Cystectomy on the tooth
What is a cystectomy?
A cystectomy is the complete surgical removal of a small jaw cyst with subsequent wound closure.
The cyst is opened, emptied and completely removed. The resulting cavity is then filled with a bone substitute material. If not already done, a cystectomy can also be combined with a root syringe resection or root canal treatment.
In general, a cystectomy is usually done for small cysts. If the cyst is already very large, surgical treatment can be a Cystotomy be considered.
Indications for a cystectomy
The main indication for performing a cystectomy, i.e. complete surgical removal of a cyst, is generally the presence of a jaw cyst. A jaw cyst is a cavity that is filled with fluid. The causes for the development can be very different. In many cases, however, a dead tooth is the cause. Since the fluid cannot drain away, the cyst begins to grow, displacing the jawbone and surrounding tissue. For this reason, a cyst must always be removed and fought. Nowadays, a cystectomy is performed when there are no disadvantages for the patient. In the case of more extensive cysts in the lower jaw, it must always be considered whether the cystectomy can be performed without damaging the neighboring structures. Furthermore, the age and general condition of the affected patient must be included in the indication of a cystectomy. In a dental practice, a cystectomy should only be performed on cysts, provided the cyst does not significantly exceed the alveolar process.
How is the diagnosis of a jaw cyst made?
To diagnose a cyst in general, after taking a medical history, attention should preferably be paid to bulges, changes in contour and sensitivity to pressure. Furthermore, the affected tooth is checked for its vitality. The cyst can be indentable or hard, depending on how far it has grown into the bone. An X-ray image is created for further diagnosis, also with regard to the treatment process. One indication for performing a cystectomy is the size and location of the cyst. A histological finding is decisive for a clear diagnosis of a cyst and for the decision to perform a cystectomy. This can precisely determine the type of cyst.
You can find more information here: X-ray of teeth
Accompanying symptoms of a jaw cyst
One of the main symptoms of a jaw cyst is a throbbing pain. This usually occurs when the cyst has already displaced the jawbone. The pain is caused by the pressure that the accumulation of fluid exerts on the sensitive periosteum. Especially in the early stages of the development of a cyst, you may well not feel any pain. These usually only arise as soon as the cyst begins to displace the surrounding bone. The cyst can also manifest itself as an unusual feeling of pressure. This is often accompanied by swelling or bulging. As soon as you determine this or one of the for a cyst, it is very important to see a doctor in order to prevent possible consequential damage from the cyst.
What is the procedure for a cystectomy on the tooth?
As part of a cystectomy, i.e. a complete surgical removal of a cyst, the maxillary sinus is first exposed. This means that you gain access to the cyst from the oral cavity or from outside the mouth.After removing the bone overlying the cyst and exposing the cyst, it is drained and completely removed. It is very important that all remnants of the cyst are removed without exception. Any remaining cyst debris can cause a cyst to recur. With small cysts (up to approx. 1 cm), the cavity does not have to be filled. The bone then grows back into the cavity. In the case of larger cysts, the cavity must be filled with a bone substitute material. This can be done through a collagen sponge or autologous bone. A sample is sent to the laboratory to determine whether it is a benign change. The wound is closed and heals in a short time. Often a cystectomy is combined with a root canal treatment or a root tip resection. In most cases, if the tooth has caused a cyst to form as it grows, it must extracted (to be pulled.
How long does a cystectomy take on the tooth?
A cystectomy is one of the routine procedures for the treating specialists. As a rule, the cystectomy is performed on an outpatient basis and in most cases does not take more than an hour to complete. 2 - 3 hours should be planned with pre- and post-operative care. The entire healing process usually takes about 2 weeks. After 7-10 days, the sutures of the wound can be removed if the course is uncomplicated. However, it can take up to several years for the bone defect to regenerate completely. However, the bone healing does not cause any harm to the patient.
Do you need an anesthetic for this?
