Discomfort/Pain Due to Periodontal Peri-Implant Probing in Titanium and Zirconium Implants

Objectives: To assess discomfort/pain following periodontal probing around teeth and peri-implant probing around titanium compared to zirconium implants
Methods: One examiner recruited and examined 70 patients, each of them exhibiting a dental implant with a contralateral tooth. Thirty-five patients contributed one titanium implant of various types and 35 patients a zirconium implant each. Periodontal and peri-implant probing depths (PPD) and clinical attachment level (CAL) were assessed. Whether implant or tooth was measured first was randomly assigned. Immediately after probing patients scored discomfort/pain using a visual analogue scale (VAS). The emergence profiles of implant crowns were assessed as transitional contour relative to the long axis on periapical radiographs of the implants.
Results: Seventy patients (age 70; 42/65 years [median; lower/upper quartile]; 43 females, 16 current smokers) were examined. Except for mean PPD and BOP (p < 0.001) clinical parameters (PPD, CAL, bleeding on probing, suppuration) were well balanced between implants and teeth. Peri-implant probing (VAS: 12.5; 4/22) caused significantly (p < 0.001) more discomfort/pain than periodontal probing (9; 2/15). Logistic regression analysis identified smaller differences of discomfort/pain between periodontal and peri-implant probing under analgesic medication (p = 0.135) and with many sites with BOP in corresponding teeth (p = 0.093). Comparing discomfort/pain between implants analgesic medication (p = 0.010), titanium (p = 0.031), emergence profile (p = 0.055) and smoking (p = 0.095) were negatively associated with discomfort/pain.
Conclusions: Peri-implant probing caused significantly more discomfort/pain than periodontal probing. After analgesic medication (p = 0.010) and in titanium compared to zirconium implants (p = 0.031) probing caused less discomfort/pain.