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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). Participants of group A felt significantly more pain from the first day and more swelling from the third day after implantation than participants of group B. The individual perception of interventions showed no significant differences between groups.

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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Acknowledgments

The study is funded by Deutsche Forschungsgemeinschaft (German research foundation, KE 477/8-1). We thank all co-workers in the study centres that supported this study by treating patients, special thanks to Michael Becker (Greifswald), Martin Sasse (Kiel), Franz Sebastian Schwindling (Heidelberg), Samir Abou-Ayash (Freiburg), and Thomas Kern (Aachen).

Author information

Authors and Affiliations

  1. Department of Prosthodontics, Gerodontology and Biomaterials, Greifswald University Hospital, Rotgerberstrasse 8, 17475, Greifswald, Germany

    T. Mundt

  2. Department of Prosthodontics, Propaedeutics and Dental Materials, Christian-Albrechts University of Kiel, Kiel, Germany

    N. Passia & M. Kern

  3. Department of Prosthodontics, Freiburg University Hospital, Freiburg, Germany

    W. Att

  4. Department of Dental Prosthetics, Center for Dental and Oral Medicine, University Medical Center Hamburg Eppendorf, Hamburg, Germany

    G. Heydecke

  5. Center for Clinical Studies and Institute of Medical Informatics and Statistics, Christian-Albrechts University of Kiel, Kiel, Germany

    S. Freitag-Wolf

  6. Department of Prosthetic Dentistry, Center of Dentistry, Ulm University Hospital, Ulm, Germany

    R. G. Luthardt

  7. Department of Prosthodontics, Heidelberg University Hospital, Heidelberg, Germany

    S. Kappel

  8. Department of Prosthetic Dentistry, Medical Faculty Carl Gustav Carus, Dresden University of Technology, Dresden, Germany

    I. K. Konstantinidis

  9. Department of Prosthodontics, University Hospital Hannover, Hannover, Germany

    M. Stiesch

  10. Department of Prosthodontics and Biomaterials, University Hospital Aachen, Aachen, Germany

    S. Wolfart

Authors
  1. T. Mundt
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  2. N. Passia
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  3. W. Att
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  4. G. Heydecke
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  5. S. Freitag-Wolf
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  6. R. G. Luthardt
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  7. S. Kappel
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  8. I. K. Konstantinidis
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  9. M. Stiesch
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  10. S. Wolfart
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  11. M. Kern
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Corresponding author

Correspondence to T. Mundt.

Ethics declarations

Conflict of interest

S. Wolfart received grants, personal fees, and non-financial support from the Camlog Foundation. The other authors declare that they have no conflict of interest.

Funding

The study is funded by Deutsche Forschungsgemeinschaft (German research foundation, KE 477/8-1).

Ethical approval

All procedures performed in this study were conducted in accordance with the ethical standards of the Ethics Commission of the University Hospital Schleswig-Holstein, UKSH (AZ 138/12), with the Ethics Commissions of all other participating centres, and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Mundt, T., Passia, N., Att, W. et al. Pain and discomfort following immediate and delayed loading by overdentures in the single mandibular implant study (SMIS). Clin Oral Invest 21, 635–642 (2017). https://doi.org/10.1007/s00784-016-1930-0

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  • DOI: https://doi.org/10.1007/s00784-016-1930-0

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