Incidence And Risk Factor Analysis For Swelling After Apical Microsurgery

Abstract The aim of this prospective observational cohort study is to evaluate developing 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 CBCT. The other variables (age, gender, operative teeth number, fistula, preoperative swelling, drug use and pre-surgery root canal treatments) were assessed during examination. Swelling degree was confirmed by questionnaires for patients on the 1st, 7th, 14th, and 21st days respectively after surgery. 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 day 7. 99% patients had no or mild swelling on 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 pre-surgery root canal treatments (P > 0.05). We conclude that younger patients with larger shadow volume and density were significantly more likely to develop swelling after apical microsurgery.