The most frequent indication for root tip resection is given when parodontitis apicalis (inflammation at the root tip) arises after root canal treatment or if an already existing inflammation does not recede despite correct root treatment. A repeat endodontic therapy is also frequently unsuccessful. Further indications are:

• Deep root fracture;
• Deep fracture of root canal instruments;
• Apical inflammation in teeth with cemented anchor structures.

    The apical inflammation is the reaction of the organism to bacteria in the root canal, whereby the bone at the root tip is replaced by special inflammation tissue. Root canal preparation may be complicated or impossible in narrow or obliterated root canals and finely branched, apical side canals. Bacteria will remain in those problem zones, which cannot be treated with even the thinnest root canal instruments.After the mucosa incision and exposure of the bone above the respective root tip, the bone and root tip are ablated and the inflamed tissue is removed. The root canal can then be orthogradally (i.e., from the crown) or retrogradally (from the root tip) closed with a suitable, bacteria-blocking filling material.