Quality of life after microscopic periradicular surgery using two different incision techniques: a randomized clinical study.
OBJECTIVE
To monitor the quality of life of patients after periradicular surgery when two different flap designs were used.


METHODS
Forty patients with teeth having a periradicular lesion of endodontic origin were included according to specific selection criteria. Patients were randomly assigned to two groups. In one group a sulcular incision (SI) with complete papilla mobilization was made, and in the other group a papilla-base incision (PBI) was used. Periradicular surgery was performed using a surgical microscope. Parameters related to life quality were recorded daily in the first week post-surgery using a questionnaire. Pain was evaluated with a 0-100 visual analog scale (VAS). Other symptoms (swelling, bleeding and nausea), plus functions (chewing, speaking, sleeping, daily routine and work) were assessed using a five-point scale. Analgesic intake was recorded. Fisher's test and unpaired t-test were used to assess the difference between groups.


RESULTS
The VAS score for pain, and the scores for swelling, chewing and phonetic impairment, peaked on days 1 and 2 postoperatively. A significant difference in favour of the PBI group was found for chewing and swelling in the first 4 days. Starting from day 3 post-surgery, the PBI group reported a significantly more rapid decrease in pain levels and analgesics use than the SI group (P < 0.05). The other parameters were similar in the two groups.


CONCLUSIONS
The papilla-base incision technique may be preferred as reduction of pain levels, swelling and drug intake were more rapid in the first week postoperatively compared with cases in which a sulcular incision was used.
Del Fabbro
M
M
Department of Health Technologies, IRCCS Istituto Ortopedico Galeazzi, University of Milan, Milan, Italy. massimo.delfabbro@unimi.it
Taschieri
S
S
Weinstein
R
R
D000203:Activities of Daily Living; D000328:Adult; D001047:Apicoectomy; D004487:Edema; D005260:Female; D006801:Humans; D008297:Male; D008409:Mastication; D008866:Microsurgery / Q000379:methods; D008875:Middle Aged; D019647:Oral Surgical Procedures / Q000379:methods*; D010147:Pain Measurement; D010485:Periapical Periodontitis / Q000523:psychology* / Q000601:surgery*; D011788:Quality of Life; D012184:Retrograde Obturation; D013060:Speech; D013524:Surgical Flaps; D011795:Surveys and Questionnaires; D055815:Young Adult