An apicoectomy, also known as a root-end resection, is a surgical dental procedure performed by an endodontist to treat a persistent infection or inflammation at the root end of a tooth. This procedure is usually considered when a previous endodontic treatment has not resolved the problem and the infection or inflammation persists.

Overview of the apicoectomy procedure:

• Clinical and radiographic evaluation
• Local anesthesia
• Opening access with an incision in the gums of the affected tooth, providing access to the underlying bone and root
• Removal of infected tissue or cysts 
• Root tip excision: a small portion of the root tip is removed to eliminate the source of the infection or inflammation. 
• Sealing of the root tip with a biocompatible material to prevent further infection.
• Suturing of the gums 
• Post-operative care: with antibiotics or painkillers as needed
• Monitoring of healing

An apicoectomy is a conservative approach to saving a tooth that would otherwise need extraction. Although it is a surgical procedure, advances in techniques and technology contribute to its overall success.