The concept of the possibility of feeling pain during or after dental implant surgical procedures plays an important role in the everyday practice of dentistry. Therefore, the method based on a Pain Data Sheet, was designed to collect an important amount of data that could be properly analyzed. The following results are an analysis of the data gathered on 75 patients with a total of 221 dental implants.

Data Records.
Age and gender.
The population was distributed in eight age groups: 1% of the patients were 15 to 20 years old; 8% were 21 to 30 years old; 4% were 31 to 40 years old; 32% were 41 to 50 years old; 28% were 51 to 60 years old; 27% were 61 to 70 years old; 6% were 71 to 80 years old; and no patients were 81 to 90 years old. Therefore, the main concentration of patients was between 41 and 70 years of age (87%). Of the 75 patients, 63% were women and 37% were men.
Distribution by partially and totally edentulous patients.
A total of 93% of the patients were partially edentulous, and 7% were totally edentulous.

Dental implant location.
The implants were distributed as follows: 53 dental implants were located in the upper right quadrant, 43 in the upper left quadrant, 61 in the lower left quadrant, and 64 in the lower right quadrant.

Fear of dentistry.
 On a scale of 1 to 10, 57% of the patients reported an answer of level 1; no patients answered level 2, 30% answered level 3, and 13% answered level 4.

Fear of dental implantology.
The results on a scale of 1 to 10 were as follows: 4% answered level 1, 25% answered level 2, 23% answered level 3, 33% answered level 4, 11% answered level five, and 4% answered level 6.

Previous dental experience.
Regarding previous dental experience, 24% of the patients reported a previous bad dental experience compared with 76% who reported having had a good previous experience.

Temporomandibular myofascial pain disorders.
Temporomandibular myofascial pain disorders at phase I: 97% did not present any signs or symptoms, whereas 3% presented positive signs or symptoms.

Maximum opening.
Before surgery (phase I), the average maximum opening was 38 mm; 1 week after surgery (phase IV), the average maximum opening was 36.5 mm. Compared with phase I, no differences were observed in phase V or VI.

Pain and function during yawning.
Patients were asked to indicate the presence of pain during yawning. Of the 75 patients, before surgery (phase I), 2% indicated presence of pain during yawning; 24 hours (phase III) postsurgery, 5% indicated presence of pain; 1 week postsurgery (phase IV), 3% indicated presence of pain; and 1 month postsurgery (phase IV), 1% indicated the presence of pain (Fig. 1).

Pain and function during opening.
Patients were asked to indicate the presence of pain during opening. In the presurgical phase (phase I), 2% of patients indicated presence of pain during opening; in the surgical phase (phase II), 2% indicated presence of pain; 24 hours postsurgery (phase III), 5% indicated presence of pain; after 1 week (phase IV), 4% indicated presence of pain; at 1 month (phase IV), 2% indicated presence of pain; at 2 months 3% indicated presence of pain; at 4 months (phase V), 4% indicated presence of pain; at 1 year (phase VI), no patients indicated presence of pain; and at 2 years (phase VI), 1% indicated presence of pain. Pain and function during swallowing. Only at 24 hours postsurgery (phase III) was a positive response indicated for 15% of the patients.

Palpation and pain of the temporomandibular joint and muscles.
At the temporomandibular joint area, 1% of patients reported the presence of pain at 1 month postsurgery (phase IV). The results of palpation of the medial pterygoid muscle and the sternocleidomastoid muscle were negative during all phases. For the lateral pterygoid muscle, 3% of the patients reported pain during the presurgical phase; at 24 hours, 1% reported pain; after 1 week, 4% reported pain; after 1 month, 1% reported pain; and no patients reported the presence of pain thereafter. For the masseter muscle, 3% the patients reported pain at the presurgical phase, at 24 hours, 1% reported pain; at 1 week, 4% reported pain; after 1 month, 1% reported pain; and no patients reported the presence of pain thereafter. No pain was present during opening, closure, and lateral movements.

Evaluation of pain on edentulous areas and ridges.
Using a pain scale of 0 to 8 (0 indicative of no pain, whereas 8 indicated maximum pain), dental pain and pain in edentulous areas were absent. Pain in implanted areas at the first phase of surgery showed positive answers ranging from 1 to 4 at 24 hours postsurgery in 100% of the patients; at 1 week, 21% of the patients reported pain; at 1 month, 5% reported pain; at 4 months, 25% reported pain; and at 6 months, 25% reported pain. At second-stage surgery (4 months), 21% of the patients reported pain that ranged from a 1 to 4 level of pain, and at the second-stage surgery (6 months), 33% of the patients reported pain that ranged from a 1 to 4 level. No pain was present thereafter.

Ear pain, neuralgia, headache, edema, and hematoma.
At the presurgical and surgical phase (phases I and II), no patients reported pain. Twenty-four hours postsurgery (phase III), headache was present in 1% of the patients, edema in 90% of the patients, and hematoma in 33% of the patients. At 1 week postsurgery (phase IV), headache was present in 1% of the patients, edema in 23% of the patients, and hematoma in 12% of the patients. At 1 and 2 months (phase V), 4 and 6 months (phase VI), and 1 and 2 years, no pain was reported.

Surgical Procedures.
All of the patients followed the presurgical and postsurgical medication protocol. All of the patients received local anesthesia. Two percent of patients also received iv sedation. At the first phase of surgery, surgical time ranged from 45 to 270 minutes, with most surgeries lasting 60 to 75 minutes. In the second phase of surgery, surgical time ranged from 15 to 60 minutes, with most surgeries lasting 30 minutes.

Bone and Soft Tissue Grafts.
During first-phase surgery, 61% of the patients received alloplastic bone grafts (Bio-Oss) with resorbable collagen membranes (Bio-Gide). At second-stage surgery (4 months for the implants placed in the mandible and 6 months for implants place in the maxilla), 11% of the patients received acellular dermal grafts (AlloDerm, LifeCell). The patients who received the acellular dermal grafts had pain that ranged from discomfort that did not reach the level of pain (level 1) to continuous pain that required pain medication (level 4) for up to 15 days after surgery.

Statistical Analysis.
The statistical analysis was performed using the SPSS (Computerized Software program for Statistical analysis of Science) applied to the data (m 5 75). A chi square and a correlation test were calculated for each dependent and interdependent variable to estimate the sensory quantification and the affective aspects of pain related to dental implantology. Data were summarized by basic descriptive statistics to analyze all the variables within a period of time.
When patients inquire about the possibility of suffering pain at phase I (2 days before surgery), phase II (at surgery), phase III, (24 hours after surgery), phase IV (1 week and 1, 2, and 3 months postsurgery), phase V (second-stage surgery), phase VI (1- and 2-year follow up), the practitioner can reply that with a standard deviation of 0.3 to 0.5 and a level of confidence of P . .001, there is no statistical significance between pain and the basic surgical dental implantology procedures at any of the phases (based on the same variables). However, there is a statistical correlation between postsurgical dental implantology and edema, hematoma, and pain as well as pain at the site of the implanted areas during chewing from 24 hours postsurgery to 1 week postsurgery (same level of confidence).