Side effects of apicoectomy

As with any operation, bleeding can occur. In the posterior region, opening of the maxillary sinus is possible. Damage to nerve fibers can also occur, although this is reversible, although only after a long period of time.

In the case of short roots, an apicoectomy can cause loosening of the tooth, which now has a shortened root. An inflammation after apicoectomy is also possible. This is often accompanied by pus formation.

Pain is likely after each surgical procedure, because each incision is a new wound and irritation. The body tries to initiate the closure of the wound and sends out pain signals. Therefore, the doctor recommends taking painkillers immediately after the operation.

The complaints subside completely after a few days, as long as no complications, such as infection of the wound, arise. In this case, the symptoms may last indefinitely, but if they do not subside, extraction is the only way out. If pus leaks from the sutured wound after apicoectomy, there is a massive inflammation, which can also lead to swelling and abscess.

An abscess describes an accumulation of pus in an encapsulated cavity. This development can lead to severe symptoms and should be treated by a physician. It can happen that an antibiotic is prescribed and the dentist has to make a relief cut to drain the pus.

Patients often complain about a “thick cheek“. A diffuse swelling on the gums or in the area of the apicoectomy is completely normal during healing. A swelling that persists for more than 2-3 weeks, which does not subside through cooling or is accompanied by severe pain, should be presented to the family doctor or dentist.

Post-operative bleeding is a possible complication after apicoectomy. The occurrence of post-operative bleeding can have various reasons.Most often it is due to the negligent behaviour of the person concerned, who exercises too early and thereby overexerts himself. The blood pressure and pulse rise and the wounded region is supplied with blood more strongly, which leads to secondary bleeding.

Therefore, resting is crucial for regeneration and a complication-free wound closure. Furthermore, blood-thinning medication and an insufficiently tight suture can also cause secondary bleeding. Patients with “blood thinners” belong to the risk group that is more likely to develop secondary bleeding.

Also, incorrect permanent cooling causes the body to signal hypothermia and increased blood pressure and blood flow are the result, which can lead to post-bleeding. The abscess is the alternative complication of a failed apicoectomy besides the fistula tract. The remaining bacteria become active and multiply.

They produce pus and in this case no duct through which it is discharged, but an encapsulated accumulation of pus. This results in swelling, severe pain, and functional restrictions of the jaw. If the abscess is not incised early so that the pus can drain away, there is a risk of acute life-threatening sepsis (blood poisoning).

If the tooth causing the abscess no longer has a hold due to the formation of the abscess, in most cases it is removed as well. The formation of a fistula tract is a possible complication after a root tip resection. The fistula tract is an outflow channel of an inflammatory focus, which forms in the direction of least resistance either inside or outside the oral cavity and constantly secretes pus.

As a complication after apicoectomy, a fistula tract indicates that not all inflammatory cells of the chronic inflammation have been removed, or that the inflammation has spread beyond the surgical window chosen to clean the root apex. A second apicoectomy, in which a larger part is cut off, is now considered a possible therapy. In addition, the fistula tract is surgically removed in order to remove all bacterially infected cells.

If this approach to therapy also fails, it must be considered whether the tooth is still worth preserving and it must be removed if the symptoms persist. However, the removal is always considered the last resort, since every effort is made to save the tooth. After the apicoectomy, healing of the wound will take some time.

Swelling after surgery is a common side effect after such an operation. The pain that occurs after the anaesthetic can be easily treated with painkillers, but cooling from the outside with an ice pack is also beneficial, as it counteracts the swelling. This therefore does not become excessively large.

The ice should never come into direct contact with the wound, but should be wrapped in a cloth and held against the cheek from the outside. The swelling can be light to moderate, how large exactly, but cannot be predicted. If the patient additionally takes blood-thinning medication, a bruise is more likely to form. The swelling also depends on how intensive the procedure was. The swelling usually peaks on the second day after the operation and should subside within a maximum of seven days after the operation.