Pre surgical perception of pain, post surgical pain and its management for patients undergoing dental implant therapy

Dental treatment including implant therapy is often regarded as painful, at times depriving patients from having dental implants. The aim of this study was to assess patient perception of pain prior to implant surgery to and their actual pain felt after implant placement in a private dental office in a Pakistani population. Two hundred and eight Straumann dental implants were placed in seventy six patients. Patients were evaluated at two points, immediately prior to surgery [T1] and ten days postoperatively [T2]. A combined word descriptor, graphical and visual analogue scale was used to assess patient response. We assessed some of the major factors that may increase the perception of pain, actual pain felt and suggest methodologies to make dental implant surgery a less painful procedure. Our results add to the literature on patients having high expectations of pain prior to implant placement and little or no pain post-operatively. Females exhibited both more pre surgical perception of pain and actual perceived pain post surgical. Similar to other studies old aged patients also showed less perception of pain pre surgical and lesser pain perceived post surgical. The perception that implant dentistry is a painful procedure should be addressed to increase the percentage of acceptance of this vital treatment modality. This study co relates perception of pain prior to implant placement, to actual pain felt during and after the procedure, strengthening previous beliefs that, implant therapy should not be painful, thus increasing the overall acceptance of this treatment modality

Immediate placement and immediate provisionalization of ITI implants in maxillary non-restorable single teeth. A prelimenary report

OBJECTIVE: This prospective study was conducted to examine the outcome of Sandblasted Large Grit Acid Etched [SLA] surface, solid screw implants placed immediately into extraction sockets and loaded within one hour of implant placement to achieve immediate replacement of non-restorable single maxillary teeth. PATIENTS and METHODS: Thirty-five ITI implants in thirty-one patients were placed and immediately restored with a non-occluding provisional acrylic crown. Porcelain fused to metal crowns were cemented six weeks later. All 35 implants achieved osseointegration as demonstrated by stability and function at the placement of the final un-splinted crown. The healing process was uneventful and without adverse events. There were no reported peri-implant mucosal complications. The prosthetic procedures occurred without intervening incident of abutment loosening or fracture. DISCUSSION: Considerable advantages exist to immediate placement and provisiolanization after tooth extraction, soft tissue profiles can remain stable and alveolar bone loss can be avoided. The rationale for replacing maxillary molars is debatable. CONCLUSIONS: Immediate placement of ITI dental implants following tooth extractions and immediately provisionalized is a viable treatment option

Prosthetic management of a partially dentate patient with fixed implant restoration: a case report

The range of implant indications has been significantly widened and partially dentate patients often seek treatment with dental implants. The aim of this case report is to highlight the current prosthetic management of the partially dentate patient by means of fixed implant restorations in the scope of a Dental Implant System

Porcelain laminate veneers for establishing aesthetics. A case report

The aesthetic restoration of anterior teeth has been revolutionized by the introduction of porcelain laminate veneers. Laminate veneers are now used as conservative aesthetic alternative to full coverage restorations in some cases. This case report highlights management of spaced anterior teeth and localized discolorations with porcelain laminate veneers

Endodontic re-treatment; an analysis based on clinical findings in a private dental practice

OBJECTIVE: To report the causes and pattern of endodontic retreatment in a private dental practice. DESIGN: This was a retrospective descriptive study. PLACE AND DURATION OF STUDY: Rahman and Rahman Dental Surgeons, Karachi, Pakistan over the period of four years. MATERIALS AND METHODS: The study included sixty-two patients with eighty-nine failed endodontically treated teeth. The data for reasons of endodontic retreatment was collected on a proforma and analyzed. Radiographic evaluation revealed periapical radiolucency in majority [51.7%] of the cases. 64% were related to poor obturation while 34% reported untreated rood canal spaces. The reasons for endodontic retreatment highlighted by the study were pain, periapical radiolucency and inadequate filling of the canal space. Generally, retreatment is considered a better option as compared to endodontic surgery