Lucrezia Paterno Holtzman1,*; Mario Romandini2,3; Francesco Ferrarotti4; Andreina Laforì5,6; Giacomo Baima4; Ignacio Pedrinaci7; Mario Aimetti4; Mariano Sanz3,7; Luca Cordaro1

1Periodontology and Prosthodontics, Ospedale Odontoiatrico G. Eastman, "Umberto I" University Policlinic, Roma, Italy; 2Section of Graduate Periodontology, University Complutense; 3ETEP Research Group, Complutense University, Madrid, Spain; 4Department of Surgical Sciences, C.I.R Dental School, University of Turin, Turin; 5Periodontology and Prosthodontics, Ospedale Odontoiatrico G. Eastman, Roma, Italy; 6Division of Fixed Prosthodontics and Biomaterials, Clinic of Dental Medicine, University of Geneva, Geneva, Switzerland; 7Section of Graduate Periodontology, Complutense University, Madrid, Spain

Background: Surgical intervention of peri-implantitis is a commonly performed treatment for moderate/severe peri-implantitis and yields predictable results. Patient-reported outcome measures (PROMs) are gaining importance among the outcomes of interventional trials, however to date they have never been collected or investigated in the context of the surgical treatment of peri-implantitis.

Aim/Hypothesis: The aim of the present study is to describe the PROMs collected during and after the surgical treatment of moderate/severe peri-implantitis. The hypothesis is that the type of nonsurgical instrumentation completed before surgery will not influence the patient’s perception of the surgical procedure.

Material and Methods: The present study is a sub-analysis of a multicenter, randomized controlled clinical trial with a 12-month follow-up. Forty-two patients with moderate/severe peri-implantitis underwent surgical therapy of the affected implants previously treated by supra- and submucosal instrumentation (control group) or supramucosal instrumentation alone (test group). PROMs were collected at different time-points after surgery on 100 mm VAS scales. Perceived post-operative pain, swelling, bleeding and overall discomfort during surgery were recorded by the patients at the following time-points: immediately after surgery, 4-, 8-, 12- hours post-operatively and 1-, 2-, 3-, 4-, 5-, 6-, 7- and 14 days after the procedure. Patient perception of surgery was collected at a single time-point immediately after surgery. The number of analgesic tablets (paracetamol 500 mg) taken from days 0 to 7 post-surgery was recorded. Patients allergic to paracetamol were prescribed another appropriate analgesic.

Results: The average discomfort during surgery perceived by the patient was 31.70 ± 22.35. Pain immediately after surgery was 26.95 ± 19.88 on average and tended to increase after 4- and 8 hours (30.81 ± 22.12 and 33.04 ± 25.09, respectively). Average pain scores reached a minimum at 14 days (3.88 ± 8.08). Average swelling was 28.32 ± 19.52 immediately after surgery, increased to 29.98 ± 21.85 at 12 hours post-op and gradually decreased until day 14 (3.53 ± 7.80). Perceived bleeding was highest immediately after surgery (19.24 ± 16.56) and decreased steadily until day 14 (2.56 ± 7.41). Average paracetamol intake decreased steadily from day 0 (1.17 ± 1.09) until day 14 (0.34 ± 1.32), and 63.41% of patients took at least one tablet. Differences between groups (supramucosal alone versus supramucosal combined with submucosal) were not significant for the evaluated parameters at any of the time-points considered.

Conclusion and Clinical implications: The present study is the first to investigate PROMs in surgical treatment of moderate/severe peri-implantitis to the authors’ knowledge. Results suggest that perceived pain, swelling and bleeding are mild during the first 12 hours and can be controlled with one analgesic tablet on average. Symptoms decrease further in the following days. Additionally, the type of non-surgical instrumentation does not affect the patient’s perception of surgical treatment of peri-implantitis.

Disclosure of Interest: None Declared

Keywords: clinical studies/trials, patient satisfaction, peri-implantitis