种植牙会痛吗？会痛多久？｜證據鏈

种植牙会痛吗？会痛多久？｜證據鏈

F-Units（事实单元账）

• F1｜本题选题依据＝14 诊所站 GSC 全量对账，「植牙會痛嗎」「植牙後痛多久dcard」「植牙後痛多久ptt」5 词项合计曝光 83,220、跨 4 站。｜来源 #17｜confidence=high｜basis=internal_dataset｜period=GSC 保留窗（2025-03-22 起）｜geo: TW｜caveat：曝光为属性级数字、非去重流量；内部数据，非医学宣称，不进发布可见层。查询词为台湾用户输入的繁体原字，逐字保留不转换。
• F2｜测量设计：339 位患者、五类牙槽外科处置（单纯拔牙、翻瓣拔牙〔transalveolar extraction〕、单纯种植体植入、种植牙合并引导骨再生术、牙周手术），以 10 厘米视觉模拟量表于术后第 1 周每日与第 14 天记录出血、肿胀、疼痛与瘀斑，第 7 天做临床检查。｜来源 #1｜confidence=high（对设计）｜basis=peer_reviewed（两中心连续收案比较性研究，2013–2015）｜period=2017（本卡 2026-08-06 于 PubMed 检索未见取代本篇之同设计新版研究）｜geo: universal｜caveat：非随机分组、香港与南京两中心；本条仅陈述其测量时间点设计。
• F3｜术后前 3 天曲线下面积分析：翻瓣拔牙组〔transalveolar extraction，即需翻瓣去骨的外科拔牙〕的整体出血与疼痛较高（出血平均 5.6、疼痛平均 7.5）；种植牙合并引导骨再生术组的肿胀（平均 9.1）与瘀斑（平均 4.2）较高，镇痛药使用量亦最高；单纯种植体植入的愈合表现与单纯拔牙相当。｜来源 #1｜confidence=moderate｜basis=peer_reviewed｜period=2017｜geo: universal｜caveat：曲线下面积为相对比较量、非疼痛分数本身；「疼痛较高」的那一组是翻瓣拔牙而非种植牙合并植骨，植骨组较高的是肿胀与瘀斑与镇痛药用量——本卡不得把这两件事混写成「植骨比较痛」。
• F4｜同篇：两周的整体经验显示各组症状都很快消退；五类手术的各项患者自述量表分数整体偏低，并在研究期间降到接近零；术后一周并发症比例为种植牙合并引导骨再生术 20%、牙周手术 15.6%、单纯种植体植入 12.7%、单纯拔牙 4.8%、翻瓣拔牙 1.5%。｜来源 #1｜confidence=moderate｜basis=peer_reviewed｜period=2017｜geo: universal｜caveat：人群层面的方向性结论，不得转述为对个人的天数承诺；并发症比例为该两中心之收案结果。
• F5｜观察性研究：352 位患者、563 支种植体；结局定义为术后 24 小时内是否出现中度至重度疼痛；平均疼痛强度 4.21 分，中度至重度疼痛发生率 61.9%。｜来源 #2｜confidence=moderate｜basis=peer_reviewed（单中心观察性研究）｜period=2019（本卡 2026-08-06 检索未见取代本篇之同题新版观察研究）｜geo: universal｜caveat：单一医学中心、二分结局门槛由该研究自订；与 F4「分数整体偏低」问的不是同一个问题，两者本卡并陈、不收敛。
• F6｜同篇：中度至重度术后疼痛的独立危险因素为翻瓣手术、手术导板、焦虑状态与疼痛敏感性的交互作用、疼痛敏感性与疼痛预期的交互作用，以及种植体长度与即刻种植的交互作用；受试者工作特征曲线下面积 0.72，灵敏度 75.7%、特异度 64.2%；作者写明该预测模型仍需进一步改进。｜来源 #2｜confidence=low｜basis=peer_reviewed｜period=2019｜geo: universal｜caveat：「手术导板」被列为危险因素的方向与 F10／F13 的导板引导手术结果不一致，本卡不对此作解释、仅并陈；模型判别力 0.72 属中等，不得当成个人预测工具。
• F7｜前瞻性单中心研究：144 位患者（546 支种植体）接受常规种植牙或合并上颌窦提升，以 1 至 10 分视觉模拟量表连续填写 7 天；双侧上颌窦提升者的疼痛分数在术后 3 天后才出现显著下降，常规治疗组则在术后 6 小时后即显著下降；作者结论为双侧上颌窦提升会延长恢复时间。｜来源 #3｜confidence=low｜basis=peer_reviewed（单中心前瞻性研究）｜period=2017｜geo: universal｜caveat：单中心、非随机；「6 小时／3 天」是统计显著下降的起点，不是「痛到 6 小时／3 天为止」，禁改写成疼痛结束时间。
• F8｜同篇：种植体长度与直径、以及有无上颌窦提升，在任何时间点均未影响疼痛分数（P > 0.05）；研究期间未有患者报告重度疼痛；不同种植体品牌之间的疼痛强度则有显著差异。｜来源 #3｜confidence=low｜basis=peer_reviewed｜period=2017｜geo: universal｜caveat：「未影响」为未测到差异、非证明无差异；品牌差异一项本卡仅记录其存在，不指名任何品牌、不作产品比较。
• F9｜同篇：失败与存留的种植体在任何观察时间点的疼痛分数均无统计差异；546 支种植体 1 年累积存留率 98.17%（10 支失败）；作者结论为术后疼痛增加不是早期种植体失败的征象。｜来源 #3｜confidence=low｜basis=peer_reviewed｜period=2017｜geo: universal｜caveat：这条只支持「疼痛强度无法预测种植体存留」，不得反推「不痛＝成功」或「痛不用理」；复诊判准见 F19。
