An apicoectomy, also known as root-end surgery, is a procedure performed when a root canal alone is insufficient to save a tooth. In this surgery, the infected tissue at the tip of the root is removed, along with a small portion of the root tip itself. This area is then cleaned and sealed to prevent further infection. 

An apicoectomy is typically recommended when a tooth has persistent infection or inflammation even after a root canal, or when there is a need to address an infection that has spread beyond the reach of traditional root canal therapy. 

This procedure can often save a tooth that would otherwise need to be extracted, helping to preserve your natural smile.