Most of the time, a tooth with a diseased pulp can be treated with a conventional root canal, and the surrounding tissue in the socket will subsequently heal on its own .  There are times, however, when infection or inflammation of the tissues adjacent to the root end persist or redevelop, and it may be prudent to approach this affected area surgically, through the gums and jawbone.  Once the area is surgically exposed, the doctor can curette and clean the site, remove any bad part of the root, and seal the canal system at the resected surface.  The purpose of this procedure is to help you save the natural tooth for as long as possible.

 

Reasons for endodontic surgery after a conventional root canal may include: persistent pain, continued inflammation and infection, removal of a cracked root if the rest of the tooth can be saved, or removal or repair of damaged/contaminated root surfaces.  Alternatives to endodontic surgery are typically root canal retreatment whenever possible, or finally extraction.  Your doctor will discuss your options, prognoses, and post-operative expectations with you. 

 

There are various types of endodontic surgery, such as apicoectomy (where just the root end is cut away), root amputation (where an entire root is removed, as long as the remaining roots are sound), or hemisection (where a two-rooted tooth is halved).  All can be done painlessly with the usual local anesthesia (numbing), so that you are able to drive yourself.  You may generally resume normal activities by the next day.