Apicoectomy in Palma de Mallorca
An apicoectomy is minor surgery that removes the tip of a tooth's root and the infection around it, when a root canal has not been able to cure it. Its aim is to save the tooth and avoid having to extract it.
It is done under local anaesthetic, through the gum, and usually takes 30 to 90 minutes. We carry it out at Udemax Miramar and Emardental, in Palma, and your first visit is free.
The last option before extraction
Painless during surgery
Usual length
First visit and diagnosis
Have you been told you need an apicoectomy? Book an appointment
We review the tooth and the X-rays, explain whether an apicoectomy is the best option or whether there are alternatives, and give you a detailed quote.
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What is an apicoectomy?
An apicoectomy, also known as apical surgery or apical microsurgery, treats the tip of the root, the apex, where nerves and vessels enter the tooth. Sometimes, even after a root canal, an infection remains in that area that does not heal: because of a very curved canal, a branch that cannot be cleaned, or a cyst.
In an apicoectomy the root is reached through the gum, removing a small amount of bone if needed. The last few millimetres of the tip are removed along with the infected tissue, and the end of the canal is sealed with a biocompatible material such as MTA. The bone then regenerates and the tooth is kept, together with the bone around it.
When is it recommended?
We consider an apicoectomy when:
- An infection at the tip of the root persists after a root canal.
- There is persistent pain or a fistula, a bump on the gum that discharges.
- There is a cyst or granuloma at the apex that does not heal.
- The root canal cannot be repeated, for example because of a post or crown.
- The root has a shape or curve that prevents it being cleaned from inside.
- There is a small fracture or perforation at the tip of the root.
Alternatives to an apicoectomy
Before deciding, we consider all the options:
Repeat the root canal
If the canals can be reached, re-treatment is usually the first option, without surgery.
Root canal treatmentApicoectomy
When re-treatment is not possible or has not worked, an apicoectomy treats the infection from the tip of the root and keeps the tooth.
Extraction and implant
If the tooth cannot be saved, it is extracted and replaced with an implant or bridge.
Dental implantsRisks and possible complications
Swelling
It is normal for the area to swell in the first few days. It is managed with cold and the prescribed medication.
Discomfort
Mild to moderate pain for the first two or three days, managed with painkillers.
Slight bleeding
There may be slight bleeding on the first day, which stops by biting on gauze.
Tingling
In lower teeth close to the nerve, there may be a temporary change in sensation in the lip or chin.
Maxillary sinus
In upper molars, the root may be close to the maxillary sinus. We plan with X-rays to avoid complications.
It may not work
In a proportion of cases the infection does not heal. We then consider repeating the surgery or extraction.
What does an apicoectomy involve?
Diagnosis
We examine the tooth and take X-rays to assess the type of infection, the size of the lesion, the shape of the root and how close it is to the nerve or sinus. In some cases a CT scan is needed.
Surgery
Under local anaesthetic, we open the gum, reach the tip of the root, remove the apex and the infected tissue, seal the canal with a biocompatible material and close with a few stitches. It usually takes 30 to 90 minutes.
Recovery and follow-up
We remove the stitches 7 to 15 days later. In the following months we take follow-up X-rays to check that the bone is regenerating.
Aftercare following an apicoectomy
For a good recovery:
- Apply cold to the outside of your face on and off for the first 24-48 hours.
- Take the medication we prescribe.
- Eat soft, lukewarm food and chew on the other side.
- Don't rinse hard on the first day; after that, use the prescribed mouthwash.
- Don't smoke while it heals.
- Don't pull your lip to look at the area: you could loosen the stitches.
What is the success rate of an apicoectomy?
According to studies, an apicoectomy cures the infection and saves the tooth in most cases: between 70% and 90%, depending on the technique, the tooth and the size of the lesion. Front teeth usually have a better prognosis than molars.
Before surgery we assess your specific case with X-rays and honestly explain the prognosis, so you can decide between an apicoectomy and other alternatives.
Who will treat you
Apicoectomies are carried out by our oral surgery team, with Dr Emilio Martínez-Almoyna Rifá and Dr Maria Morro.
Where we carry out apicoectomies
We carry out apicoectomies at two of our clinics in Palma: Udemax Miramar and Emardental.
Oral surgery
Udemax Miramar
Outpatient department, Hospital Juaneda Miramar
Camí de la Vileta, 30 · 07011 Palma
- Monday to Thursday
- 9:00–13:00 · 16:00–20:00
- Friday
- 9:00–20:00
By car
Paid parking at the Hospital Juaneda Miramar car park, a one-minute walk away, plus street parking. There is also free parking on Camí de la Vileta, about a 10-minute walk away.
Go to the car parkBy bus
EMT bus routes 6, 8 and 29, stopping at "Policlínica", in front of the hospital.
View bus routeBy taxi
Taxi ranks at Camí de la Vileta, 51 and Carrer de Pasqual Ribot, 1.
Oral surgery
Emardental
Carrer d’Alfons el Magnànim, 2, ground floor
Bons Aires · 07004 Palma
- Monday to Thursday
- 9:00–13:00 · 16:00–20:00
- Friday
- 9:00–13:00
By car
Street parking and the Santa Pagesa underground pay car park (Carrer d’Ausiàs March, 26), a 4-minute walk away. There is also a pay car park at s’Escorxador, about a 5-minute walk away.
Go to the car parkBy bus
EMT bus routes 12, 20, 24 and 40, stopping at "Pl. d’Abú Yahya", "Alfons el Magnànim" or "31 de desembre".
View bus routeBy taxi
Taxi rank at Plaça d’Abú Yahya, 2.
Frequently asked questions about apicoectomy
Does an apicoectomy hurt?
Not during surgery, as it is done under local anaesthetic. Afterwards there is some discomfort and swelling for two or three days, managed with painkillers.
How long is the recovery?
Most people are back to normal within a day or two. Stitches are removed 7 to 15 days later, and the bone regenerates over the following months.
What is the success rate?
Between 70% and 90% according to studies, depending on the tooth, the size of the infection and the technique. At your assessment we give you the prognosis for your case.
What are the risks?
The usual effects are swelling, discomfort and slight bleeding. Less often, a temporary change in sensation in lower teeth, or the infection not healing.
Can it be done on molars?
Yes, although it is more complex because of access and the proximity of the nerve or maxillary sinus. For molars we carefully weigh up whether an apicoectomy or an extraction is better.
What are the symptoms of a failed apicoectomy?
Pain that comes back, a bump or abscess on the gum next to the tooth, or a lesion that does not shrink on follow-up X-rays. If you notice them, call us.
Apicoectomy or extraction?
If the tooth has a good prognosis, keeping it with an apicoectomy is usually better. If the tooth is badly damaged or the prognosis is poor, extraction and an implant may be more predictable.
Is an apicoectomy covered by the Spanish public health system?
Generally, no. For adults, the public system mainly covers extractions and emergencies and does not usually include apicoectomy. We recommend checking with your health centre.
How much does an apicoectomy cost in Palma?
It depends on the tooth and its complexity. At your free first visit we give you a detailed quote, and you can finance your treatment.