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.