In some cases it may be necessary to remove the infected root tips or apex and the nearby tissue. This is known as a apical surgery or an apicoectomy. The area around the apex of the tooth that is infected is cleaned, and the tip of the root is resected and sealed. Sutures are placed and an ice pack is applied. Medication is prescribed to help alleviate any pain or discomfort and it is best to plan to rest for the remainder of the day. Most patients will have some minor swelling and occasional bruising with some numbness.