Abstract
During the coronavirus disease 2019 (COVID-19) pandemic, aerosol-generating procedures, including dental implant treatments, are considered high-risk. With dental implant treatment mostly an elective procedure, we aimed to assess whether the pandemic influenced patient selection, surgical procedures, and postoperative complications. We compared dental implant treatments during (March to December 2020) and before (December 2018 to February 2020) the COVID-19 pandemic based on patient and implant parameters, as well as postoperative complications. For analysis, we used the Chi-squared test with the Holm–Sidak correction for multiple comparisons. The number of implants placed during the COVID-19 pandemic (696 implants in 406 patients, 70 implants per month) was comparable to pre-pandemic levels (1204 implants in 616 patients, 80 implants per month). Regarding patient parameters, there were no significant differences in respiratory (p = 0.69) and cardiovascular conditions (p = 0.06), diabetes (p = 0.69), and smoking (p = 0.68). Regarding implant parameters, there was a significant difference in the distribution of augmentative procedures (no augmentation, guided bone regeneration, and sinus floor elevation, p = 0.01), but no significant differences in the types of edentulous spaces (p = 0.19) and the timing of implant placement (p = 0.52). Regarding complications, there were significantly fewer minor complications (p < 0.001) and early (i.e., before loading) implant failures (p = 0.02) compared with pre-pandemic levels. Our results suggest that the COVID-19 pandemic had no effect on patient selection and only a slight effect on the surgical procedures. However, postoperative complications, including early failures, were significantly less prevalent during the pandemic.
Highlights
The aim of this study was to retrospectively assess whether the COVID-19 pandemic had an effect on patient selection, surgical procedures, and postoperative complications
We studied dental implant treatments during the COVID-19 pandemic and compared them to a pre-pandemic control population with regards to patient and implant factors as well as postoperative complications
Our data suggested a significant difference in the use of bone augmentation but no differences between the types of edentulous spaces as well as timing of implant placements performed during and before the pandemic
Summary
The airborne transmission of severe acute respiratory syndrome coronavirus 2 (SARSCoV-2), the RNA virus that causes coronavirus disease 2019 (COVID-19), poses a considerable challenge in the dental setting, where patients are unable to wear masks or other facial barriers while in close contact to the personnel providing care [1]. Aerosol-generating procedures, including dental implant placement, are generally considered high-risk as they can produce and spread contaminated droplets [2–5]. Surface contamination through these droplets is substantial at close proximity and still detectable at a maximum distance of 4 m from the source [6]. Multiple guidelines have recommended prioritizing no-aerosol over aerosol-generating procedures (e.g., using manual over rotary or ultrasonic instruments [1]) or postponing aerosol-generating procedures of potentially infectious patients or patients at an increased risk for COVID-19 entirely, especially if these procedures are elective [7–10]
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