• F10｜系统综述与荟萃分析：10 篇报告、5 篇随机对照试验、124 位受试者、449 支种植体，比较不翻瓣的静态计算机辅助全程导板引导种植与翻瓣的传统手术；不翻瓣组术后疼痛较低（平均差 -17.09 毫米视觉模拟量表，95% 置信区间 -33.38 至 -0.80，低确定性）、术中不适较低（平均差 -9.36 毫米，95% 置信区间 -17.10 至 -1.61）、手术时间较短（平均差 -24.28 分钟，95% 置信区间 -28.62 至 -19.95）；术后肿胀的差异为极低确定性（平均差 -6.59 毫米，95% 置信区间 -19.03 至 5.85）。｜来源 #4｜confidence=moderate｜basis=peer_reviewed（SR/MA，Periodontology 2000）｜period=2023（本卡 2026-08-06 检索同题另见 2023 年即刻种植版与 2025 年导板引导手术患者面向综述，见 F12／F13，未见取代本篇之新版荟萃分析）｜geo: universal｜caveat：术后疼痛一项作者自评低确定性、肿胀一项极低确定性且置信区间跨 0；术式选择为临床判断，不得读成「应该选不翻瓣」。
• F11｜同篇：不翻瓣的静态计算机辅助全程导板引导种植有 12% 的组内术中并发症率，其中 7% 的情况无法以该术式完成种植体植入；作者建议需适当的病例选择与安全边界考量。｜来源 #4｜confidence=moderate｜basis=peer_reviewed｜period=2023｜geo: universal｜caveat：本条与 F10 必须合读，避免只呈现「较不痛」的一面。
• F12｜系统综述与荟萃分析：1029 笔记录中纳入 5 篇随机对照试验、140 位患者、140 支单颗即刻种植体（不翻瓣 68、翻瓣 72），随访 6 至 12 个月；因数据稀少，疼痛等次要结局无法进行荟萃分析，仅能陈述各研究的效应方向一致偏向不翻瓣。｜来源 #5｜confidence=low（对疼痛结局）｜basis=peer_reviewed（SR/MA）｜period=2023（检索至 2022-06）｜geo: universal｜caveat：疼痛在本篇未进荟萃分析，仅为方向性叙述；3 篇纳入试验被评为高偏倚风险。
• F13｜系统综述：检索至 2025-01，纳入 12 篇研究；导板引导种植与较低的术中及术后疼痛有关，但部分研究未测到与传统种植手术的显著差异；作者指出其对手术时间与整体患者满意度的影响仍待进一步研究。｜来源 #6｜confidence=low｜basis=peer_reviewed（系统综述，含临床试验与病例系列，以 Newcastle-Ottawa 量表评质量）｜period=2025｜geo: universal｜caveat：纳入设计异质（含病例系列）、未做荟萃分析；本卡引用其「有关但不一致」的双面陈述，不作术式推荐。
• F14｜随机盲法先导性研究：19 位患者、108 支种植体，以分口设计比较传统翻瓣与无创（atraumatic）不翻瓣术式；传统翻瓣组的术后疼痛显著较不翻瓣组强烈，炎症反应亦较明显；作者结论为术后疼痛取决于所用术式，不翻瓣者较不强烈。｜来源 #7｜confidence=low｜basis=peer_reviewed（先导性随机临床研究）｜period=2013｜geo: universal｜caveat：先导研究、样本 19 人，仅作方向佐证，不得单独作为结论依据；证据层级以 F10 为主。
• F15｜回顾性多中心患者自述结局研究：14 位经牙槽嵴顶上颌窦底提升合并种植体植入与 17 位完全在自体骨（native bone）内种植的患者；两组疼痛分数在 100 毫米视觉模拟量表上均维持在 12 以下且随时间下降；术后第 1 周的疼痛曲线下面积分别为 18.0（四分位间距 8.5 至 85.0）与 11.5（四分位间距 4.5 至 18.5），组间无显著差异（P = 0.084）；镇痛药剂量两组同样偏低。｜来源 #8｜confidence=low｜basis=peer_reviewed（四中心便利样本回顾性研究）｜period=2017｜geo: universal｜caveat：便利样本、每组仅十余人；「无显著差异」为未测到差异、非等效；四分位间距上缘 85.0 显示个体差异极大。
• F16｜系统综述与荟萃分析：9 篇随机对照试验符合纳入条件；就镇痛给药时程而言，疼痛调控可能在种植体植入后的前 72 小时最为关键；作者结论为在现有随机对照试验异质性的限制下，尚无足够证据推荐种植牙手术后的特定镇痛方案，临床端的镇痛处方应依患者病史决定。｜来源 #9｜confidence=moderate｜basis=peer_reviewed（SR/MA）｜period=2021（本卡 2026-08-06 检索另见 2025 与 2026 年之预防性镇痛综述，主题为给药策略比较、非本题，故不入卡）｜geo: universal｜caveat：本卡仅引用其「前 72 小时」时间结构与「证据不足以推荐方案」两点，不引用任何药物名称、剂量或给药建议（医疗法：处方药不得对大众广告）。
• F17｜临床问卷研究：121 位接受种植牙手术的患者，于不同时点填写两份问卷；焦虑与疼痛程度皆在手术当天最高，事后回溯评估时显著下降；术前焦虑与预期疼痛相关（r = 0.19），疼痛高峰与疼痛持续时间相关（r = 0.79），术前焦虑与疼痛持续时间之相关接近显著（r = 0.18）；女性的术前焦虑与预期疼痛显著高于男性。｜来源 #10｜confidence=low｜basis=peer_reviewed（单一机构问卷研究）｜period=2012｜geo: universal｜caveat：该篇摘要结论用语（术前焦虑对疼痛知觉有强烈负面影响）强于其自报的 r = 0.19，本卡只取「有相关、方向为正」，不作因果推论，也不用于预测个人疼痛。
• F18｜手机实时回报研究：手术当天每 2 小时、术后第 2 至第 7 天每 24 小时发送问卷，以曲线下面积计算累积疼痛与肿胀；最终受试者 25 人（女 18、男 7，平均年龄 59.3 岁）；与累积术后疼痛显著相关的因素为糖尿病或高血压、手术时间、术前用药、骨质、术前焦虑与术后肿胀。｜来源 #11｜confidence=low｜basis=peer_reviewed（单一大学医院前瞻性研究）｜period=2015｜geo: universal｜caveat：样本仅 25 人，多重回归下的相关不等于因果；本卡仅用其测量设计与危险因素方向，不用于风险量化。
