Objectives To assess patient discomfort in terms of pain, swelling and bleeding following immediate implant placement in molar regions using one of three regenerative techniques. Methods Ninety-two patients (44 women and 48 men; mean age 50 years [range 23-77], 35 smokers and 57 non-smokers) in need of a single implant crown to replace a molar were included. After placing the implant large periimplant defects were present. These defects were treated either with autologous bone (AB) chips, Ossix membrane (OM) or a combination of AB chips and OM. The postoperative course was recorded on 100 mm visual analogue scales (VAS) with extreme end points for the level of pain on the day of surgery, 1, 2 and 3 days postoperatively (no/extreme pain); swelling on the day of surgery, 1, 2 and 3 days postoperatively (no/severe swelling); and bleeding from the wound on the day of surgery, 1, 2 and 3 days postoperatively (no/severe bleeding). Results Pain peaked 5-6 h postoperatively (mean VAS=25). Swelling (mean VAS=62) and oozing from the wound (mean VAS=13) peaked 1 day postoperatively. There were no significant differences in the perception of pain, swelling or oozing from the wound between the three regenerative groups. The VAS score for pain was higher for smokers than for non-smokers at all times; a significant difference was found from 1 day until 3 days postoperatively (0.011 < P < 0.048). All pain scores, except the score for the day of the operation, were significantly higher in younger (< 50 years) than in older patients (>= 50 years) (0.002 < P < 0.49). Conclusions Patients experienced little to moderate pain in combination with marginally severe swelling and mild oozing after immediate implant placement in molar regions involving regenerative techniques. Being a smoker was associated with more pain in contrast to being > 50 years, which was associated with less pain. To cite this article:Urban T, Wenzel A. Discomfort experienced after immediate implant placement associated with three different regenerative techniques.Clin. Oral Impl. Res. 21, 2010; 1271-1277.doi: 10.1111/j.1600-0501.2010.01943.x.