Published online Sep 16, 2022. doi: 10.12998/wjcc.v10.i26.9303
Peer-review started: February 13, 2022
First decision: June 7, 2022
Revised: June 15, 2022
Accepted: July 27, 2022
Article in press: July 27, 2022
Published online: September 16, 2022
Swelling after apical microsurgery is a postoperative reaction and may reduce quality of life during healing.
To evaluate periapical swelling after apical microsurgery and determine potential risk factors.
Ninety-eight apical microsurgery patients were selected for this study. Before surgery, bone shadow volume and density of pathological tissue were measured by cone beam computed tomography. The other variables (age, gender, operative teeth number, fistula, preoperative swelling, drug use and preoperative root canal treatments) were assessed during examination. Swelling degree was confirmed by questionnaires for patients on postoperative days 1, 7, 14 and 21. Statistical analyses were performed to identify predictors for swelling.
Majority of patients reported moderate (45.9%) or severe (34.7%) swelling on day 1, and moderate (44.9%) or mild (45.9%) on postoperative day 7. Ninety-nine percent of patients had no or mild swelling on postoperative day 14. The average swelling level peaked on day 1 postoperatively and gradually decreased. Of statistical significance, age, bone shadow volume and density of pathological tissue acted as predictors of swelling (P < 0.05). However, there was no significant difference in gender, tooth number, fistula, preoperative swelling, drug use, or preoperative root canal treatments (P > 0.05).
Younger patients with larger shadow volume and density were significantly more likely to develop swelling after apical microsurgery.
Core Tip: The impact of postapical swelling on daily life was viewed from the patients’ perspective. The conclusions demonstrate that postoperative swelling is more severe in those with larger volume and density of apical lesions, so the importance of preoperative cone beam computed tomography examination is emphasized. Younger patients with high postoperative prognostic requirements may have more severe postoperative swelling than older patients and should be given more clinical attention.