Pain and discomfort following immediate and delayed loading by overdentures in the single mandibular implant study (SMIS)
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Abstract
Objectives
This randomized
clinical trial compares immediate and delayed loading of single implants
to support mandibular overdentures. The aim of this preliminary
analysis is to test the hypothesis whether patients with immediate
loading will experience less pain and discomfort through the
intervention than patients with delayed loading.
Materials and methods
Edentulous patients
in nine German dental schools received a midline implant with a length
of 11 mm. Implants with a minimum insertion torque of 30 Ncm and an
implant stability quotient of ≥60 were randomly allocated to group A for
immediate loading using ball attachments or to group B for delayed
loading after 3 months. Patients completed questionnaires with 100-mm
visual analogue scales about the items pain, pain during chewing,
swelling, bleeding, and perception of the intervention at the day of
surgery and 1, 2, 3, and 7 days, thereafter. Groups were compared by
Wilcoxon–Mann–Whitney tests (P ≤ 0.05).
Results
The questionnaires
of 81 patients in group A and 74 patients in group B were completed. The
medians for pain and discomfort were moderate (<30 a="" after="" and="" b.="" between="" day="" differences="" felt="" first="" from="" group="" groups.="" implantation="" individual="" interventions="" more="" no="" of="" p="" pain="" participants="" perception="" showed="" significant="" significantly="" swelling="" than="" the="" third="">
Conclusions
Immediate loading evoked more postoperative pain and swelling than the two stages of delayed loading.
Clinical relevance
Immediate loading of a single mandibular midline implant supporting overdentures should be carefully considered.
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