Risks

Since apicoectomy is a surgical procedure, the patient must be informed of possible risks before the actual treatment begins. The most common side effects that occur during an apicoectomy depend on the position of the tooth to be treated and the initial condition of the root tip to be treated. A special risk in the maxillary posterior tooth region is the danger that the surgical procedure may result in a so-called maxillary sinus opening.

This results in the unintentional creation of a connection between the oral cavity and the maxillary sinus (one of the paranasal sinuses). This fact is due to the fact that the bony lower jaw enters into close, neighboring relationships with nerves and blood vessels. The “large” mandibular nerves (alveolar and lingual nerves) are particularly at risk.

If one or both of these nerve branches are irritated or injured, a temporary loss of sensitivity can usually be expected. The ability to perceive different tastes may also be temporarily restricted.In the majority of cases, the reduction in sensation and/or taste disappears of its own accord after some time, but there are also patients in whom there is a permanent loss of sensitivity since the execution of a root tip resection in the lower jaw. In addition to the specific risks, which are strictly dependent on the location of the tooth to be treated, there are other general risks in the case of surgical apicoectomy. As with any other operation, root apex resection can lead to wound healing disorders and/or infections in the area of the surgical site. In addition, the usual risks apply when using general anesthesia, which include above all cardiovascular failure.

Prognosis

The prognosis of a root tip resection is positive. According to studies, apicoectomy has a success rate of over ninety percent if an adequate form of therapy is used. By means of apicoectomy, a tooth can be fully reintegrated into the dental arch and can be included in dental prosthesis planning.

The new techniques of apicoectomy offer highly effective ways to treat a tooth in a minimally invasive manner and is a routine procedure nowadays. The tooth is free of complaints and can be preserved in the long term. Nevertheless, apicoectomy cannot save all failed root canal treated teeth. Longitudinally fractured teeth or perforated root fillings that have erroneously penetrated outside the tooth are just a few examples of teeth that can only be extracted.