Gums that become infected after a root canal are treated with an apicoectomy, the removal of the root tip, or root apex, and the surrounding infected tissue. Root canals have many small branches off the main canal that can retain infected tissue even after root canal treatment, according to Colgate.com.
An apicoectomy is termed endodontic microsurgery because it is usually performed using an operating microscope. During an apicoectomy, an endodontist cleans and seals the end of the tooth's canal. The cleaning is performed under a lighted microscope with ultrasonic instruments, reports Colgate.com.
The endodontist makes a small cut in the gum, then lifts it away from the tooth. Drilling may be required to access to the root. The infected tissue is then removed, including the root apex, the final few millimeters of the root tip. The endodontist then takes an X-ray of the area before stitching the tissue back in place, explains Colgate.com.
An apicoectomy is performed only after a tooth has had at least one root canal procedure and performing a root canal again is not possible because a tooth has a crown or makes up part of a bridge. When another root canal would destroy the crown or the bridge, an apicoectomy is often the best option, says Colgate.com.