When infection persists at the tip of a tooth’s root despite quality root canal treatment — or when retreatment through the crown isn’t feasible — apical microsurgery can save the tooth. Also called an apicoectomy, this microsurgical procedure treats the problem exactly where it lives: at the root end. It is the definitive tooth-saving procedure of the specialty, and Dr. Roque performs it with the surgical operating microscope, ultrasonic instrumentation, and biocompatible materials that define the modern microsurgical standard.

After complete local anesthesia, Dr. Roque gently accesses the root tip through the gum, removes the infected tissue and the last few millimeters of the root, and seals the root end with a bioceramic filling. The microscope makes the difference: modern microsurgery uses smaller access, greater precision, and finer suturing than the apicoectomies of a generation ago — which translates to faster, more comfortable healing and markedly better outcomes. The procedure typically takes 60–90 minutes.

Most patients return to normal activity the next day. Mild swelling or tenderness near the site is common for a few days and manages well with cold compresses and over-the-counter medication. Sutures are typically removed or dissolve within a week, and the bone around the root end regenerates over the following months — something we confirm with follow-up imaging.

Your dentist or Dr. Roque may recommend an apicoectomy when a lesion persists after root canal treatment or retreatment, when the canal is blocked by a post or restoration that shouldn’t be disturbed, when a root fracture or hidden anatomy is suspected and needs direct visual inspection, or when a crown you’ve invested in should stay untouched. Every recommendation at Centre Endodontics follows a diagnostic workup with CBCT 3D imaging, so surgery is chosen because it’s the best option — never the default.

Many of our retreatment patients arrive by referral after their general dentist spots a problem on routine imaging. We work in close partnership with referring dentists across Wellesley, Newton, Needham, Natick, and Greater Boston — same-day reports, shared imaging, and coordinated restorative planning are standard at Centre Endodontics.

Microsurgery rewards specialist training more than almost any procedure in dentistry. Dr. Roque is a Board Certified Endodontist and Diplomate of the American Board of Endodontics, trained at the Harvard School of Dental Medicine, serving patients from Needham, Natick, Wellesley, and throughout the western suburbs of Boston.

Centre Endodontics is located at 486 Washington Street in the heart of Wellesley, minutes from Wellesley Square. Patients visit us from Wellesley, Newton, Needham, Natick, Weston, Dover, and across Greater Boston, both by referral from their general dentist and directly.

Facing a stubborn infection or been told your tooth can’t be saved? Get a specialist’s opinion first. Call (617) 410-8595.