The Impact of Surgical Trauma, BMI and Analgesics Intake on Postoperative Pain after Periapical Surgery in the Anterior Maxillary Region.

Objective: To investigate whether factors associated with surgical trauma influence postoperative pain in the first postoperative week.

Study design: The study included 30 healthy, non-smoker adults of both genders, with an indication for periapical surgery on a single tooth in the upper anterior region, no history of prior surgery, no allergies to lidocaine with adrenaline or ibuprofen, no acute inflammation or pain, and a PAI of 3, 4, or 5. A single surgical team treated all patients by following the same surgical protocol. In the first postoperative week, each patient received the same postoperative instructions and a pain questionnaire to record pain intensity and analgesic consumption.

Results: The highest pain intensity was recorded on the day after surgery, while the highest analgesics consumption was recorded on the day of surgery. Participants with a BMI correlated positively with the amount of analgesics taken in the postoperative period (P<0.05). The duration of the operation correlated negatively with the intensity of pain and the consumption of analgesics after the operation (P<0.05). The volume, height and width of the alveolar bone defect after the operation did not significantly influence the intensity of pain and the consumption of analgesics in the postoperative period (P>0.05). The presence of a fistula correlated negatively with analgesic consumption after surgery (P<0.05), while preoperative fenestration correlated negatively with the intensity of postoperative pain (P<0.05).

Conclusion: Patients with a preoperative fistula and fenestration reported less pain and lower analgesic consumption in the postoperative period. These results indicate a potential relationship between the severity of postoperative pain and the degree of surgical trauma.