Also called a root-end resection, an apicoectomy is the surgical removal of the root tip (called the apex) of an abscessed tooth, plus any surrounding infected tissue. The procedure is typically done after root canal treatment has failed and the tooth remains infected. An apicoectomy is often the last chance to avoid a tooth extraction.
Typical costs:
Without dental insurance, an apicoectomy typically costs $900-$1,300 or more, depending on the position and type of tooth, local rates, and the qualifications and training of the endodontist or oral surgeon performing the procedure. An endodontist is a dentist with at least two years additional training in diagnosis and root canal treatment, while an oral and maxillofacial surgeon is a dentist with an additional four to six years of surgical training. Typically a specialist with more training, expertise and status will charge more, but this varies by location and by the individual specialist.
With dental insurance coverage, the patient can expect to pay $100-$500, depending on the terms of the policy.
A general dentist with advanced training can perform an apicoectomy, but this outpatient surgery is typically performed by an endodontist or oral surgeon. The procedure includes using an operating microscope, and an apicoectomy is sometimes referred to as endodontic microsurgery. SimpleStepsDental.com by Aetna dental insurance provides an overview[1] of an apicoectomy.
Although a patient can request nitrous oxide (laughing gas) or IV sedation, an apicoectomy is typically done with a strong local anesthetic. When the area is numb, a small area of gum is cut open to reveal the underlying bone and the apex (root end) of the tooth. In some cases it may be necessary to use a drill to access the root. The infected tissue and root-end are removed, the space is cleaned and filled with appropriate material, and the gum is sealed with a few stitches. The process can take 30-90 minutes, depending on the type of tooth involved. Oral surgeons in Texas provide a video illustration of the apicoectomy procedure.
There may be some soreness, swelling and minor discomfort after the procedure; ice is often applied to the area (typically 20 minutes on, 20 minutes off) for the first 10-12 hours and patients usually take an over-the-counter anti-inflammatory like ibuprofen (Advil, Motrin and others). Hard and crunchy foods should be avoided for several days. Most patients can return to work and normal activities in a few days. Stitches are usually removed 2-7 days after the procedure or they may simply dissolve as the area heals; all soreness and swelling are typically gone within two weeks. The bone tissue around the root tip will heal in a few months. Dr. Drew G. Smith in New Hampshire explains what to do[2] after an apicoectomy.
Additional costs:
Before an apicoectomy, a dentist will typically prescribe antibiotics and take x-rays of the problem area, to help plan the procedure. There will also be a follow-up exam and x-rays to confirm that the procedure was successful. Ask if these are included in the quoted price or if they will be an additional cost. Dental x-rays can cost $10-$250; for details, see How Much Do Dental X-Rays Cost.
Discounts:
Dental college clinics often offer reduced rates for services by supervised students or faculty; some low-income patients report paying $600-$650 for an apicoectomy performed by a postgraduate student. The American Student Dental Association[3] maintains a list of dental schools.
Some dental organizations pay partial fees for low-income patients; the American Dental Association[4] lists state and local associations.
Shopping for an apicoectomy:
Search for local members of the American Association of Endodontists[5] , the American Association of Oral and Maxillofacial Surgeons[6] or the American Dental Association[7] . In selecting a specialist, ask how many apiocoectomies they have done, and how frequently.
If the patient has dental insurance, the insurance company will provide a list of approved dentists, endodontists and oral surgeons.
Material on this page is for informational purposes only and should not be construed as medical advice. Always consult your physician or pharmacist regarding medications or medical procedures.
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I got a premolar apico (#4). Work perfectly executed by a very professional surgeon in Tijuana, BC, Mexico. I saved ~$1,500 vs the same treatment in Southern California.
I needed an apicoectomy on one of my two front teeth. I went to an endodontist who quoted me $1,100 out of pocket with insurance. My dentist told me he could do the exact same procedure for $434 out of pocket with insurance. Guess which one I went with.
I was quoted $2400 for an Apicoectomy on a molar (3 roots). An apicoectomy (end root fill) on a tooth with only 1 or 2 roots would be less. The price shown is w/o insurance. If you belong to a Discount Dental plan and your endo accepts it; you can save $800.
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