title: Pain and discomfort following immediate and delayed loading by overdentures in the single mandibular implant study (SMIS).
abstract: OBJECTIVE
  This randomized clinical trial compares immediate and delayed loading of single implants to support mandibular overdentures. The aim of this preliminary analysis is to test the hypothesis whether patients with immediate loading will experience less pain and discomfort through the intervention than patients with delayed loading.
  
  
  METHODS
  Edentulous patients in nine German dental schools received a midline implant with a length of 11 mm. Implants with a minimum insertion torque of 30 Ncm and an implant stability quotient of ≥60 were randomly allocated to group A for immediate loading using ball attachments or to group B for delayed loading after 3 months. Patients completed questionnaires with 100-mm visual analogue scales about the items pain, pain during chewing, swelling, bleeding, and perception of the intervention at the day of surgery and 1, 2, 3, and 7 days, thereafter. Groups were compared by Wilcoxon-Mann-Whitney tests (P ≤ 0.05).
  
  
  RESULTS
  The questionnaires of 81 patients in group A and 74 patients in group B were completed. The medians for pain and discomfort were moderate (<30). Participants of group A felt significantly more pain from the first day and more swelling from the third day after implantation than participants of group B. The individual perception of interventions showed no significant differences between groups.
  
  
  CONCLUSIONS
  Immediate loading evoked more postoperative pain and swelling than the two stages of delayed loading.
  
  
  CONCLUSIONS
  Immediate loading of a single mandibular midline implant supporting overdentures should be carefully considered.
authors: Department of Prosthodontics, Gerodontology and Biomaterials, Greifswald University Hospital, Rotgerberstrasse 8, 17475, Greifswald, Germany. mundt@uni-greifswald.de.
authors: T
authors: T
authors: Mundt
authors: Department of Prosthodontics, Propaedeutics and Dental Materials, Christian-Albrechts University of Kiel, Kiel, Germany.
authors: N
authors: N
authors: Passia
authors: Department of Prosthodontics, Freiburg University Hospital, Freiburg, Germany.
authors: W
authors: W
authors: Att
authors: Department of Dental Prosthetics, Center for Dental and Oral Medicine, University Medical Center Hamburg Eppendorf, Hamburg, Germany.
authors: G
authors: G
authors: Heydecke
authors: Center for Clinical Studies and Institute of Medical Informatics and Statistics, Christian-Albrechts University of Kiel, Kiel, Germany.
authors: S
authors: S
authors: Freitag-Wolf
authors: Department of Prosthetic Dentistry, Center of Dentistry, Ulm University Hospital, Ulm, Germany.
authors: R G
authors: RG
authors: Luthardt
authors: Department of Prosthodontics, Heidelberg University Hospital, Heidelberg, Germany.
authors: S
authors: S
authors: Kappel
authors: Department of Prosthetic Dentistry, Medical Faculty Carl Gustav Carus, Dresden University of Technology, Dresden, Germany.
authors: I K
authors: IK
authors: Konstantinidis
authors: Department of Prosthodontics, University Hospital Hannover, Hannover, Germany.
authors: M
authors: M
authors: Stiesch
authors: Department of Prosthodontics and Biomaterials, University Hospital Aachen, Aachen, Germany.
authors: S
authors: S
authors: Wolfart
authors: Department of Prosthodontics, Propaedeutics and Dental Materials, Christian-Albrechts University of Kiel, Kiel, Germany.
authors: M
authors: M
authors: Kern
mesh_terms: D003758:Dental Implantation, Endosseous / Q000379:methods*; D019250:Dental Implants, Single-Tooth; D019094:Dental Prosthesis, Implant-Supported; D003781:Denture Retention; D003828:Denture, Overlay; D005260:Female; D005858:Germany; D006801:Humans; D057893:Immediate Dental Implant Loading; D007575:Jaw, Edentulous / Q000534:rehabilitation; D008297:Male; D008334:Mandible; D010147:Pain Measurement
keywords: Immediate loading; Mandibular overdenture; Postoperative pain; Randomized trial; Single dental implant