Postoperative discomfort after implant placement according to the All-on-4 concept with or without Zygoma implants: A prospective clinical study

Objectives: The purpose of the study was to assess patients' postoperative discomfort after implantations according to the All-on-4 concept with and without using Zygoma implants. Material and methods: Three treatment groups were formed for this prospective study: All-on-4 rehabilitation in the maxilla (group 1, N = 25), All-on-4 rehabilitation in the maxilla using at least two Zygoma implants (group 2, N = 25), and All-on-4 rehabilitation in the mandible (group 3, N = 20). Principal outcome parameters were postoperative pain (100 mm VAS) and perceived swelling (100 mm VAS). Also, the use of analgesics was documented. Results: The worst postoperative pain of 21.3 (SD 18.9) VAS was observed in group 2, but there was no statistically significant difference between the groups (mixed ANOVA p = .791). The postoperative total intake of painkillers was significantly higher in group 2 than in the other groups (p < .001). On postoperative day 28, the mean pain scores in all groups declined to values below 5 VAS. Postoperative perceived swelling in group 2 was significantly more severe than it was in group 1 and 3 (p < .001). Conclusions: The use of Zygoma implants in All-on-4 surgical interventions had an essential effect on postoperative swelling, but less so on postoperative pain. The slightly increased, but statistically not significantly different postoperative pain in group 2 was compensated by an overall higher postoperative intake of painkillers compared to the other groups.