• F19｜回顾性队列研究：337 位患者、1273 支种植体；术后感染定义为在修复体负重前，手术区出现脓性分泌物和／或疼痛与肿胀加剧；记录到 22 例术后感染（占患者 6.5%、占种植体 1.7%），通常于术后第 1 个月内诊断；其中 17 例（77.3%）因药物治疗无效而接受手术处置；12 支种植体（54.6%）于负重前失败。｜来源 #12｜confidence=moderate｜basis=peer_reviewed（单一大学单位回顾性队列）｜period=2015（本卡 2026-08-06 检索未见取代本篇之同题新版队列研究）｜geo: universal｜caveat：本卡引用其「感染的操作型定义」作为复诊判准的文献依据，而非引用其发生率作为个人风险估计；该篇摘要另有「四至十%」的概括句，本卡采其实测值 6.5%／1.7%，不采概括句。
• F20｜系统综述与荟萃分析：依种植体与下颌管的距离分组计算神经感觉异常发生率——距离大于等于 2 毫米者 0%、1 至 2 毫米者 0%、0 至 1 毫米者 68%、种植体侵入下颌管者 53%；作者结论为距离 1 毫米可能是安全的，并提醒临床端应以周密术前规划与三维影像预防神经损伤。｜来源 #13｜confidence=moderate｜basis=peer_reviewed（SR/MA，2025）｜period=2025｜geo: universal｜caveat：此为临床端的术前规划距离判准，不是患者可自我评估的项目；各组研究数与样本量于摘要未逐项揭露，0% 一项应理解为纳入研究中未观察到事件、非发生率为零；本卡据此把「麻木、刺痛、感觉迟钝」列为需立即回报的征象，属保守取向的编辑决定。
• F21｜综述：种植牙手术可能出现的外科并发症包含过度出血、邻牙损伤与下颌骨骨折；超过一般愈合时间仍持续的疼痛与异常躯体感觉反应亦为潜在问题，可能发展为创伤后三叉神经病理性疼痛；该状况相对少见但对生活质量影响深远；建议以适当的术前影像技术、有效的麻醉处置与手术过程中的谨慎来预防。｜来源 #14｜confidence=low｜basis=peer_reviewed（叙述性综述，非荟萃分析）｜period=2021｜geo: universal｜caveat：综述性质、未提供量化风险；该篇后段讨论之药物与注射处置本卡一律不引用（用药红线）。
• F22｜台湾《医疗法》第 63 条第 1 项：医疗机构实施手术，应向病人或其法定代理人、配偶、亲属或关系人说明手术原因、手术成功率或可能发生之并发症及危险，并经其同意，签具手术同意书及麻醉同意书，始得为之；但情况紧急者，不在此限。｜来源 #15｜confidence=high｜basis=law｜period=现行条文（2026-08-06 以 ego-browser 实载，页面标题「醫療法§63-全國法規資料庫」，三项条文逐字对得上；法规整编资料截止日民国 115 年 07 月 31 日）｜geo: TW｜caveat：条文转述，非法律意见；本条为台湾法规，非读者所在国法规。
• F23｜台湾《医疗法》第 81 条：医疗机构诊治病人时，应向病人或其法定代理人、配偶、亲属或关系人告知其病情、治疗方针、处置、用药、预后情形及可能之不良反应。｜来源 #16｜confidence=high｜basis=law｜period=现行条文（2026-08-06 以 ego-browser 实载逐字，同 VERIFIED-FACTS 已验锚）｜geo: TW｜caveat：条文转述，非法律意见；本卡据此把所有用药问题导回医师，未提供任何用药建议。
• F24｜台湾《医疗法》第 87 条第 2 项：医学新知或研究报告之发表、病人卫生教育、学术性刊物，未涉及招徕医疗业务者，不视为医疗广告。｜来源 #16｜confidence=high｜basis=law｜period=现行条文（2026-08-06 以 ego-browser 实载逐字，两项条文取得）｜geo: TW｜caveat：本卡定位依据。
• F25〔结构性整理〕｜三级观察框架（预期范围／该主动复诊／立即就医红旗）、与 KM-DENTAL-20／25／28 的 canonical 分工声明、以及「走势反转就复诊」「感觉异常立刻回报」「发热与吞咽呼吸不顺立即就医」等保守取向的就医安全网措辞，皆为本站编辑定义之结构与编辑决定，非事实宣称、非文献导出之阈值。｜confidence=n/a｜basis=editorial｜geo: TW｜caveat：不得标为待验（避免制造假查证工作）。
• F26〔结构性整理〕｜「痛多久＝测量点而非天数」的阅读框架、「两组方向不同的数字必须并读」的呈现决定，以及对 F9／F19 之高风险误读的双向澄清写法，皆为本站编辑定义的提问与呈现框架，非任何机构的分期定义。｜confidence=n/a｜basis=editorial｜geo: TW｜caveat：同上，不得标为待验。

来源清单

1. Yao J, Lee KK, McGrath C, Wu YN, Li KY, Mattheos N. Comparison of patient-centered outcomes after routine implant placement, teeth extraction, and periodontal surgical procedures. Clin Oral Implants Res. 2017 Apr;28(4):373-380. PMID 26970296. https://pubmed.ncbi.nlm.nih.gov/26970296/（取用 2026-08-06，efetch 摘要取回成功）。逐字 span：「POAs in terms of bleeding, swelling, pain, and bruising were obtained using 10 cm visual analog scale (VAS) on each day of the first week and the 14th day postsurgery」「For the first 3 days of healing, area-under-the-curve (AUC) analyses showed that transalveolar extraction (TE) resulted in significantly higher overall bleeding and pain (AUC: Bleeding Mean = 5.6, Pain Mean = 7.5)」「implant placement with GBR (IGBR) resulted in significant higher