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Factors Associated with Postsurgical Pain and Swelling Following Endodontic Microsurgery: The Role of Radiographic
Abdulwahed Alghamdi1, Dana Mominkhan2, Reem Sabano1
1Department of Endodontics, University Dental Hospital, King Abdulaziz University, P.O. Box 80209, Jeddah 21589, Saudi Arabia.
Healthcare (Basel, Switzerland)
|May 14, 2025
Summary
Endodontic microsurgery (EMS) patients with larger periapical lesions (>4mm) may experience less swelling. Lesion size, bone perforation, and mouthwash use did not significantly impact post-EMS pain.
Area of Science:
- Dentistry
- Endodontics
- Oral Surgery
Background:
- Endodontic microsurgery (EMS) is a common procedure.
- Limited research exists on predicting post-EMS pain and swelling based on preoperative lesion characteristics.
- Cone beam computed tomography (CBCT) provides detailed imaging of periapical lesions.
Purpose of the Study:
- To investigate the relationship between CBCT-assessed periapical lesion characteristics and post-EMS pain and swelling.
- To identify potential predictors of post-surgical symptoms following EMS.
Main Methods:
- 61 patients undergoing EMS reported pain and swelling using VAS at 8, 24, 48, and 72 hours post-surgery.
- CBCT periapical index, lesion characteristics, and surgical details were analyzed.
- Fisher Exact test and multivariate regression were used to identify significant factors (p≤0.05).
Main Results:
- Peak pain occurred at 8 hours (4.26 ± 3.13), and peak swelling at 24 hours (6.46 ± 2.87).
- Patients with CBCT index scores >3 had a significantly lower risk of swelling (AOR = 0.243, p = 0.024).
- No significant correlation was found between pain and lesion size, cortical bone perforation, or mouthwash use.
Conclusions:
- Periapical lesions larger than 4 mm are associated with reduced post-EMS swelling.
- Pain after EMS is not significantly influenced by lesion size, cortical bone perforation, or mouthwash use.
- Periapical lesion size is a novel predictor for managing post-EMS swelling.
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