An apicoectomy is a surgical procedure that attempts to remove infection, usually the result of failed root canal therapy, from the tip of the tooth root (apex). During root canal treatment, the canals inside the tooth are cleaned and infected nerve tissue is removed. Root canal systems are very complicated with many small off-shooting branches. Sometimes, even after root canal treatment, infected debris can remain in these branches and possibly prevent healing or cause reinfection later.

The resulting infection of a failed root canal may be present in the absence of pain and x-ray evidence is usually required to diagnose the problem. Sometimes a fistula, or pimple, might be present in the gum.

In an apicoectomy, the root tip or apex is removed along with the infected tissue. A filling is then placed to seal the end of the root. The procedure is very safe. However, if the surgery may does not work then the tooth may need to be extracted.