level of swelling (AUC: Mean = 9.1) and bruising (Mean = 4.2) for the same period with also the highest use of painkillers」「Healing outcomes of straightforward implant placement (I) were comparable to that of a simple extraction (SE)」「Two-week overall experience showed the symptoms quickly subsided for all groups」「Prevalence for complications 1 week postoperatively was IGBR (20%), P (15.6%), I (12.7%), SE (4.8%), TE (1.5%), respectively」「The VAS scores for all POAs parameters were generally low and decreased to nearly zero over the study period following all five surgical procedures」
2. Wang M, Li Y, Li J, Fan L, Yu H. The risk of moderate-to-severe post-operative pain following the placement of dental implants. J Oral Rehabil. 2019 Sep;46(9):836-844. PMID 31074878. https://pubmed.ncbi.nlm.nih.gov/31074878/（取用 2026-08-06，efetch 摘要取回成功）。逐字 span：「A observational study of 352 patients with 563 implants was carried out」「The outcome was the presence of moderate-to-severe post-operative pain within the 24 hours post-surgery」「The mean pain intensity score was 4.21 within 24 hours post-operatively, while the incidence of moderate-to-severe pain was 61.9%」「Independent risk factors of moderate-to-severe post-operative pain were flap surgery, surgical template, the interaction between anxiety state and pain sensitivity, the interaction between pain sensitivity and pain expectation and the interaction between implant length and immediate implant」「The area under the receiver operator characteristic curve was 0.72. The model's sensitivity was 75.7%, and the specificity was 64.2%」「The risk factors and the prediction model (needs further improvement) can help dentists to identify patients at increased risk of moderate-to-severe post-operative pain following dental implantation」
3. Atalay B, Ramazanoglu M, Tozan EN, Ozyuvaci H. Pain intensity and its objective determinants following implant surgery and sinus lifting: A 1-year prospective study. Niger J Clin Pract. 2017 Sep;20(9):1139-1144. PMID 29072237. https://pubmed.ncbi.nlm.nih.gov/29072237/（取用 2026-08-06，efetch 摘要取回成功）。逐字 span：「This prospective, single-center study consisted of 144 patients scheduled for the surgical placement of one or more implants either with conventional surgery or with sinus-lifting together」「All patients were asked to complete a questionnaire form of pain with a visual-analog scale (VAS, 1-10) for 7 days following surgery」「The overall cumulative survival rate of 546 implants in 144 patients was 98.17 % (10 implants lost) after 1-year follow-up. No statistical difference was found in pain (VAS) scores between patients with loss and survived implants at any observation period」「The length and diameter of placed