An apicoectomy, or root-end resection, is the removal of the root tip and the surrounding infected tissue of an abscessed tooth when inflammation and infection persists in the area around the root tip.  It is usually done after root canal therapy or as a root canal re-treatment. It is impossible to fill all the root spaces in the canals and those spaces harbor anaerobic bacteria that can cause a dental abscess.  An apicoectomic procedure is also used to locate fractures or hidden canals that do not appear on x-rays but still manifest pain in the tooth.  Damaged root surfaces or the surrounding bone may also be treated with this procedure.  An incision is made in the gum tissue to expose the bone and surrounding inflamed tissue. The damaged tissue is removed along with the end of the root tip. A root-end filling is placed to supposedly prevent re-infection of the root and the gum is sutured.

If you are told you need an apicoectomy and do not yet have a root canal, an apicoectomy is essentially a root canal, in that, it is damaging roots and the tooth will die anyway.  It is done to get rid of some abscess at the root tips.  But, the source of that abscess will still prevail and come back later.  Then you will be told you need a root canal.  The tooth should have been extracted in the first place.  However, most apicoectomies are done after a root canal in an attempt to clean out infection in the root tips from a failed root canal.

Root canals are done on teeth where there is an abscess, or pain, or doing a filling would go too close to the pulp chamber to fill.  When a root canal is done, 1/3 of the roots are removed.  The other 2/3 reside in the Dentine, which is the part of the tooth just under the enamel.  There are over 3 miles of roots (called tubules) remaining there.  Once you remove the other 1/3 of the roots in the canals, the tooth dies.  The remaining roots decay and produce bacteria.  This anaerobic bacteria is sealed off from air and feeds off itself and slowly eats away at your jaw.  Root-canaled teeth are dead teeth and the bacteria infecting them causes gangrenous tissue and bone to develop which causes foul-smelling pus and can cause abscess, thus, leading Dentists to perform an apicoectomy.  I have been present during root canal extraction and the smell is putrid.  Many patients who chose to be awake during removal have told me how disgusting the smell was.  This bacteria cannot be totally killed off no matter what the roots are filled with, and an apicoectomy is a temporary fix that will not get at the source of infection, which is the tooth itself.  Cleaning the canals will not work, either.  My father and I both had root canals re-treated several times to no avail.  The Dentist actually put a drainage tube implanted in my dad's gum that could be accessed ever so often to drain off infection that would build up.  When my dad finally came down here to Mexico and had it pulled by a Biologic Dentist, it shot infection all over the Dentist and he had to change his uniform.  More recently, a patient came from Nebraska.  He had 10 root canals, 5 of which had been extracted by his regular Dentist.  That Dentist told him they were so badly infected that he was afraid to pull the remaining 5 and told him to go ahead and go to Mexico and have it done there.  He did.  Plus, he had the cavitations done on the previously extracted root canals.

Mainstream Dentists will go to great lengths to save a tooth.  The aim of Root Canal Therapy is to save a tooth which has become infected or dead, in an attempt to make it functional and pain free.  After scraping out the inside of the tooth the Dentist will attempt to disinfect the tooth and the canals to eliminate any source of infection.  The canal is then filled with a combination of cement and Gutta Percha in an attempt to completely occlude these canals (there are other materials available, but the end result is the same).  This is supposedly to prevent any microorganisms from entering the tooth either through the crown or the root.  If you consider pain control, mechanical function and aesthetics to be the limit of good dental treatment, then you will have "SAVED" the tooth.  If systemic effects are included in your concept of dentistry, then all that has happened, is that you have kept dead, infected tissue, buried in the bone, within a couple of inches from your brain. For some reason we are all conditioned to think that teeth are not a part of the body, but that they are inert calcified material, and that they are sort of dead anyway. Dentistry is the only one of all the medical & para-medical professions that thinks it is a good idea to keep dead, gangrenous tissue in the body.  One eminent Endodontist says:  It is wrong to speak of Root Canal Therapy as a dead tooth;  It is more correct to describe such a tooth as non-vital or, better, pulpless. Even though the central blood supply to the tooth has been lost, the tooth itself still retains its connection to the body via the periodontal membrane and the cementum.  The Oxford dictionary defines non-vital as Fatal To Life. It defines Dead as No longer Alive. It is like saying that even though the blood supply to your leg may be completely cut off, it would be wrong to suggest that the leg is dead, because it is still connected to your body by your hip joint.  http://www.bcd.com.au

Contrary to what Mainstream Dentists would have you believe, Biologic Dentists try to save teeth.  But, in doing so, they are not going to jeopardize your health.  First of all, if you were told you need a root canal, they will do an evaluation and tell you if the tooth really is in that condition to warrant their diagnosis.  Often times it is not accurate and the Biologic Dentist can do a filling or a crown and save the tooth.  If your Dentist recommends either a root canal or an apicoectomy, go to a Biologic Dentist who does not perform root canals and get an assessment.  No matter what they diagnose, in the long run, it can save time, money, trauma and your health.  If you have a root canal in your mouth, do not have it extracted by a Mainstream Dentist, as they do not know how to properly extract and clean the site.  It will feel better for a while, but the infection will return.