Causes:
The most common cause is dental caries. If a root canal treatment is not successful at first, the apicoectomy might be a good way to go. Most dentists do a re-treatment of the root canal and if that is not successful also, then the last option is apicoectomy. Other factors include broken or chipped teeth, teeth with abnormal shapes of the roots, cysts on the roots tips, secondary canals and more.
Symptoms:
The patient might or might not be having any symptoms. If the infection surrounding the tip of the tooth is acute and active, the patient will feel severe pain and might even have a significant swelling. Other symptoms include sensitivity to hot and cold foods and drinks, sensitivity on touch or pressure and more.