When retreatment through the crown is not an option, going in through the bone gives the tooth one more chance.
An apicoectomy is the last line of defence for a tooth with a persistent root-tip infection that cannot be reached through the crown. The surgeon accesses the root tip through a small window in the bone, removes the infected tissue, trims the root end, and seals it with bioceramic material. Success rates exceed 90% when performed microsurgically. Thailand's endodontic surgeons handle these cases at a fraction of Western costs, often saving patients from an extraction they thought was inevitable.
Free, no-obligation — you pay the hospital directly with no markup.
An apicoectomy is performed when infection persists at the root tip despite previous root canal treatment and retreatment through the crown is not feasible. Complex canal anatomy, calcified channels, a cemented post, or an existing crown may block conventional access. The surgeon approaches the root tip directly through the bone instead.
A small gum flap exposes the bone over the root tip. The infected tissue and the last few millimetres of root are removed. An ultrasonic cavity is prepared in the root end and sealed with bioceramic material such as MTA or Biodentine. Performed under a surgical microscope, modern apicoectomy achieves success rates above 90% — a substantial improvement over the older technique done without magnification.
Apicoectomy is a specialist procedure that many general dentists do not perform. In Thailand, you get endodontic surgeons with the right equipment at a fraction of the cost.
Microsurgical
Specialist Equipment and Skills
Our partner endodontic surgeons perform apicoectomies under operating microscopes with ultrasonic instruments and bioceramic materials — the full microsurgical protocol, not a scaled-down version.
60–70%
Substantial Savings
Apicoectomy at $300–$600 in Thailand versus $900–$1,800 at home. The savings make it practical to save a tooth that might otherwise be extracted because of the cost of surgery at home.
5–7 Days
Procedure and Follow-Up in One Trip
The procedure takes under 90 minutes. A week in Thailand covers the surgery, suture check, and healing confirmation. Many patients combine apicoectomy with other dental work during the same visit.
English
Specialist Communication
English-speaking endodontic surgeons explain your CBCT findings, the surgical plan, and the prognosis directly. Your care coordinator manages all appointment logistics and daily check-ins.
We do not charge for our service — you pay the clinic directly with no markup. Here is what apicoectomy costs and how it compares internationally.
Your Quote Will Include
Prices are approximate and vary by technique, surgeon, and hospital. Your personalised quote will include a full cost breakdown.
An apicoectomy in Thailand typically costs between $300 and $600 per tooth, depending on the tooth type, root anatomy, and complexity. Single-rooted front teeth sit at the lower end. Multi-rooted molars and retreatment cases sit higher due to longer operating time and greater anatomical complexity.
The total cost covers the endodontic surgeon's fee, local anaesthesia, CBCT scan, the microsurgical procedure, bioceramic root-end filling material, sutures, post-operative medications, and follow-up appointments. Any crown work is quoted separately if needed.
Tooth type and complexity are the main variables. Front teeth with single roots are faster and less expensive. Molars with multiple roots take longer and cost more. Cases involving thick bone, limited access, or proximity to nerves or sinuses increase complexity and price.
Pricing varies by the complexity and scope of the procedure. Typical ranges at our partner hospitals in Thailand:
Exact pricing is confirmed after your consultation and treatment plan are finalised.
Apicoectomy in Thailand costs 60–70% less than equivalent microsurgical treatment in the US ($900–$1,800), Australia (A$850–A$1,650), and UK (£750–£1,500). The savings often make the difference between saving a tooth and extracting it.
Modern microsurgical apicoectomy is a fundamentally different procedure from the older technique. The difference in equipment, materials, and success rates is significant.
The current gold standard. The entire procedure is performed under a surgical operating microscope at 10–25x magnification. Ultrasonic tips prepare a precise root-end cavity. Bioceramic material seals the root end. Success rates exceed 90% and tissue trauma is minimal.
The earlier technique performed without magnification, using conventional burs and amalgam or glass ionomer for the root-end seal. Less precise, with lower success rates. Largely replaced by the microsurgical approach at specialist centres.
In rare cases where the root tip is surgically inaccessible — such as lower molars close to the inferior alveolar nerve — the tooth is carefully extracted, treated outside the mouth, and replanted into the socket. A niche technique reserved for anatomically challenging situations.
The equipment and materials used during apicoectomy directly determine the outcome. Here is what the microsurgical approach involves.
The microscope provides 10–25x magnification and co-axial illumination of the surgical site. The surgeon can visualise the cut root surface, identify extra canals and isthmuses, detect micro-fractures, and assess the quality of the root-end seal — none of which is possible without magnification.
Ultrasonic tips prepare the root-end cavity along the canal axis, which is impossible with a conventional bur due to access limitations. The resulting cavity is smaller, more centred, and more conservative than one prepared with rotary instruments.
Materials such as mineral trioxide aggregate (MTA) and Biodentine seal the root end with a biocompatible barrier that stimulates bone healing around it. These materials have largely replaced amalgam, which was the older standard. The biological seal they produce is a major reason microsurgical success rates exceed 90%.
