Postoperative expectation for a necrotic tooth after endodontic treatment includes the possibility of:

• A. Tender to touch and biting; achy for up to 1 week.
• B. Most patients feel better after treatment.
• C. Swelling may develop if it hasn't already.
• D. May get worse before it gets better.

Answer: (C)

Postoperative swelling is a recognized possibility after endodontic treatment of a necrotic tooth because the infection and inflammatory mediators in the periapical tissues provoke edema as the tissues respond to instrumentation and irrigation. Even if there isn’t swelling before treatment, edema can develop afterward, typically within the first 24 to 72 hours, and often settles with appropriate analgesia and anti-inflammatory therapy. This outcome is more consistently expected than a uniform improvement in all patients or a necessary worsening before improvement; pain and healing vary, but swelling remains a common potential postoperative event in necrotic cases.