Postoperative discomfort after implant placement according to the All-on-4 concept with or without Zygoma implants: A prospective clinical study.

Abstract

The purpose of the study was to assess patients' postoperative discomfort after implantations according to the All-on-4 concept with and without using Zygoma implants. Three treatment groups were formed for this prospective study: All-on-4 rehabilitation in the maxilla (group 1, N=25), All-on-4 rehabilitation in the maxilla using at least two Zygoma implants (group 2, N=25), and All-on-4 rehabilitation in the mandible (group 3, N=20). Principal outcome parameters were postoperative pain (100mm VAS) and perceived swelling (100mm VAS). Also, the use of analgesics was documented. The worst postoperative pain of 21.3 (SD 18.9) VAS was observed in group 2, but there was no statistically significant difference between the groups (mixed ANOVA p=.791). The postoperative total intake of painkillers was significantly higher in group 2 than in the other groups (p<.001). On postoperative day 28, the mean pain scores in all groups declined to values below 5 VAS. Postoperative perceived swelling in group 2 was significantly more severe than it was in group 1 and 3 (p<.001). The use of Zygoma implants in All-on-4 surgical interventions had an essential effect on postoperative swelling, but less so on postoperative pain. The slightly increased, but statistically not significantly different postoperative pain in group 2 was compensated by an overall higher postoperative intake of painkillers compared to the other groups.