Pharmacological vs. non-pharmacological interventions for anxiety control in dental implant surgery: a systematic...

Dental anxiety associated with dental implant surgery can adversely affect patient comfort, cooperation, and overall procedural outcomes. Both pharmacological and non-pharmacological interventions are commonly employed to manage preoperative anxiety; however, their comparative effectiveness remains unclear. A systematic evaluation of these approaches is important to determine their relative benefits in terms of anxiety reduction, onset of action, safety profile, and patient acceptability. Existing evidence suggests that pharmacological interventions may provide rapid anxiolytic effects, whereas non-pharmacological approaches, such as relaxation techniques, mindfulness-based interventions, and audio distraction, may reduce anxiety without the potential adverse effects associated with medication use. Therefore, this systematic review aims to compare the effectiveness of pharmacological and non-pharmacological anxiety control strategies in dental implant surgery and evaluate their clinical applicability in optimizing patient management.

A comprehensive literature search was conducted across PubMed, Scopus, Web of Science, and the Cochrane Library to identify randomized controlled trials evaluating the effectiveness of pharmacological and non-pharmacological interventions for the management of dental anxiety in adult patients undergoing dental implant surgery, up to September 2025. The systematic review was conducted according to a pre-specified protocol in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The methodological quality and risk of bias of the included studies were assessed using the revised Cochrane Risk of Bias tool (RoB 2.0).

The electronic database search identified a total of 225 articles related to anxiety management during dental implant placement. By evaluating titles, abstracts, and full texts, 15 articles met the inclusion criteria; however, no relevant studies were found through hand searching. The evidence suggested that that multimodal anxiety-reduction strategies, particularly dexmedetomidine sedation and behavioural distraction techniques, are effective in reducing dental anxiety during implant procedures.

Both non-pharmacological and pharmacological anxiety management strategies demonstrate considerable potential in reducing dental anxiety during implant placement. Behavioural interventions, including effective communication, relaxation techniques, distraction methods, and complementary therapies, appear beneficial for patients with mild to moderate anxiety, whereas pharmacological sedation is particularly effective for managing moderate to severe dental fear, thereby enhancing patient cooperation, procedural comfort, and overall acceptance of implant therapy.

https://www.crd.york.ac.uk/PROSPERO/view/CRD420261376502, identifier CRD420261376502.