In Parts I and II of this series, we discussed the preparation of the patient, the incision, and atraumatic flap elevation. These are the first three steps necessary to perform predictable apical microsurgery. As was mentioned, it is of utmost importance that each step is completed before proceeding to the next step. If a step is omitted or not completed, the next step will be difficult, if not impossible, to complete properly. The operation will develop into a stressful experience for the patient, the staff, and the doctor, with a less desirable or predictable end result. If all of the steps are completed as outlined, all procedures can be performed without stress and a favourable post-operative result is predictable. I have completed hundreds of apical microsurgical operations and the desirable results were mainly the same with just a few exceptions. The technique is very gentle and predictableÑif all of the steps are followed without compromise!