Incidence and risk factor analysis for swelling after apical microsurgery

BACKGROUND: Swelling after apical microsurgery is a postoperative reaction and may reduce quality of life during healing. AIM: To evaluate periapical swelling after apical microsurgery and determine potential risk factors. METHODS: 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. RESULTS: 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). CONCLUSION: Younger patients with larger shadow volume and density were significantly more likely to develop swelling after apical microsurgery.