Assessment of pain associated with the surgical placement of dental implants

Background: Despite increasing popularity and established predictability, limited information is available on the pain experience associated with the surgical placement of dental implants. The aim of this study was to assess patient-reported pain during and after implant insertion and to evaluate factors associated with this pain. Methods: This was a prospective, two-center study of adult patients scheduled for the surgical placement of one or more implants. Surgery was performed by an experienced periodontist or periodontal graduate students. Mean pain scores were evaluated with the use of a 0 to 10 scale during surgery and 24 hours and 1, 6, and 12 weeks after surgery and compared between the two centers. The association of pain scores at each time-point with patient-, operator-, and surgery-related factors was examined through univariate and multiple logistic regression analyses. Results: Five hundred ten implants were placed in 234 patients during the study. Mean pain scores were highest at 24 hours after surgery (2.01 +/- 0.11) and decreased gradually thereafter. Pain intensity was mild for the majority of patients at all time-points, and only a few patients had moderate or severe pain. Regression analysis revealed that factors significantly associated with pain after 24 hours included operator experience (odds ratio [OR] = 24.86), pain during surgery (OR = 2.81), and female gender (OR = 2.51). After 1 week, pain levels were associated significantly with having pain after 24 hours (OR = 38.69) and having a surgical template used during surgery (OR = 1.11). Conclusions: Pain experienced by patients following the surgical placement of dental implants was generally mild and gradually decreased with time. Operator experience, female gender, surgical difficulty, and pain at earlier time-points were associated significantly with patient reports of pain.