01 September 2020

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Treatment of peri-implantitis: evaluation of post-operative pain

Lara Figini

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Implant treatment has become a popular option for patients who have lost one or more teeth. As a result of this, more implant related infections occur. Periimplantitis has been defined as an inflammatory reaction associated with bone loss around a functioning implant. The treatment of peri-implantitis involves non-surgical treatments that precede surgical treatments.
 At the moment there is no literature information on post-operative pain and discomfort caused by the treatment of peri-implantitis. Improved knowledge of pain and discomfort after peri-implant treatment will provide patients and operators with valuable information.  

Materials and Methods
In a clinical study, published on Acta Odontologica Scandinavica on Nov / Dec 2019, the authors assessed the intensity and quality of pain after non-surgical and surgical treatment of peri-implantitis. A total of 30 patients with a diagnosis of peri-implantitis were included in the study. The patients registered pain using a VAS scale after non-surgical and surgical treatment of periimplantitis. The data were registered for one week after each treatment. The patients also recorded quality of pain and if analgesics were taken. Factors included in the study were number of implants, severity of peri-implantitis (millimetre bone loss at most severely affected implant), implant localization, smoking and gender.  

Results  
Statistically significant difference in intensity of pain was found between day zero and day one for both non-surgical and surgical treatment of peri-implantitis (p<.05). Number of implants, severity of peri-implantitis, implant localization, smoking and gender were not statistically significant related to intensity of pain post-treatment. The most frequently reported quality of pain was throbbing/ soreness and numbness for both non-surgical and surgical treatment.  

Conclusions  
From the data of this study, which must be confirmed in other similar studies, it can be concluded that the pain levels are low to moderate for most patients after the treatment of peri-implantitis. Pain is most pronounced in the first two days after treatment. Throbbing/soreness and numbness were the most frequently reported quality of pain.    

Clinical implications  
Because in this study there was no standardized regiment for the use of analgesics, this might have influenced the perception of pain and the use of analgesics. A potential carryover effect on the next day must be considered. As expected, more pain relievers are taken after surgical treatment than non-surgical treatment.

For additional information:  Pain and morbidity after non-surgical and surgical treatment of peri-implantitis