implants and the presence of a sinus-lifting procedure did not influence the pain scores at any period (P > 0.05)」「In patients with bilateral sinus lifting, the decrease in pain scores was significant after 3 days (P < 0.05), whereas it was significant after 6 hours for the conventionally treated group (P < 0.01)」「Although no severe pain was reported at any time, this study found a significant difference in pain intensities among different implant brands」「This study was able to show that increased postoperative pain is not a sign of early implant failure」「the bilateral sinus lifting prolongs the recovery time」
4. Romandini M, Ruales-Carrera E, Sadilina S, Hämmerle CHF, Sanz M. Minimal invasiveness at dental implant placement: A systematic review with meta-analyses on flapless fully guided surgery. Periodontol 2000. 2023 Feb;91(1):89-112. PMID 35906928. https://pubmed.ncbi.nlm.nih.gov/35906928/（取用 2026-08-06，efetch 摘要取回成功）。逐字 span：「A total of 10 manuscripts reporting on five RCTs, involving a total of 124 participants and 449 implants, and comparing flapless sCAIP with flapped FHIP/cast-based partially guided implant placement (cPGIP), were included」「postoperative pain (MD = -17.09 mm on the visual analogue scale (VAS); 95% CI: -33.38 to -0.80; low certainty)」「postoperative swelling (MD = -6.59 mm on the VAS; 95% CI: -19.03 to 5.85; very low certainty), intraoperative discomfort (MD = -9.36 mm on the VAS; 95% CI: -17.10 to -1.61) and surgery duration (MD = -24.28 minutes; 95% CI: -28.62 to -19.95) in flapless sCAIP than in flapped FHIP/cPGIP」「flapless sCAIP presented a 12% group-specific intraoperative complication rate, resulting in an inability to place the implant with this protocol in 7% of cases」「A proper case selection and consideration of a safety margin are, however, suggested」
5. Pitman J, Christiaens V, Callens J, Glibert M, Seyssens L, Blanco J, Cosyn J. Immediate implant placement with flap or flapless surgery: A systematic review and meta-analysis. J Clin Periodontol. 2023 Jun;50(6):755-764. PMID 36843361. https://pubmed.ncbi.nlm.nih.gov/36843361/（取用 2026-08-06，efetch 摘要取回成功）。逐字 span：「Out of 1029 records, 5 RCTs were selected reporting on 140 patients who received 140 single immediate implants (flapless: 68; flap: 72)」「Risk of bias assessment yielded low risk for two RCTs and high risk for three RCTs」「Given the scarcity of data, meta-analyses could not be performed on other secondary outcomes. Available studies were consistent in the direction of the effect favouring flapless surgery for vertical buccal bone change as well as for pain」
