Types of Endodontic Surgery and What to Expect

September 4, 2025

Endodontic surgery might sound overwhelming, especially if you’ve only heard of root canals. But sometimes, surgery becomes the best way to save a natural tooth. Knowing what exactly to expect can help reduce fear and make you feel more in control. In this blog, we’ll explain the most common types of endodontic surgeries and walk you through what the process really looks like—before, during, and after.

1. Apicoectomy: When Root Canal Isn’t Enough

Sometimes, even after a root canal, an infection might linger at the very tip of the tooth root. That’s where an apicoectomy steps in. Think of it as a targeted fix for a small but stubborn problem.

Here’s what happens during an apicoectomy:

The dentist makes a small incision in the gum to access the bone.
They remove any infected tissue and the very end of the root.
A tiny filling seals the tip to prevent future infection.
The gum is stitched back and allowed to heal naturally.

This is typically recommended when a root canal fails, but the tooth is still worth saving. You might need it if you’re experiencing sensitivity or swelling near a previously treated tooth.

Healing usually takes a few weeks. Most patients feel relief quickly, and the long-term outcome is often excellent. It’s a small procedure that can make a big difference in preserving your natural smile.

2. Root Resection (Hemisection) and Why It’s Used

A root resection—also called a hemisection—is a bit more involved. It’s typically done on molars, where the tooth has multiple roots. If one of those roots is badly damaged or infected but the remaining of the tooth is healthy, this surgery might be the best option.

Here’s a breakdown:

The damaged root is surgically removed along with the portion of the crown above it.
The remaining tooth structure is cleaned and restored, often with a crown.

This procedure helps you keep part of your tooth rather than pulling it entirely. It’s especially helpful when bone loss or deep decay affects just one root.

Benefits:

Preserves most of the tooth
Avoids extraction
Supports long-term chewing function

Considerations:

Best success with good oral hygiene
May need a crown afterward
Not ideal if more than one root is affected

For many patients, this offers a practical path to keeping their natural tooth instead of jumping to implants or bridges.

3. Intentional Replantation: A Last Resort Technique

This one sounds wild at first—take a tooth out and put it back in? Yes, really. Intentional replantation is used when other options just aren’t working, and it’s still possible to save the tooth.

Why would anyone do this? Sometimes, a problem can’t be treated while the tooth is in place—maybe it’s a fracture or a missed canal that wasn’t addressed in a previous procedure.

Here’s how it goes:

The dentist carefully removes the tooth.
While it’s out, they fix the issue (often removing infection or sealing a root tip).
Then, they reinsert the tooth into the socket and stabilize it.

Risks and Success Rates:

Success depends on quick handling (ideally under 15 minutes out of the mouth).
Not for teeth with short or brittle roots.
Works best with healthy gums and bones.

For certain patients, this can be a tooth-saving miracle. It’s not common, but it’s a tool endodontists keep in their back pocket.

4. Endodontic Retreatment Surgery: Correcting Past Procedures

Sometimes a root canal just doesn’t hold up. Maybe a canal was missed, a crack formed, or a new infection appeared years later. Retreatment surgery steps in when redoing a root canal through traditional means won’t cut it.

Here’s what it typically involves:

Reopening the treated area surgically
Cleaning and disinfecting the canals
Sealing any gaps or cracks
Removing infected tissue or materials that may have caused reinfection

This is different from standard retreatment, which is done through the crown. Surgery allows more access and precision, especially when the issue is hiding near the root tip.

It’s often the best option when nonsurgical methods don’t work. With modern tools and skilled care, retreatment success is much higher today than it used to be.

If you’re seeking endodontics in Redding, consult a specialist to determine whether surgical retreatment is the best step forward.

5. Pre- and Post-Surgical Expectations: What Patients Should Know

The idea of endodontic surgery can feel intimidating, but knowing what to expect makes it far less stressful. Let’s break it down:

Before Surgery:

You’ll likely undergo 3D imaging or X-rays to pinpoint the problem.
Your provider will explain sedation options and what type of surgery is recommended.
You may be advised to eat a light meal and arrange for someone to drive you home.

During the Procedure:

Local anesthesia keeps you comfortable.
The surgery typically lasts 30 to 90 minutes, depending on complexity.

After Surgery:

Mild swelling and tenderness are common for a few days.
Ice packs and over-the-counter pain relief usually do the trick.
Soft foods and rest help speed up recovery.

Follow-Up Care Tips:

Stick to soft food items for the initial 24-48 hours.
Avoid hard brushing near the surgical site.
Attend all follow-up appointments to monitor healing.

Watch out for any signs of complications like increased pain, fever, or swelling. Prompt care is key if something feels off. If you ever need emergency dental pain treatment in Redding, don’t wait—seek help right away.

Final Thoughts

Endodontic surgery may sound complex, but it’s a reliable way to save natural teeth and relieve pain. If you’re considering Endodontic Surgery in Redding, trust the experienced team at Park Marina Endodontics. With advanced techniques and personalized care, we help you understand your options and guide you through every step toward a healthier, more comfortable smile.