Root canal therapy as performed by a dentist for various indications might fail because of persistent infection in the bone around the root tips. A surgical apicectomy (section or removal of the root tips) might be required in an attempt to save the tooth and relieve symptoms.
These procedures can be performed under a local anaesthetic, but more invasive procedures require a general anaesthetic. Bone grafting will be performed to fill the defect and facilitate healing. A root canal apicectomy is often not successful due to underlying undetectable fractures and the tooth might require removal after which an implant can be placed.