Objective  To explore the related risk factors for poor healing after periapical cyst surgery.

Methods  A case-control study design was adopted. The study subjects were patients who underwent periapical cyst surgery in the Department of Stomatology of Zhuhai People's Hospital (The Affiliated Zhuhai Hospital of Jinan University) from October 1, 2017 to October 1, 2023. Patients were divided into the case group (poor healing) and the control group (good healing) based on their healing conditions. The preoperative imaging data, buccolingual bone wall defects, cyst volume size, and related clinical data of the patients were collected. The predictive variables were age, smoking history, cyst volume, bone wall defect, preoperative infection, and lesion location. The outcome variables was the healing condition (good or poor).

Results  A total of 124 patients were finally included, with 20 cases in the case group and 104 cases in the control group. The results of multivariate Logistic regression analysis showed that middle-aged and elderly individuals (age > 40 years old) [OR=4.636, 95%CI (1.298, 16.558), P=0.018], bone wall defects greater than 2 cm [OR=8.149, 95%CI (1.604, 41.392), P=0.011], perforated bone wall defects [OR=6.301, 95%CI (1.581, 25.116), P=0.009], large cysts (cyst diameter greater than 1.5 cm) [OR=5.836, 95%CI (1.154, 29.516), P=0.033], and smoking history [OR=4.327, 95%CI (1.089, 17.198), P=0.037] were risk factors for poor healing after periapical cyst surgery.

Conclusion  A buccal and lingual single-sided bone wall defect larger than 2 cm and perforated bone wall defects on the buccal lingual side are risk factors for poor healing after periapical cyst surgery. Cyst volume, age and smoking history also have certain effects on the healing of periapical cyst.

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