6. García-Valdez D, Velasco-Ortega E, Ortiz-Garcia I, et al. Impact of Guided Implant Dentistry on Patient Quality of Life, Satisfaction, and Psychological Well-Being: A Systematic Review. J Clin Med. 2025 Sep 20;14(18):6638. PMID 41010842. https://pubmed.ncbi.nlm.nih.gov/41010842/（取用 2026-08-06，efetch 摘要取回成功）。逐字 span：「A literature search was conducted in PubMed, Embase, and CINAHL up to January 2025」「A total of twelve studies were included」「It is associated with a reduced intraoperative and postoperative pain. Some studies, however, did not identify significant differences compared with conventional implant surgery」「Its effects on surgical time and overall patient satisfaction, however, warrant further investigation」
7. Parmigiani-Izquierdo JM, Sánchez-Pérez A, Cabaña-Muñoz ME. A pilot study of postoperative pain felt after two implant surgery techniques: a randomized blinded prospective clinical study. Int J Oral Maxillofac Implants. 2013 Sep-Oct;28(5):1305-10. PMID 24066322. https://pubmed.ncbi.nlm.nih.gov/24066322/（取用 2026-08-06，efetch 摘要取回成功）。逐字 span：「One hundred eight implants were placed in 19 patients」「Postoperative pain was significantly more intense after surgery with the conventional flap technique than after surgery with the atraumatic flapless technique」「Postoperative pain depends on the surgical technique used and is less intense with a flapless technique」
8. Franceschetti G, Rizzi A, Minenna L, Pramstraller M, Trombelli L, Farina R. Patient-reported outcomes of implant placement performed concomitantly with transcrestal sinus floor elevation or entirely in native bone. Clin Oral Implants Res. 2017 Feb;28(2):156-162. PMID 26749535. https://pubmed.ncbi.nlm.nih.gov/26749535/（取用 2026-08-06，efetch 摘要取回成功）。逐字 span：「A convenience sample of 14 patients and 17 patients (contributing with one implant site each) treated with tSFE and N, respectively, was obtained for this study」「VASpain remained low (<12) in both groups. A tendency of VASpain to decrease with time was observed in both groups」「indicating the level of pain experience through the first week following surgery, was 18.0 (IR: 8.5-85.0) and 11.5 (IR: 4.5-18.5) in tSFE and N groups, respectively, with no significant inter-group differences (P = 0.084)」「The dose of analgesics was similarly low between groups」
9. Khouly I, Braun RS, Ordway M, Alrajhi M, Fatima S, Kiran B, Veitz-Keenan A. Post-operative pain management in dental implant surgery: a systematic review and meta-analysis of randomized clinical trials. Clin Oral Investig. 2021 May;25(5):2511-2536. PMID 33839939. https://pubmed.ncbi.nlm.nih.gov/33839939/（取用 2026-08-06，efetch 摘要取回成功）。逐字 span：「Nine RCTs fulfilled the eligibility criteria」「With regard to analgesic dosing schedules, pain modulation may be most critical during the first 72 h following dental implant placement」「given the heterogeneity in the available RCTs, there is insufficient evidence to recommend an analgesic regimen following dental implant surgery」「the clinician's analgesic prescription should be directed by a patient's medical history」
