Patients’ perception of peri‐implantitis and its treatment – a pilot study

Abstract

Background : Replacing missing teeth with dental implants have a positive impact on the patient ' s quality of life. Most patients are satisfied with the aesthetic result and experience an improved ability to chew. Patients developing peri-implantitis are at risk of losing their implants, which can affect their physical and mental well-being. There are a limited amount of studies looking into patients experiences of the disease as well as its treatment. Aim/Hypothesis : The aim of this study was to gain a deeper understanding of patients' perceptions of the peri-implantitis disease and its treatment with either laser or conventional mucosal flap surgery. Materials and Methods : This qualitative study was based on semi-structured interviews with participants undergoing treatment for periimplantitis with either laser or conventional mucosal flap surgery. The study population was recruited from a specialist clinic in Stockholm. The interview guide had questions within three different themes: living with dental implants, how the disease peri-implantitis affects daily life, and how the patients experience the different treatment methods. The recorded interviews were transcribed and analysed with qualitative content analysis of the manifest and latent content. The patients also graded their pain and discomfort (no to maximum, 0-100) on a visual analogue scale (VAS) at the initial clinical examination, after the treatment and one week after treatment. Comparison between the interview answers and VAS scores was done with a mixed methods approach. Results : 11 women, mean age 65.9 (SD 15.6) years, were included in this pilot study. 6 received laser treatment while 5 underwent conventional flap surgery. Few symptoms of the peri-implantitis disease were expressed, but some expressed a feeling of pounding and some soreness in the area around the implant. This was reflected in their initial VAS discomfort which was between 15-51, whereas those that had not noticed the disease reported 0-3. In the laser group when asked to compare that treatment with their recollection of previous surgical treatments, e.g. of periodontitis, they expressed that the laser caused less discomfort during the first week of healing. The laser group graded their discomfort as a mean of 10.1 (SD 12.4), and the surgery group graded 30.8 (SD 28.6), which was nearly significant with a P-value of 0.55 (Mann-Whitney U-test). Conclusions and Clinical Implications : Within the limitations of this pilot study, it can be concluded that it is important to consider the patient ' s experience of peri-implantitis and its treatment as it seems to vary greatly on an individual basis. Further studies are needed to assess the clinical effects of laser treatment and confirm the finding of less post-treatment discomfort.