title: Intravenous sedation as an adjunct to advanced comprehensive dental implantology: the patient's perspective and operator satisfaction.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
authors.affiliation: The dental implant and gingival plastic surgery centre, Bournemouth, Dorset, BH7 6AF, UK.
authors.forename: S J J
authors.initials: SJ
authors.lastname: McCrea
mesh_terms: D000328:Adult; D000367:Age Factors; D000766:Anesthesia, Dental / Q000379:methods* / Q000523:psychology; D000771:Anesthesia, Intravenous / Q000379:methods / Q000523:psychology; D018686:Anesthetics, Intravenous / Q000627:therapeutic use; D001291:Attitude of Health Personnel; D016292:Procedural Sedation / Q000379:methods / Q000523:psychology; D016854:Dental Anxiety / Q000517:prevention & control; D003757:Dental Implantation / Q000379:methods / Q000523:psychology; D003815:Dentists / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008874:Midazolam / Q000627:therapeutic use; D008875:Middle Aged; D061646:Operative Time; D017060:Patient Satisfaction; D012737:Sex Factors; D055815:Young Adult
chemical_list: D018686:Anesthetics, Intravenous; D008874:Midazolam