Comparing patient-reported outcome measures among 3 methods of dental implant placement

Abstract

The purpose of this study was to compare patient-reported outcome measures including post-operative pain, swelling, patient's expectation and satisfaction among 3 techniques of dental implant placement including a) conventional freehand, b) dynamic, and c) static Computer-Aided Implant Surgery. Ninety patients were randomly assigned to receive dental implant placement with one of the 3 protocols. Participants were asked to fill in a series of self-administered questionnaires assessing 1) pre-operative expectations, 2) post-operative healing events during the first week after surgery, and 3) overall satisfaction with the procedures at two weeks. Eighty-eight patients completed the study, 2 patients in dynamic CAIS group who failed to follow-up were excluded. Comparing among 3 groups, patients’ expectation on the duration of post-operative chewing difficulty was significantly different (p=0.04). Their experiences of the duration of post-operative pain, speaking limitations, and impact on routine activities were significantly different among 3 groups (p=0.01, 0.038, and 0.046, respectively, Kruskal Wallis test). Overall, the duration of post-operative pain and swelling was longer than they expected (p=0.035 and 0.001, respectively, Wilcoxon signed rank test). Nevertheless, no significant difference in magnitude of post-operative pain, swelling, and painkiller consumption was found among the groups. The short-term functional limitations after surgery were deemed acceptable by most participants and 89% were satisfied by the overall procedure. In conclusion, surgical placements of dental implant with conventional freehand, static, and dynamic computer-aided techniques did not result in any difference in the level of post-operative pain and swelling. All techniques appeared to lead to equal levels of satisfaction as expressed by the patients post-operatively. However, the expectation of the duration of chewing difficulty, as well as the experience of pain duration, speaking difficulty and inability to conduct daily routine activities after surgery were significantly different among groups. Patients appeared to significantly underestimate the duration of post-operative pain and swelling.