Clinical signs, symptoms, perceptions, and impact on quality of life in patients suffering from peri-implant diseases: a university-representative cross-sectional study

Abstract

Objectives: To study the symptoms and perception reported by patients with peri-implant diseases, as well as their signs and their potential impact on the oral health quality of life.

Material and methods: Two hundred and forty randomly selected patients were invited to participate. As part of the history assessment, the patient OHIP-14Sp was evaluated together with, for each implant, the patient perception regarding the peri-implant health status and the history of pain, spontaneous discomfort, bleeding, suppuration, swelling, and discomfort during brushing. As part of the clinical examination, the following potential signs of peri-implant diseases were collected: probing pocket depth (PPD), mucosal dehiscence (MD), extent of BoP, presence of SoP, and visual signs of redness and swelling. Those parameters were analyzed in relation to the actual peri-implant health diagnosis.

Results: Ninety-nine patients with a total of 458 dental implants were studied. Even in case of peri-implantitis, 88.9% of the implants were perceived by the patients as healthy. The total OHIP-14Sp sum score did not differ in relation to the peri-implant health diagnosis. Increased reports of spontaneous discomfort, bleeding, swelling, and discomfort during brushing were observed in presence of disease. However, only a minor proportion of implants with peri-implant diseases presented symptoms. PPD ≥ 6 mm was more frequent in diseased than in healthy implants (p < .01), while PPD ≥ 8 in pre-peri-implantitis/peri-implantitis than in healthy/mucositis implants (p < .01). Implants with peri-implantitis showed higher MD than implants without peri-implantitis (p < .01).

Conclusion: Peri-implant diseases are in most cases asymptomatic and not perceived by the patients. Despite being unable to accurately discriminate between peri-implant mucositis and peri-implantitis, PPD and MD resulted as the only two clinical signs associated with pre-peri-implantitis/peri-implantitis.

Keywords: OHRQoL; Oral Health Impact Profile-14; biological complications; bleeding; cross-sectional studies; dental implants; dental prosthesis; diagnosis; discomfort; epidemiology; implant failure; implant loss; pain; peri-implantitis; periodontal diseases; quality of life; redness; signs; suppuration; swelling; university-based.