Intravenous sedation as an adjunct to advanced comprehensive dental implantology: the patient's perspective and operator satisfaction

Br Dent J. 2015 Mar 13;218(5):E11. doi: 10.1038/sj.bdj.2015.192.


Objectives: The aim of this three-year study was to evaluate whether elective comprehensive dental implant procedures involving guided bone and soft tissue regeneration carried out under intravenous sedation (midazolam) would be influenced by patient self-reported pre-operative anxiety levels; age and gender; effect the level of sedation with respect to the amount of sedative administered and the time taken in the procedures; effect patient intra-operative cooperation, and post-operative levels of patient satisfaction; influence further acceptance of dental implant surgical procedures; effect intra-operative surgeon satisfaction and consequently his/her post-operative sense of achievement.Design Single centre general dental practice, open study as a clinical audit.

Method: One hundred and seventy-three consecutive patients undergoing prolonged surgical procedures involving dental implantology with the adjunctive facility of intravenous sedation were monitored with respect to self-reported levels of anxiety. Vital signs of heart rate, mean systolic and diastolic blood pressure and arterial oxygen saturation were recorded and monitored pre-intra- and post-surgery. A post-operative questionnaire was completed as to the perceptions of the level of sedation.

Results: A distinct relationship between self-reported pre-operative anxiety levels, age and gender were recorded - the younger the age, the higher the anxiety, with females dominating. Females required more midazolam than males. However, the analysis of the data as a whole, incorporating both genders, revealed a non-significant correlation result. The correlation between the midazolam dosage and the Corah anxiety score produced a p value result of: r (161) = 0.008, p <0.01. Forty-four percent of the patients described themselves as having 'high anxiety and fear of the dentist', however, 99.4% of the patients answered 'yes' to having sedation again in the future. For the purpose of this study, detailed consideration was given to the gender specific results in order to reveal a wider understanding of who poses as a 'cooperative patient'.

Conclusions: The results should prompt a rethink as to who a cooperative patient is, and whether the self-assessed level of anxiety will influence further acceptance of dental implant surgical procedures under intravenous sedation.

MeSH terms

  • Adult
  • Age Factors
  • Anesthesia, Dental / methods*
  • Anesthesia, Dental / psychology
  • Anesthesia, Intravenous / methods
  • Anesthesia, Intravenous / psychology
  • Anesthetics, Intravenous / therapeutic use
  • Attitude of Health Personnel
  • Conscious Sedation / methods
  • Conscious Sedation / psychology
  • Dental Anxiety / prevention & control
  • Dental Implantation* / methods
  • Dental Implantation* / psychology
  • Dentists / psychology
  • Female
  • Humans
  • Male
  • Midazolam / therapeutic use
  • Middle Aged
  • Operative Time
  • Patient Satisfaction*
  • Sex Factors
  • Young Adult


  • Anesthetics, Intravenous
  • Midazolam