Occasionally endodontic retreatment alone cannot resolve the infection and endodontic surgery may be indicated. Surgery allows access to the infected area and the infected tissues are removed and the root surface inspected for small fractures or hidden canals that weren’t detected on x-rays or during previous treatment. The end of the root is usually resected and a small filling placed to seal the end of the root canal. The gingival tissues are then sutured back in place and removed a couple of days later. Surgery is usually performed under local anesthetic and most patients return to their normal activities the next day.