Pain and inflammation after periapical surgery in 60 patients

Periapical surgery is followed by manifestations such as pain and swelling, the magnitude of which depends on the degree of tissue damage produced. A study is made of pain and inflammation in the 7 days after periapical surgery and its relation to patient age, gender, smoking, oral hygiene, the location and number of teeth implicated, the duration of the operation, the type of incision and flap involved, and the extent of ostectomy.

Sixty patients (22 males, 38 females) with a mean age of 38.7 years underwent periapical surgery with ultrasound and retrograde filling with silver amalgam. The postoperative course was evaluated based on a descriptive 4-point scale of pain and swelling. The SPSS statistical package for Microsoft Windows (SPSS, Chicago, IL) was used for the statistical analysis of the results.

The greatest prevalence of maximum intensity pain was recorded after 2 days (in 14.6% of all patients); at this point two-thirds of the patients reported either no pain or only mild intensity pain. Swelling likewise peaked on the second postoperative day, when two-thirds of the patients presented moderate inflammation. Patient age, gender, oral hygiene, and smoking exerted no influence on the postoperative period (P > .05). Pain was greater when treating anterior sector mandibular teeth and when trapezoidal incisions were made. Inflammation in turn increased with longer surgical times, and pain and swelling increased with the number of teeth treated.

Periapical surgery caused little pain and moderate swelling during the first 2 days after the intervention. The secondary manifestations increased with the number of teeth treated and with the duration of surgery.