Mild swelling and discomfort around the surgical site. Apply ice packs intermittently and take prescribed medication. Avoid chewing on the treated side. Light bleeding may occur and resolves within hours.
Swelling peaks then begins subsiding. Continue ice application and gentle salt-water rinses after meals. Over-the-counter pain relief is usually sufficient. Avoid brushing directly over the suture site.
Sutures are checked or removed at your follow-up. Swelling and tenderness have largely resolved. A periapical X-ray confirms the root-end filling is positioned correctly and the surgical site is healing.
Bone gradually fills in around the sealed root tip, visible on follow-up X-rays. Complete radiographic healing may take up to 12 months. The tooth functions normally throughout with no restrictions.
Most patients can fly home three to five days after an apicoectomy, once the follow-up confirms the surgical site is healing well. The procedure involves a small incision in the gum and bone work around the root tip, so a few days of monitored recovery is sensible before travelling. Cabin pressure does not affect the healing site.
Stick to soft foods and avoid chewing on the treated side for the first three to five days while the gum incision heals. Cold foods can help with comfort in the first 24 hours. Once the sutures dissolve or are removed at your follow-up, you can gradually return to normal eating. Most patients eat without restriction within a week.
The infected root tip is removed and sealed during the procedure, so the source of infection is eliminated immediately. Gum tissue heals within one to two weeks. Bone regeneration around the root-end filling takes three to six months and is confirmed on follow-up X-rays. Success rates with microsurgical technique exceed 90%.
Microsurgical apicoectomy has a strong safety and success profile when performed by an endodontic specialist with proper equipment and materials.
A detailed review of your CBCT scan clarifies prognosis and any anatomical considerations that may affect the outcome. This is discussed before surgery so you can make an informed decision about proceeding.
Yes. Apicoectomy is a well-established microsurgical procedure performed under local anaesthesia as an outpatient. Our partner endodontic surgeons use operating microscopes, ultrasonic instruments, and bioceramic materials that match the standard at leading centres internationally. The procedure is significantly less invasive than extraction and implant placement.
Ensure the surgeon uses an operating microscope — this is the single most important factor in apicoectomy success. Verify bioceramic materials are used for the root-end seal rather than older amalgam. Ask about the CBCT scan findings, specifically whether the root shows signs of fracture. A fractured root will not respond to apicoectomy, and an honest surgeon will tell you that upfront.
If healing does not occur, the options are re-surgery or extraction followed by implant placement. Failure is uncommon with microsurgical technique — success rates exceed 90%. The prognosis is discussed honestly before the procedure so you can weigh the likelihood of success against the alternative of extraction from the start.
Apicoectomy is a specialist procedure that requires specific equipment and training. Here is what to look for.
Our partner clinics have dedicated microsurgical suites with operating microscopes, ultrasonic systems, and CBCT scanners. They are equipped for the precision and magnification that apicoectomy demands — this is not a procedure suited to a standard treatment room.
Our partner surgeons hold postgraduate qualifications in endodontics and perform apicoectomies as a regular part of their practice. They are experienced with both front-tooth and molar cases, including anatomically challenging situations near nerves and sinuses.
Confirm the surgeon has endodontic specialist training and performs apicoectomies regularly. Ask whether an operating microscope is used for every case. Verify bioceramic root-end filling materials are standard. A surgeon who reviews your CBCT findings with you, discusses prognosis honestly, and mentions root fracture assessment is approaching the procedure correctly.
Apicoectomy results are radiographic and functional. Here is what to expect.
A successful apicoectomy eliminates the root-tip infection and preserves the tooth. Pain and swelling resolve as the surgical site heals. The dark area on the X-ray around the root tip fills in with bone over three to twelve months, confirming the seal is holding. The tooth continues functioning normally with the existing crown in place.
Symptoms resolve within days as the infection is removed. The tooth remains in your mouth with its existing crown undisturbed. Radiographic healing — bone regeneration around the sealed root tip — takes three to twelve months and is confirmed on follow-up X-rays. The success rate exceeds 90%, which is comparable to initial root canal treatment performed by a specialist.
Apicoectomy fits into a five-to-seven-day trip. Here is how to plan it.
Plan for five to seven days. Day one covers the CBCT scan and consultation. The procedure is performed on day two or three. A follow-up appointment around day five or six checks sutures and confirms healing. If you are combining apicoectomy with other dental work, the schedule is adjusted accordingly.
Your care coordinator arranges the consultation, CBCT scan, procedure, and follow-up. The treatment quote covers the surgeon's fee, CBCT imaging, anaesthesia, the microsurgical procedure, bioceramic materials, medications, and follow-up. Flights and accommodation are separate.
Apicoectomy is often combined with other dental work during the same trip — crowns, bridges, implant consultations, or general check-ups. Since recovery from apicoectomy is mild, other non-surgical dental treatments can usually proceed on adjacent days without conflict.
Everything you need to know before your procedure
Patient Care Director
Last reviewed: March 25, 2026
Medical disclaimer: This information is for educational purposes only and does not replace professional dental advice. Individual results, recovery times, and suitability vary. Always consult a qualified dentist before making decisions about treatment.
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