In general, a root canal treatment is all that is needed to save a tooth with an injured pulp and prevent it from being extracted. Occasionally, this non-surgical procedure is not sufficient to heal the tooth and your endodontist will recommend surgery. Endodontic surgery can be used to locate fractures or hidden canals that do not appear on radiographs but still manifest pain in the tooth. Damaged root surfaces or persistent infection may also be treated with this procedure. The most common surgery used to save damaged teeth is an apicoectomy in conjunction with a root-end filling, performed in a micro-surgical environment.