Implant placement-associated tissue swelling: a digital three-dimensional and patient-based assessment.

Abstract

Objectives: There is scarce evidence on immediate soft tissue and patient-reported outcome measures (PROMs) following implant surgery. This prospective study aimed to quantify post-implant placement intraoral swelling and to correlate it with PROMs.

Materials and methods: Twenty-six patients undergoing standardized single implant placement (two-stage protocol) were recruited. Soft tissue swelling was recorded by intraoral scans immediately pre-surgery (PS) and post-operatively (IP), and at 2 (2d), 7 (7d) and 14 days (14d) and 2 months (2 m). Ridge width, height, and volume changes from IP were recorded. PROMs (pain, swelling, difficulty of mouth opening, and OHIP-14) were recorded pre- and post-operatively.

Results: Ridge width (1.9±0.04 mm), height (1.4 ±0.02 mm) and volume (37.8±0.8%) peaked on 2d (p < 0.0001 vs. IP for all). Width returned to IP levels by 7d (p = 0.43; 7d vs. IP), and height and volume between 14d and 2 m (p≤0.002; all time points vs. IP). Patient-reported pain, swelling and difficulty of mouth opening exhibited a similar trajectory, while OHIP-14 values improved until 2 m (p < 0.0001 vs. PS). Ridge width differences IP/2d were correlated with patient-reported swelling (ρ = 0.53-0.54) and difficulty of mouth opening (ρ = 0.43-0.45) at 2d.

Conclusion: Following implant placement, soft tissue exhibits maximal swelling at 2 days and patients experience the most significant pain, swelling and difficulty of mouth opening at the same time.

Clinical relevance: The swelling timing and magnitude findings of the present study may assist clinicians when delivering and modifying temporary restorations (safety distance between restoration/tissue), as well as managing patient pain and swelling expectations following implant placement surgery.