Assessment of pain perception following periodontal and implant surgeries

Abstract

Objective: To evaluate patients' pain perception following periodontal or implant surgery and to explore risk factors associated with post-surgical pain.

Materials and methods: Patients undergoing periodontal or implant surgery were recruited. Post-surgical pain perception was evaluated by a numeric rating scale (NRS, 1-10) after 1 week. Self-reported durations of pain (DOP) and of swelling (DOS), and consumption of prescriptions were also recorded. Demographic and surgical variables were compared between the groups of mild (MP) and moderate-to-severe post-surgical pain (SP). Factors associated with SP were analysed statistically.

Results: Ten surgical types in three categories, comprising 330 surgeries in 253 patients, were included. Overall, 70.3% of the subjects experienced MP, 25.5% experienced moderate pain and 4.2% experienced severe pain. The highest median NRS score was found in subjects having advanced implant surgery [4.0, interquartile range (IQR) 4.00] and the lowest in open flap debridement surgery (1.0, IQR 1.00). The median DOP was 2.0 days (IQR 2.00). Analgesic need (median = 2.0 days, IQR 4.00) was correlated with the DOP (r = 0.406, p < 0.01) and the NRS score (r = 0.358, p < 0.01). Subjects receiving periodontal plastic surgery (OR = 3.20, 95% CI = 1.06-9.71), complex surgery (OR = 2.63, 95% CI = 1.31-5.25), increased surgical extension (OR = 1.78, 95% CI = 1.21-2.62) and increased anaesthesia (OR = 2.32, 95% CI = 1.13-4.76) were more likely to experience SP.

Conclusions: The majority of patients perceived mild post-surgical pain, but the pain level varied among different surgical procedures. Periodontal plastic surgery, complex surgery, surgical extension and anaesthetic volume were associated with more pain.

Keywords: analgesic; dental implant treatment; numeric pain scale; pain; periodontal surgery.