All on 4 implants and Midazolam

A question I often get asked is “is Midazolam sedation good for longer sessions like all of four cases or zygomatic implants” and the answer is a resounding Yes!

Anecdotally it has been said that Midazolam sedation is difficult to control for longer sessions but with the proper patient expectations and the right protocol for topping up, it can be easily achieved. 

Over a three of four hour session, there will be moments when the patient is temporarily more aware of their surroundings. It is crucial to advise the patient of this beforehand and if they understand this, this should avoid the situation where they keep asking for more drugs. 

With regular top ups, the amnesia effect continues so even if the patient is going through bouts of lucidity, this will often be forgotten. 

With well planned implant surgery, in general, the invasiveness of the procedure reduces over the course of the surgery. From initial extractions, incisions, bone reduction and osteotomies, to implant placement, bone augmentation and suturing, the amount of potential pain, vibration and hassle the patient experiences reduces, as the depth of sedation decreases. 

This is why I believe sedation lends itself very nicely to implant surgery as the two run parallel. 

It is often not necessary to keep the patient topped up towards the end, it is rare that I give top ups during suturing and impression taking. 

This means a nice long recovery time with the patient still experiencing anxiolysis. 

If you would like to offer sedation for your longer cases, do drop us a line and we would be delighted to take you though it. 

Dr Rob Endicott BDS