322 F. D. Fragiskos
Fig. 13.35. Periapical radiograph taken after suturing of flap, showing retrograde amalgam filling
Fig. 13.36. Amalgam splatter at operation site, as a result of improper manipulations for removal of excess material
13.5 Complications
The most common perioperative and postoperative complications that may occur during and after the surgical procedure, respectively, are:
ΟDamage to the anatomic structures in case of penetration of the nasal cavity, maxillary sinus and mandibular canal with the bur.
ΟBleeding from the greater palatine artery during apicoectomy of palatal root.
ΟSplattering of amalgam at the operation site, due to
inadequate apical isolation and improper manipulations for removal of excess filling material (Fig. 13.36).
ΟStaining of mucosa due to amalgam that remained at the surgical field (amalgam tattoo) (Figs. 13.37,
13.38).
ΟHealing disturbances, if the semilunar incision is made over the bony deficit (Fig. 13.39) or if the flap, after reapproximation, is not positioned on healthy bone.
ΟDislodged filling material due to superficial placement, as a result of insufficient preparation of apical cavity (Fig. 13.40).
ΟIncomplete root resection, due to insufficient access or visualization and misjudged length of root
(Fig. 13.41). As a result, the apical portion of the root remains in position and the retrograde filling is placed improperly, with all the resulting consequences.
Fig. 13.37. Staining of mucosa due to amalgam that remained at surgical field after apicoectomy (amalgam tattoo)
Fig. 13.38. Periapical radiograph of the case shown in Fig. 13.37
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Fig. 13.39. Wound dehiscence, as a result of improper design of semilunar incision
Fig. 13.40. Malpositioned retrograde obturation material, due to insufficient preparation of apical cavity
Fig. 13.41. Periapical radiograph showing unsatisfactory apicoectomy at maxillary second premolar, due to failure to define root before resection
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