Apicoectomy in San Francisco, CA

Medically reviewed by Dr. Angela Leung, DDS – Last reviewed August 19, 2026

If your tooth has a root canal but you’re still getting swelling, a gum “pimple” that drains, bite pain, or flare-ups that keep coming back, the problem is often a hidden infection at the root tip.

At Angela Leung DDS PC – The Endodontics Implant Center, your apicoectomy isn’t treated like a quick add-on. Dr. Angela Leung plans it like a precision infection-control procedure: confirm the true source, rule out cracks or non-restorable teeth, map anatomy, then remove and seal with a documented plan to confirm healing.

The real reason an infection keeps coming back after a root canal

Most repeat flare-ups aren’t “bad luck.” They’re usually one of these:

Ignore it and you risk: repeated swelling cycles, ongoing tenderness with chewing, bone loss around the root, and in upper teeth, possible sinus-adjacent complications.

Endodontics-first apicoectomy planning (so the surgery actually solves the problem)

An apicoectomy shouldn’t be “cut, snip, hope.” The outcome depends on variables that many pages barely mention: diagnosis accuracy, access, sterile control, seal quality, and follow-up confirmation.

Here’s how we stack the odds in your favor:

Start with the non-negotiables

Confirm the true pain/infection source (not guessing)
Review your prior root canal/restoration history and flare-up pattern
Screen for red flags that change the plan (crack signs, poor restorability, advanced periodontal issues)
Use focused imaging when it adds clarity (root anatomy, lesion size, proximity to sinus/nerve)

Plan the end result first

We plan around what matters:

When apicoectomy beats retreatment

You deserve a straight answer, not a default procedure.

Apicoectomy is often the better path when:

You had retreatment (or can’t reasonably do it) and infection still persists
A crown/post makes dismantling the tooth risky
The infection is localized at the root tip and the tooth is otherwise strong
You need a focused surgical solution rather than reopening the entire canal system

Extraction is better when:

If the best plan is not apicoectomy, we’ll say so and explain the decision clearly (including extraction + implant pathways when that’s the safer long-term call).

Under Endodontics | Services

General & Specialized Dental Services

Our apicoectomy protocol (diagnose → remove infection → seal → confirm healing)

1. Candidacy exam + risk review

We review health factors that affect healing and safety (medications, bleeding considerations, diabetes control, smoking/vaping, immune issues), plus your symptom timeline and prior treatment details.

2. Tooth viability check (so we don’t “save” a tooth that can’t last)

We evaluate restorability, periodontal support, mobility, and crack risk signals so your time, money, and healing are aimed at a tooth worth keeping.

3. Surgical precision with a clean-field mindset

Apicoectomy is microsurgery in spirit: controlled access, removal of infected tissue at the root tip, root-end preparation, and a retrograde seal that blocks reinfection from the outside.

4. Follow-up checkpoints that confirm it worked

You shouldn’t be left wondering. We plan specific checkpoints to evaluate symptom resolution and healing progress, and we’ll tell you what would trigger re-imaging or a plan adjustment.

Risks, safety standards, and who may not be a candidate

Any surgical procedure has risks. Common considerations include swelling, bleeding, infection, and temporary discomfort. Less common but important risks depend on anatomy (for example, nerve-adjacent areas or sinus-adjacent roots).

We reduce avoidable risk through:

If your medical history adds complexity, we coordinate care and timing appropriately.

Comfort, recovery, and getting back to normal

You’re not just a tooth. You’re a human with a schedule, stress, and a nervous system that didn’t ask for dental drama.

Most patients experience:

We give clear instructions on:

If you’re anxious, tell us your visit can be paced and explained step-by-step.

Reviews and patient stories

(4.8) 120+ Google reviews.

Payment and financing options

We’ll give you a written plan with costs before treatment begins, then help you choose a realistic path forward.

Staged payment policy (for larger cases):

Financing partners may include:

Insurances we accept:

Questions people ask before booking

Will an apicoectomy hurt?

You’ll be numb during the procedure. Afterward, most people describe soreness and swelling that improves over the first several days. You’ll get clear aftercare guidance and a direct line for anything that feels off.

Is this my only option?

No. The real decision is retreatment vs apicoectomy vs extraction/implant. We’ll explain which fits your tooth and why—based on restorability, anatomy, and infection behavior.

How do you know the infection is really gone?

We set follow-up checkpoints to track symptom resolution and healing progress, and we tell you what would trigger additional imaging or a plan change.

What if my tooth is cracked?

A crack changes everything. That’s why we screen for crack signals and restorability before recommending surgery.

Can I go back to work the next day?

Many patients can return quickly, depending on the tooth, procedure complexity, and how you tend to swell. We’ll give realistic timing guidance for your specific case.

Expert Endodontic & Implant Care

Angela Leung DDS PC – The Endodontics Implant Center
1131 Mission Road, South San Francisco, CA 94080

Phone: 415-681-2697

Hours: Monday–Friday 10:00 am – 6:00 pm (Saturday & Sunday closed)

Ready to get a real plan?

If you’re dealing with missing teeth, failing dental work, or full-mouth breakdown, the fastest relief is clarity.