Surgery?
Endodontic treatment (root canal) involves going in through the tooth itself, drilling a small opening in the tooth and removing the infected and damaged tooth pulp. Endodontic surgery takes a different approach to address hard-to-reach places within the tooth, often involving small incisions in the gum to access the bottom of the tooth root from below.
The most typical type of endodontic surgery is done to access the root of the tooth when the surrounding bone has been affected, or if there are calcium deposits in the canals. Surgery may also be able to find small fractures or canal abnormalities that could be causing the problem. A variety of advanced tools are used to complete these surgeries and make them minimally traumatic and successful. While endodontic surgery is more complex and invasive than a simple root canal, patients are relieved to find that the process is not as arduous as expected.
Signs of Needing Endodontic Surgery
Many people who need endodontic surgery first notice the same types of symptoms that present when there is a need for a root canal. Pain is often the first sign of trouble, as the infection can cause severe pain or sensitivity to hot and cold in the tooth. In some cases, an external abscess will emerge, a further sign the infection is advanced. Sometimes, however, there are no symptoms, which is why it is so important to continue receiving routine dental checkups.
Patients may need endodontic surgery initially, or it may be recommended for patients who have had a previous root canal that did not heal properly (which can happen for a number of reasons, and may not occur until years later). Endodontic surgery is intended to save the natural tooth, and it is sometimes the next step for patients who sustain further damage to the tooth, whether from an overlooked canal in the roots, a persistent infection, new trauma, or other complication.
Finally, endodontic surgery can be used in certain circumstances as a diagnostic tool. Visual analysis and x-rays don’t always explain the symptoms patients experience, so in rare cases, exploratory surgery may be recommended.
Endodontic surgery will only be recommended by a dentist or endodontist if the goals of the procedure cannot be met with a standard root canal. It is important to discuss your options with our Miami dental specialists and decide what option is best for you.
The Endodontic Surgery Procedure
While there are many different types of endodontic surgery, the most common procedure is an apicoectomy. An apioectomy addresses the bone at the end of the root and the end of the root itself.

The procedure can typically be done under local anesthetic, with just a small incision made in the gum to access the root. Once the incision is made and the infection in the bone is located, our Miami endodontists can remove the infected tissue, and a small portion of the tip of the root. Once this is complete, a small filling will be placed to seal the root, and sutures are used to close the gum. This procedure may be performed on its own or alongside a standard root canal procedure. In the months following the procedure, the bone will gradually heal itself and return to normal, saving the tooth and surrounding tissues.
The other types of endodontic surgeries are more individualized, and the procedure itself will vary based on the needs of the patient. Some types of surgery may include exploratory surgery to find a fracture or other issue, repairing or removing a damaged tooth root, or even extracting the tooth, working on it outside of the mouth, and replacing it. Endodontic technology is highly advanced, and even teeth that might have been lost a few years ago can now be saved in many cases.
Post-Procedure Care
Because typically a local anesthetic is used during endodontic surgery, most patients can return home and to normal activities very shortly after the procedure, usually within a day or two. Patients can often drive themselves home from the office following the procedure, as long as the doctors feel it is safe. Your endodontist will give out detailed information on recovery, but most patients should not need more than over-the-counter pain medication to control the swelling and discomfort from the incision in the gum while it heals.
How Much Will the Procedure Cost?
Endodontic surgery is more expensive than a normal root canal, but until you are assessed by a doctor, it is impossible to estimate the cost of your individual surgery. Some insurance plans do cover dental surgery, but it’s important to know what’s covered and what isn’t so you can look into financing options if necessary. Our staff will walk you through the process and help you understand how you can manage the cost of this vital procedure.
Alternatives to Endodontic Surgery

In many cases, endodontic surgery is the only option for saving a natural tooth and restoring normal function. While many people find the prospect of surgery very scary, the Miami endodontists we will refer to you will only offer you the procedures that will be most beneficial to you. If you are having trouble with the inside of a tooth, the only other alternative to endodontic treatment and/or surgery is extraction, which should always be a last resort. Extracted teeth need to be replaced with implants, bridges, or partial dentures, all of which involve much more cost and inconvenience than endodontic surgery.