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Evaluation of intravenous sedation in dental implant surgeries: A prospective cohort study.

Xin Liu·Zemin Cai·Chuxiao Chen·Jiawei Zhang·Fengxiao He·Qiong Xiang·Wei Peng·Haibin Xia·Yi Zhou·Tao Wu
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Abstract

PURPOSE: This study aimed to evaluate the impact of intravenous sedation on patient-centered outcomes during implant and bone augmentation surgeries. METHOD: A prospective observational cohort study included 40 patients undergoing placement of &#x2265;3 implants, with or without bone augmentation. Patients underwent surgery under either intravenous sedation (n = 20) or local anesthesia alone (n = 20), according to routine clinical decision-making and patient preference. The sedation group received intravenous sedation with a multimodal regimen comprising remimazolam, dexmedetomidine, alfentanil, and low-dose esketamine, whereas the control group received local anesthesia only. Patient-reported outcome measures, hemodynamic parameters (SBP, DBP, HR, SpO2), postoperative pain (0-10 scale), and OHRQoL (OHIP-14) were recorded from baseline through 7 days post-surgery. RESULTS: Intravenous sedation was associated with significantly lower intraoperative pain (0.5 [IQR: 0&#x223c;2.75] vs. 3.25 &#xb1; 2.40, p = 0.003), anxiety (1 [IQR: 0&#x223c;2.75] vs. 4 [IQR: 3&#x223c;6], p = 0.001), and experienced discomfort (2 [IQR: 1&#x223c;3.75] vs. 4.15 &#xb1; 2.16, p = 0.016), and shortened perceived treatment duration (2.90 &#xb1; 2.34 vs. 5 [IQR: 4&#x223c;5], p = 0.020). Early postoperative pain was lower in the sedation group from Days 1-4 (p = 0.003-0.010). Hemodynamic parameters were more stable under sedation, with lower SBP (116.42 &#xb1; 13.32 vs. 144.11 &#xb1; 17.42 mmHg, p < 0.001), DBP (73.21 &#xb1; 10.28 vs. 82.37 &#xb1; 11.03 mmHg, p = 0.012), and HR (71.00 [IQR: 62.50&#x223c;79.25] vs. 85.00 &#xb1; 10.72 bpm, p = 0.021). OHRQoL scores favored the sedation group in swallowing, diet, malaise, and daily activities, particularly during the first three postoperative days (p=0.006-0.040). CONCLUSION: Intravenous sedation may enhance the patient experience during implant and/or bone augmentation procedures by reducing intraoperative pain and anxiety, improving hemodynamic stability, and promoting better early-postoperative recovery and OHRQoL. These findings suggest that intravenous sedation provides a safe and effective alternative for implant dentistry surgery, particularly for anxious or pain-sensitive individuals.

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HumansProspective StudiesFemaleMalePostoperative PainMiddle AgedProcedural SedationDental ImplantsAdultHypnotics and SedativesPatient Reported Outcome MeasuresDental Implantation, EndosseousCohort StudiesHemodynamicsAnesthesia, LocalPain MeasurementAnesthesia, DentalImplant dentistryIntravenous sedationOral health&#x2013;related quality of lifePatient-reported outcomesPerioperative anxietyPostoperative painJournal ArticleObservational Study

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Xin Liu, Zemin Cai, Chuxiao Chen, Jiawei Zhang, Fengxiao He, Qiong Xiang, Wei Peng, Haibin Xia, Yi Zhou, Tao Wu. 2026-06-27. Evaluation of intravenous sedation in dental implant surgeries: A prospective cohort study.. https://doi.org/10.1016/j.jdent.2026.106865

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Adult subjectCohort Studies subjectFemale subjectHumans subjectJournal Article subjectJournal Article; Observational Study resourceMale subjectMiddle Aged subjectObservational Study subjectPain Measurement subject

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