Clinical signs, symptoms, perceptions and impact on quality of life of patients suffering peri-implant diseases: a university-representative cross-sectional study

Aim To study the symptoms and perception reported by patients with peri-implant diseases, as well as their signs and their potential impact on the oral health quality of life. Materials and Methods 240 randomly selected patients were invited to participate. As part of the history assessment, the patient OHIP-14Sp was evaluated together with, for each implant, the patient perception regarding the peri-implant health status and the history of pain, spontaneous discomfort, bleeding, suppuration, swelling and discomfort during brushing. As part of the clinical examination, the following potential signs of peri-implant diseases were collected: probing pocket depth (PPD), mucosal dehiscence (MD), extent of BoP, presence of SoP, and visual signs of redness and swelling. Those parameters were analyzed in relation to the actual peri-implant health diagnosis. Results 99 patients with a total of 458 dental implants were studied. Even in case of peri-implantitis, 88.89% of the implants were perceived by the patients as healthy. The total OHIP-14Sp sum score did not differ in relation to the peri-implant health diagnosis. Increased reports of spontaneous discomfort, bleeding, swelling and discomfort during brushing were observed in presence of disease. However, only a minor proportion of implants with peri-implant diseases presented symptoms. PPD≥6 mm was more frequent in diseased than in healthy implants(p<0.01), while PPD≥8 in pre-periimplantitis/peri-implantitis than in healthy/mucositis implants(p<0.01). Implants with peri-implantitis showed higher MD than implants without peri-implantitis(p<0.01). Conclusions Peri-implant diseases are in most cases asymptomatic and not perceived by the patients. Despite being unable to accurately discriminate between peri-implant mucositis and peri-implantitis, PPD and MD resulted as the only two clinical signs associated with pre-periimplantitis/peri-implantitis.