Retreatment or Apicoectomy? Your Options in Finchley Central

Choosing between these procedures depends on why the first root canal failed. Retreatment is non surgical and is often the first option. It suits cases where the infection was not fully cleared, new decay has appeared, or the canals can be accessed again. With success rates around 75 to 90 percent, it is a strong way to save the tooth without surgery. An apicoectomy becomes the better option in specific cases. If the tooth has a large crown and post that would be risky to remove, surgery lets us treat the infection directly at the root tip while preserving the existing restoration. It also helps with complex root shapes or blockages that stop instruments from reaching the infection from inside the tooth.

A patient from Finchley Central came to us with lingering pain in a molar treated years ago. A 3D scan showed a missed canal harbouring bacteria. Since the crown could be accessed without damage, retreatment was recommended. The process involved removing the old filling material, locating and cleaning the missed canal, and resealing the entire system. The tooth is now pain-free and fully functional.

Another patient had persistent infection around a front tooth with a sturdy crown and a metal post inside the root. Removing the post for retreatment would have created a high risk of fracturing the tooth. An apicoectomy was the ideal solution. We surgically accessed the root tip through the gum, removed the infected tissue, and sealed the end of the root. This resolved the infection while leaving the crown and post intact.

First, local anaesthetic is given so you are numb. The treatment, which typically lasts 90 to 120 minutes, begins by opening through the tooth’s crown to access the old root filling. Using a dental operating microscope for high magnification, the old material is removed, the canals are cleaned and reshaped, and they are disinfected. Finally, the canals are refilled and sealed with a compatible material. Afterward, you are referred back to your general dentist for a permanent crown or filling.

An apicoectomy is also performed under local anaesthetic and usually takes 60 to 90 minutes. A small incision is made in the gum near the tooth’s root to expose the underlying bone. A tiny opening in the bone reveals the infected root tip, which is removed. The end of the remaining root canal is cleaned and sealed with a small filling to prevent reinfection. The gum tissue is sutured back and stitches are typically removed after one week.

Recovery after retreatment mirrors a standard root canal. You may feel some tenderness for 2 to 4 days, easily managed with over-the-counter pain relief. Normal activities can usually resume the next day. Recovery after an apicoectomy takes a bit longer. Expect some swelling and bruising for the first 3 to 5 days. Use ice packs on the area for the first 24 hours and eat soft foods for a few days. Discomfort is manageable with prescribed pain relief. Avoid strenuous activity for 48 hours. If you experience increasing pain after day 4, fever, or persistent bleeding, contact our practice during office hours (Mon/Wed/Fri 9-5, Tue/Thu 11-7). For emergencies outside hours, call NHS 111 or visit the nearest A&E.

To choose what fits you best, ask the right questions whether you are speaking with us or another Finchley area practice. Ask why the first root canal failed. Based on your 3D scan, what is the success rate for retreatment versus an apicoectomy in your case? What are the risks if you choose one procedure over the other? Do you use a dental operating microscope for these procedures? What is the total cost, including scans and follow-up visits? And finally, what are the alternatives if you decide not to proceed, such as extraction and an implant?

The cost of retreatment or an apicoectomy depends on the case and the tooth involved. As a private-only practice, NHS treatment is not offered. We provide fully transparent, itemised treatment plans after your initial consultation and 3D scan, with no hidden fees. We accept several private dental insurance plans, including Max Bupa, Denplan, and Cigna. Please bring your insurance details to your consultation so we can explain your coverage. Our goal is to save your natural teeth with high standards of care.