Pain and swelling after periapical surgery related to oral hygiene and smoking

Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007 Aug;104(2):271-6. doi: 10.1016/j.tripleo.2007.01.025. Epub 2007 May 15.


Objectives: To evaluate pain and swelling during the first week after periapical surgery and its relation to patient age, gender, oral hygiene, and smoking.

Study design: One hundred two patients (31 men and 71 women) with a mean age of 40.2 years underwent periapical surgery. Age, gender, and oral hygiene and cigarette smoking before and during the postoperative course were noted. Pain and swelling scores were recorded on a descriptive 4-point scale at 2, 6, and 12 hours after surgery, and each day thereafter for 1 week. The data were statistically evaluated for significant differences.

Results: The highest intensity of pain occurred during the first 48 hours, and swelling peaked on the second postoperative day. Patient age and gender had no significant effect on postoperative symptoms (P > .05). Patients with poor oral hygiene before surgery presented greater pain and swelling during the first postsurgical hours, and smokers before surgery also suffered more pain. The number of cigarettes smoked in the postoperative period and oral hygiene after surgery had no effect on pain or inflammation (P > .05).

Conclusions: Periapical surgery caused little pain and moderate swelling during the first 2 days after the intervention; these findings were more distinct in patients with poor oral hygiene before surgery and in smokers.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Analysis of Variance
  • Edema / etiology*
  • Female
  • Humans
  • Male
  • Oral Hygiene
  • Oral Surgical Procedures / adverse effects*
  • Pain, Postoperative / etiology*
  • Periapical Diseases / surgery*
  • Prospective Studies
  • Retrograde Obturation / adverse effects
  • Sex Factors
  • Smoking / adverse effects
  • Statistics, Nonparametric