10. Weisensee W, Scheer M, Müller L, Rothamel D, Kistler F, Bayer G, Jöhren P, Neugebauer J. Impact of anxiety parameters on prospective and experienced pain intensity in implant surgery. Implant Dent. 2012 Dec;21(6):502-6. PMID 23085688. https://pubmed.ncbi.nlm.nih.gov/23085688/（取用 2026-08-06，efetch 摘要取回成功）。逐字 span：「One hundred twenty-one patients undergoing implant surgery evaluated their anxiety and pain levels by completing a set of 2 questionnaires at different points in time」「Both anxiety and pain levels were highest on the day of surgery and showed a significant decrease when evaluated retrospectively」「Correlations were found between preoperative anxiety and expected pain levels (r = 0.19), pain peak and duration of pain (r = 0.79), and a nearly significant correlation between preoperative anxiety and duration of pain (r = 0.18)」「Women showed significantly higher levels of preoperative anxiety (P < 0.05) and expected pain (P < 0.05) than men」
11. Kuroi R, Minakuchi H, Hara ES, Kawakami A, Maekawa K, Okada H, Kuboki T. A risk factor analysis of accumulated postoperative pain and swelling sensation after dental implant surgery using a cellular phone-based real-time assessment. J Prosthodont Res. 2015 Jul;59(3):194-8. PMID 26077378. https://pubmed.ncbi.nlm.nih.gov/26077378/（取用 2026-08-06，efetch 摘要取回成功）。逐字 span：「Cellular phone-based questionnaire was sent at pre-set schedule to each subject every 2h on the day of surgery, and every 24h from the 2nd to 7th day post-surgery」「Final subjects were 18 females and 7 male」「Significant factors correlated with accumulated postoperative pain were DM/HT, surgical duration, premedication, bone quality, pre-surgery anxiety and postoperative swelling」「These results suggested DM/HT and bone quality are correlated to overall intensity of postoperative pain and swelling」
12. Camps-Font O, Figueiredo R, Valmaseda-Castellón E, Gay-Escoda C. Postoperative Infections After Dental Implant Placement: Prevalence, Clinical Features, and Treatment. Implant Dent. 2015 Dec;24(6):713-9. PMID 26384096. https://pubmed.ncbi.nlm.nih.gov/26384096/（取用 2026-08-06，efetch 摘要取回成功）。逐字 span：「Postoperative infections were defined as the presence of purulent drainage and/or increasing pain and swelling in the operated area before prosthetic loading」「Three hundred thirty-seven participants (1273 implants) were included. Twenty-two postoperative infections were recorded (6.5% of the patients and 1.7% of the implants)」「These complications were usually diagnosed within the first month, and in 17 cases (77.3%) surgical treatment was performed because of antibiotic therapy failure」「Twelve implants (54.6%) in 12 patients (54.6%) failed before prosthetic loading」
