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Root Canal vs. Apicoectomy

What's the difference between root canals and apicoectomies? When would we recommend each procedure? In this post, our Mississauga endodontists explain the differences between root canals versus apicoectomies, who performs them, and when each procedure may be recommended.

If your tooth has been damaged by a crack, fracture or decay, this leaves an opening for bacteria to enter the inner pulp chamber, which can lead to tooth pain. Believe it or not, one of the most common ways to save a damaged tooth from extraction is by undergoing a root canal procedure. That said, sometimes another procedure called an apicoectomy is considered as a treatment option. 

Root Canals

During a root canal procedure, the pulp that's located in the centre of the tooth is removed. This pulp is made of living tissue, blood vessels, nerves and cells, and it can become extremely painful if it's infected with bacteria. When it comes to pulp removal, there are several steps that must be taken:

  • Your endodontist drills an access hole into your tooth 
  • The infected pulp is removed with a special dental tool
  • The interior of the tooth is cleaned and disinfected. A rubber-like material called gutta percha is used to replace the pulp
  • The hole is filled, very similar to a dental filling 
  • If necessary, your dentist might place a dental crown over the tooth to straighten and protect it


An apicoectomy is a type of surgery that is performed on the root of the tooth rather than the crown of the tooth in order to cure an infection. Using the root tip, also known as the apex, it is possible to reach the infected tissue, and a filling is then used to close the root's end. Patients who are concerned about the sensitivity of their mouths or who are experiencing a variety of symptoms associated with poor oral health might benefit from this treatment.

It may be the right treatment of choice for someone:

  • who has already had a root canal procedure performed, but was unsuccessful, or if a root canal treatment, for whatever reason, is not possible
  • if the tooth in question already has a crown or is part of a bridge and where a root canal would mean cutting through the crown or bridge or both (in most circumstances, this is not a viable option)

Who performs root canals and apicoectomies?

While a dentist can perform a root canal, they will most likely refer you to an endodontist if you need an apicoectomy. If your dentist doesn't perform root canals, they may also refer you to an endodontist for that procedure too.

Endodontists are dentists who specialize in the treatment of tooth pain, disease, and infection. They have received training that enables them to identify and treat tooth pain, as well as perform root canal procedures, apicoectomies, and various other procedures, normally to help relieve mild to severe tooth pain.


In cases where a root canal is insufficient, an apicoectomy is a routine procedure that is usually recommended. Apicoectomies may also be recommended if a root canal procedure has failed and an infection has developed around the tip of the tooth's root canal system.

An infection in the area of one of your teeth has the potential to spread and cause serious oral health complications. As a result, if you suspect that something is wrong with your oral health, it is critical that you consult with your dentist as soon as possible.

Contact our Mississauga endodontists if you're still curious about root canals and apicoectomies, or if you need to schedule your bi-annual dental checkup!

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