Implant placement-associated tissue swelling: a digital three-dimensional and patient-based assessment

There is scarce evidence on immediate soft tissue and patient-reported outcome measures (PROMs) following implant surgery. This prospective study aimed to quantify post-implant placement intraoral swelling and to correlate it with PROMs.

Twenty-six patients undergoing standardized single implant placement (two-stage protocol) were recruited. Soft tissue swelling was recorded by intraoral scans immediately pre-surgery (PS) and post-operatively (IP), and at 2 (2d), 7 (7d) and 14 days (14d) and 2 months (2 m). Ridge width, height, and volume changes from IP were recorded. PROMs (pain, swelling, difficulty of mouth opening, and OHIP-14) were recorded pre- and post-operatively.

Ridge width (1.9±0.04 mm), height (1.4 ±0.02 mm) and volume (37.8±0.8%) peaked on 2d (p < 0.0001 vs. IP for all). Width returned to IP levels by 7d (p = 0.43; 7d vs. IP), and height and volume between 14d and 2 m (p≤0.002; all time points vs. IP). Patient-reported pain, swelling and difficulty of mouth opening exhibited a similar trajectory, while OHIP-14 values improved until 2 m (p < 0.0001 vs. PS). Ridge width differences IP/2d were correlated with patient-reported swelling (ρ = 0.53-0.54) and difficulty of mouth opening (ρ = 0.43-0.45) at 2d.

Following implant placement, soft tissue exhibits maximal swelling at 2 days and patients experience the most significant pain, swelling and difficulty of mouth opening at the same time.

The swelling timing and magnitude findings of the present study may assist clinicians when delivering and modifying temporary restorations (safety distance between restoration/tissue), as well as managing patient pain and swelling expectations following implant placement surgery.