*Article* **Factors Affecting the Outcome of Periapical Surgery; a Prospective Longitudinal Clinical Study**

**Muhammad Adeel Ahmed 1,2,\* , Nouman Mughal 3,4, Syed Hani Abidi <sup>4</sup> , Muhammad Furqan Bari 5, Mohammed Mustafa 6, Fahim Vohra 7,8 and Ali Alrahlah 8,9**


**Abstract:** Wound healing following periapical surgery is influenced by age, gender, smoking, periapical lesion size, type of root-end filling, method of root-end cavity preparation and the use of microsurgical or conventional technique. This study aimed to evaluate the influence of various preoperative factors such as age, gender, smoking, preoperative pain, and preoperative periapical lesion size on the outcome of surgical endodontic treatment. A thorough history, examination, and investigation were performed to establish patient age, gender, smoking status, periapical lesion size, and the presence of preoperative pain. Forty patients aged between 15–57 years presented with persistent chronic apical periodontitis of single-rooted anterior teeth after conventional re-root canal treatment were enrolled for periapical surgery. Following periapical surgery, all patients were recalled for evaluation of periapical healing after 12 months based on clinical and periapical X-ray examination due to inaccessibility of an advanced imaging system (CBCT). Chi-squared and Fisher's exact test were applied, which revealed a statistically significant association of periapical healing with age (*p* = 0.025), smoking (*p* = 0.029), and lesion size (*p* < 0.001). Although, the success of periapical healing was higher in males 78.6% (22/28) compared to females 58.3% (7/12) however, no statistically significant relationship was found between gender and healing (*p* = 0.254). Patient age, smoking status, and size of the preoperative lesion had a strong influence on periapical healing after surgical endodontic treatment.

**Keywords:** periapical surgery; surgical endodontic treatment; preoperative factors; prospective study
