DISCUSSION.
Overall, the patients who requested dental implantology treatment were between the ages of 41 to 70 years. Women outnumbered men at a ratio of 2 to 1. The majority of patients were partially edentulous (93%). (This could be related to the high socioeconomic level of the patients at the private dental clinic.) Of particular interest was the finding that the greater percentage of implants were placed in the lower left quadrant. There was no statistically significant difference between maximum jaw opening before and 1 week after surgery. Fifty-seven percent of patients responded that they had no fear toward dental treatment. However, 48% of the patients had fear toward dental implants. The latter finding might be related to lack of the correct information on dental implantology and the abundance of hearsay comments. Only one patient presented temporomandibular disorder-related symptoms in the postsurgical phase. This patient had symptoms after the surgical procedure when she had been deprived of her full-mouth dentures; it is likely that the lack of support for muscle function and the diminished vertical dimension during function were the causes of these signs and symptoms. The restitution of the denture to the patient’s mouth immediately resolved the problem. Five percent of the patients had pain during yawning and opening, which was localized to the lateral pterygoid and masseter muscles, before and after surgery. These symptoms disappeared before the first postoperative month was over. After the first-stage surgery, 15% of the patients had a positive response of pain during swallowing. This symptom disappeared after the first 24 hours and was not observed at second-stage surgery. This finding is probably due to the fact that secondstage surgery is less traumatic to the patient. Although pain is a subjective sensation, at 24 hours after firstphase surgery, 100% of the patients reported discomfort or pain in a range of 1 to 4 (on a scale of 0 to 8); 40% presented only discomfort that did not reach a level of pain, and 45% reported only sporadic or intermittent pain. At second-stage surgery, 45% of the patients reported no pain, and 55% of the patients reported pain ranging from a level 1 (discomfort that did not reach pain) to a level 4 (strong persistent pain that required medication). Pain was present in 22% of the patients who received second-phase surgery after 4 months and in 33% of the patients who received second-stage surgery after 6 months. Of these patients, in 11% of the cases, the pain was related to acellular dermal soft tissue grafts. The pain related to the acellular soft tissue grafts was of a higher level and longer duration, needing more medication for pain relief. Edema was present in 95% of the patients after first-phase surgery, and hematoma was present in 12% of the patients. Both edema and hematoma diminished gradually. After 1 week, edema was only present in 23% of the patients, and before the end of the first month, no signs remained of either edema or hematoma. Edema and hematoma were not present after second-stage surgery.

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