Page 129 - Demo

Effect of periapical surgery on oral health-related quality of life1277surgery, previous radiation therapy to the maxillofacial region, or lack of consent to undergo the procedure or participate in the study. SurgeryThe surgery was performed by two surgeons (JT and JL). Patients received local anesthesia with 40 mg of articaine/hydrochloride and 0.01 mg epinephrine (Ultracain D-S Forte, Sanofi-Aventis Netherlands BV, Gouda, the Netherlands). The surgical technique consisted of a mid-level, rectangular or triangular, full-thickness mucoperiosteal flap. The surgical flap was reflected, and bone removed by a round burr with continuous sterile distilled water irrigation to expose the root apex. After debridement of the pathological tissue, the root was resected approximately 3 mm from the apex using a cylinder burr with minimal or no bevel. Using glasses with 5.0 magnification loupes and a PureLight Headlamp with 140 mm spot size (SL Company, London, UK), the root end was prepared using ultrasound to a 2-3 mm depth with ultrasonic retrotips (Mectron S.p.A., Carasco, Italy). Intermediate Restorative Material (IRM, Dentsply, Konstanz, Germany) was placed into a dried cavity after adequate hemostasis. Before wound closure, the bone cavity was cleaned with 10 ml of 0.9% NaCl solution (B Braun, Melsungen, Germany). The wound was closed by re-approximating the soft tissue to the original position and sutured with Vicryl 4/0 (Johnson and Johnson; Somerville, NJ) before taking final radiographs. Postoperative instructionsAfter surgery, patients were given verbal and written instructions, including information about swelling, using an ice pack for cooling the cheek to reduce swelling and pain relief, avoiding mouth rinsing and spitting, practicing caution when eating and drinking hot food and beverages and, to avoid physical activities. Patients <50 years of age with an ASA I classification were prescribed 600 mg ibuprofen (Brufen; Abbot BV, Hoofddorp, the Netherlands) three times a day postoperatively, whereas patients ≥50 years old or with an ASA II classification were prescribed 1000 mg paracetamol 3-4 per day postoperatively. No antibiotics were prescribed. The day after surgery, patients began using a 0.12% aqueous chlorhexidine mouth rinse twice a day for 1 minute for 7 days. Patients were informed to contact the surgeon if they experienced severe pain, swelling, fever, bleeding, or any concerns after surgery.