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COMPARISON OF PATIENT-CENTERED OUTCOMES AFTER ROUTINE IMPLANT PLACEMENT, TEETH EXTRACTION, AND PERIODONTAL SURGICAL PROCEDURES

Dr Farheen Iqbal, Dr Sarwat Ali, Dr Hafiz Muhammad Ummad

Objectives: To compare patient-centered outcome assessments (POAs) over a 2-week period after five categories of dento-alveolar surgical procedures. Place of Study: Medina Teaching Hospital Faisalabad, Pakistan. Methods: A total of 339 patients in need of dento-alveolar surgical procedures such as simple tooth extraction (SE), trans alveolar extraction (TE), straight forward implant placement (I), implant placement with guided bone regeneration (IGBR), and periodontal surgery (P) dental clinic were consecutively recruited. POAs in terms of bleeding, swelling, pain, and bruising were obtained using 10 cm visual analog scale (VAS) on each day of the first week and the 14th day post-surgery. Clinical examinations were recorded on the 7th day post operation. Results: For the first 3 days of healing, area-under-the-curve (AUC) analyses showed that transalveolar extraction (TE) resulted in significantly higher overall bleeding and pain (AUC: Bleeding Mean = 5.6, Pain Mean = 7.5). However, implant placement with GBR (IGBR) resulted in significant higher level of swelling (AUC: Mean = 9.1) and bruising (Mean = 4.2) for the same period with also the highest use of painkillers. Healing outcomes of straightforward implant placement (I) were comparable to that of a simple extraction (SE). Two-week overall experience showed the symptoms quickly subsided for all groups. Prevalence for complications 1 week postoperatively was IGBR (20%), P (15.6%), I (12.7%), SE (4.8%), TE (1.5%), respectively. Conclusions: The highest extent of swelling and bruising was observed in patients who got implant placement with GBR (IGBR), while healing events of straightforward implants were similar to these of simple extraction. The VAS scores for all POAs parameters were generally low and decreased to nearly zero over the study period following all five surgical procedures. Low prevalence of postsurgical complications was reported. Keywords: Dento-alveolar, trans alveolar extraction, implant placement, periodontal surgery.

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