Evaluation of clinical and serological responses after post full mouth implantation in single visit versus multiple visit

Abstract

Background and purpose: It is important to control the inflammation around dental implants in order to reduce the amount of bone loss around the implant, maintain health of the surrounding soft tissue and increase the efficiency and life of dental implants. Extracting teeth with a poor prognosis and placing implants in one session cleans the mouth from bacteria, reduces the possibility of infection, and reduces trauma and stress to the patient compared to surgery in several sessions. The purpose of this research is to evaluate the clinical characteristics of pain and wound healing and serological inflammatory markers in the placement of a full oral implant in one session compared to several sessions. Materials and methods: The present study was conducted as a single-blind clinical trial on 20 patients (10 people in each group) referred to Tabriz Dental School of Medical Sciences to receive full oral implants. Written consent was obtained from the patients and then they were randomly divided into two groups. Surgery was performed in the first group of patients under anesthesia in the operating room and in the second group in the surgery department of the faculty. Evaluation of the level of inflammation through the inflammatory biomarkers WBC and serum CRP was done one day before the implant surgery and 48 hours and then 7 days after the implant surgery through the blood test of the patients in both groups. Evaluation of pain was done at 24 hours, 48 hours and 7 days after implantation with analog scale (VAS) and assessment of early wound healing was conducted through three indicators (clinical signs of re-epithelialization (CSR), hemostasis (CSH) and inflammation (CSI) ). Comparison of serological data in two groups was done by Repeated Measures ANOVA and sidak test, and comparison of clinical indicators was done by U-Man-Whitney test using SPSS.20 software. Results: The level of serum CRP 48 hours after treatment was not different in multi-session surgery compared to one session; however, 7 days after treatment, it was more in multi-session surgery than single session. The amount of WBC at 48 hours and 7 days after treatment was not different in multi-session surgery compared to single session. Serum levels of WBC and CRP increased 48 hours after surgery and gradually decreased until 7 days later. Wound healing index (hemostasis, inflammation and re-epithelialization) showed no difference between the two groups in the three investigated time periods. The amount of VAS index at 24 hours, 48 hours and 7 days after treatment was higher in multi-session surgery than in one session. In both surgical methods, the amount of pain was not different at 24 hours and 48 hours after the treatment and gradually decreased over 7 days. Conclusion: The amount of serum inflammatory marker (CRP) and patient pain in implant surgery during several sessions are more than patients who undergo surgery during one session. Considering that the index of wound healing is the same in both groups, the surgery of patients without teeth or patients who receive more than one implant unit causes less inflammation and pain during one session than several sessions.