Apicoectomy also called as root resection or root amputation is the ablation of the apically infected portion of the tooth and curettage of all periapical necrotic and inflammatory tissue.

INDICATIONS

• Maxillary or mandibular anterior teeth with periapical infection.
• Teeth in which the destruction of the investing alveolar bone does not extend over one third the length of the root.
• Teeth with apical resorption.
• Teeth with well circumscribed periapical granular tissue.
• Tooth in young patients which is an etiologic factor in the production of radicular cysts or which has been divatalized by extension of cysts.
• Teeth in which root has been fractured by trauma.

CONTRAINDICATIONS

• When general health of the patient is below par especially those who have had rheumatic fever or are suffering from rheumatism, nephritis, diabetes, cardiac disease, thyrotoxicosis.
• In teeth with deep periodontal pockets and excessive mobility.
• In cases where tooth approximates important anatomic structures.
• In inaccessible areas.
• In cases where it is necessary to remove too much tooth structure.
• When traumatic occlusion cannot be corrected.

REASONS FOR FAILURE

• Improper selection of teeth.
• Negligence of pre operative measures.
• Operation of tooth with partial root filling without refilling the canal.
• Faulty technique.
• Lack of surgical asepsis.
• Removal of tooth along with the cortical plates. This retards healing as there is an opening created.
• Traumatic occlusion.
• Failure to incise properly, this prevents good visibility of the field.