As a rule, local anesthesia is sufficient to perform a cystectomy. Depending on the patient's wishes, however, either general anesthesia or the patient can be put into a kind of twilight sleep with nitrous oxide. General anesthesia is particularly recommended for anxious or very sensitive patients. In most cases, however, this is not borne by the health insurance company, but must be made by the patient himself as an additional payment.
Complications of cystectomy on the tooth
As with any surgical procedure, treatment with a cystectomy carries certain risks and can lead to complications. Depending on the size and location of the cyst, the operation can damage nerves or vessels. As part of these injuries, temporary numbness in the mouth, jaw and face area can occur. In rare cases, teeth need to be extracted completely. In exceptional cases, a broken jaw cannot be ruled out. There is also the risk of further infections. Complications in general can never be completely ruled out during an operation, but you can get detailed information about the individual risks and complications beforehand.
Pain after a cystecomy on the tooth
The pain after the treatment is mainly typical wound healing pain. The operation of a cystectomy is an invasive procedure. The tissue must first recover and regenerate from this. The pain usually manifests itself as a throbbing or knocking. Furthermore, there can be severe sensitivities in the area of the wound. Here you should be careful, especially when eating, not to reopen the wound with hard food. You should also try to avoid excessive physical exertion and heat. The latter in particular can be conducive to the development of inflammation.
What can you do about the pain?
Pain relievers prescribed by the doctor, such as ibuprofen or paracetamol, can be taken to alleviate the pain during wound healing. However, ibuprofen or paracetamol are also available in pharmacies without a doctor's prescription. It is important to refrain from using products such as Aspirin®. These have an anticoagulant effect and therefore increase the risk of rebleeding. Furthermore, sucking ice cubes from the inside of the mouth or cold compresses on the cheek can relieve pain. Heat or physical exertion should always be avoided. After eating, prophylactic rinsing with chamomile can be used to prevent infection of the wound and prevent further pain.
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Inflammation after cystectomy on the tooth
After every operation, which naturally involves a wound, a healing process begins. This is accompanied by the typical signs of inflammation such as pain, redness, swelling and warming in the affected area. This process begins immediately after the operation. The wound has been sutured and now the tissue has to regenerate. Increased blood flow to the affected areas causes more cells to be washed to the site of the wound. The inflammatory process usually intensifies immediately after the operation and increases over the first night. It is therefore typical that the pain is felt to be very severe the first night after the operation. If the symptoms go well, the symptoms subside after a few days and the wound heals. In the case of an infected wound and a prolonged painful inflammation, it must be cleaned with antibiotics or a new opening.
What does the aftercare look like?
If the wound heals without complications, i.e. without the development of inflammation or bleeding, the sutures can be removed after 7-10 days. The bone regeneration should then be checked by X-ray controls over the next few months and years. If there is inflammation with secretion after the operation, i.e. after the operation, the wound must be reopened and cleaned.
How long is the healing time?
The healing time depends primarily on the oral hygiene and the care of the patient. As a rule, the wound will heal again after 7-10 days, if the stitches can also be removed. However, the scar can be felt for a while longer. The bone defect created by the cyst will regenerate over the next few years. However, this does not mean any restrictions for the patient. The person concerned should take care not to smoke or to engage in physically demanding activities during the healing phase. Furthermore, heat should be avoided and good oral hygiene should be used.
Cost of cystectomy on the tooth
In the case of a medically necessary complete removal of a cyst, i.e. a cystectomy, the majority of the operation is covered by the health insurance company. Often, any desired general anesthesia or a bone substitute material that is filled into the cavity created by the cyst must be carried by the patient himself. These costs can total around EUR 200-700. The prices vary depending on the treating doctor. However, if there is evidence of medical necessity for these two parameters, these costs will also be borne by the health insurance company.
How long will I be on sick leave?
A cystectomy is usually an outpatient procedure. It is best to schedule the operation in the afternoon. Patients should not use machines on the same day. This means that an accompanying person should pick up the patient, because he or she may still be a little weakened and disoriented after the operation. Physical exertion should also be avoided. There is usually no sick leave after a cystectomy. However, if there is an indication or other complications have arisen, sick leave can be issued for a few days.