Generally, a root canal treatment is all that is needed to save damaged teeth from extraction. Occasionally, this non-surgical procedure will not be sufficient to heal the tooth and peri-apical surgery is required. The most common surgery used to save damaged teeth is an apicectomy(also called peri-radicular surgery, root-end surgery, or a root-end resection).
In this surgery, an incision is made in the gum tissue to expose the bone and surrounding inflamed tissue. The damaged tissue is removed along with the end of the root tip. A root-end filling is placed to prevent re-infection of the root and the gum is sutured. The bone naturally heals around the root over a period of months restoring full function.