Sometimes the infection persists even after root canal therapy. In these cases, an apicoectomy, or root end resection can be performed to remove diseased tissue.

1. An incision is made to allow access to the base of the tooth. The inflamed or infected pulp is treated and the canals are carefully cleaned and shaped.
2. A small filling may be placed in the remaining tip of the tooth to seal the root canal. The gum tissue is stitched back into place.
3. A crown is placed to protect the tooth.