Pain and swelling in periapical surgery. A literature update

In recent years, periapical surgery (PS) has evolved thanks to the incorporation of technical and diagnostic advances. In PS, secondary effects such as pain and swelling occur as with all surgical procedures. The objective of the present study is to review the literature of articles published on pain and swelling during the postoperative period in periapical surgery. For this review, a search was made in Medline and of literature published in Spanish odontological journals. In the reviewed literature the maximum pain was produced during the first 24 postoperative hours and maximum swelling between the first and second day. Recent studies propose the use of corticoids and nonsteroidal anti-inflammatory drugs (NSAIDs) during the pre-and post-operative period, in order to reduce pain perception during the first postoperative week after surgery. Likewise, low-level laser therapy has been used; although with no statistically significant results being observed for the control of pain. In the majority of published studies there was no statistically significant relationship between age and sex and the postoperative symptoms. However, greater pain and swelling is observed in patients with poor oral hygiene before surgery, and higher pain in patients who smoke, and in those with pain before surgery. Surgery of anterior teeth and molars is associated with greater pain.