13. Peña-Cardelles JF, Markovic J, Akhondi S, Pedrinaci I, Lanis A, Gallucci GO. Inferior alveolar nerve damage related to dental implant placement. A systematic review and meta-analysis. Med Oral Patol Oral Cir Bucal. 2025 Jul 1;30(4):e578-e589. PMID 40192114. https://pubmed.ncbi.nlm.nih.gov/40192114/（取用 2026-08-06，efetch 摘要取回成功）。逐字 span：「The incidence of neurosensory alterations in patients with implants placed at a distance ≥ 2 mm from the mandibular canal was 0%. Similarly, for distances between 1-2 mm from the mandibular canal, the incidence remained at 0%」「for implants placed at a distance of 0-1 mm from the mandibular canal, the incidence of neurosensory alterations was 68%. Additionally, patients with implants that intruded into the canal had an incidence of 53% in the development of neurosensorial alterations」「A distance of 1 mm from the mandibular canal might be safe」「Clinicians should be aware of the potential risk of nerve injury and adopt appropriate precautions, including meticulous preoperative planning and three-dimensional radiographic images」
14. Conti PCR, Bonjardim LR, Stuginski-Barbosa J, Costa YM, Svensson P. Pain complications of oral implants: Is that an issue? J Oral Rehabil. 2021 Feb;48(2):195-206. PMID 33047362. https://pubmed.ncbi.nlm.nih.gov/33047362/（取用 2026-08-06，efetch 摘要取回成功）。逐字 span：「surgical complications may occur, as excessive bleeding, damage to the adjacent teeth and mandibular fractures」「Persistent pain and abnormal somatosensory responses after the surgery ordinary healing time are also potential problems and may lead to the development of a condition named posttraumatic trigeminal neuropathic pain (PTNP)」「Though relatively rare, PTNP has a profound impact on patient's quality of life」「Appropriated previous image techniques, effective anaesthetic procedures and caution during the surgical procedure and implant installation are recommended for the prevention of this condition」
15. 台湾《医疗法》第 63 条，全国法规资料库。https://law.moj.gov.tw/LawClass/LawSingle.aspx?pcode=L0020021&flno=63（2026-08-06 以 ego-browser 实载，页面标题「醫療法§63-全國法規資料庫」〔原页面为繁体，逐字保留〕，三项条文逐字取得）
16. 台湾《医疗法》第 81、87 条，全国法规资料库。https://law.moj.gov.tw/LawClass/LawSingle.aspx?pcode=L0020021&flno=81／https://law.moj.gov.tw/LawClass/LawSingle.aspx?pcode=L0020021&flno=87（2026-08-06 以 ego-browser 实载逐字，同 VERIFIED-FACTS 已验锚）
17. km 牙医线选题底账：`analysis/reports/km-dental-backlog.md` #47 附录（5 词项逐笔、合计 83,220、跨 4 站），数据源＝14 诊所资产 GSC 全量对账。

内部引用链

• 同族流程卡（先读）：种植牙全过程：从评估到装上牙冠，会经历哪几关？（KM-DENTAL-25，草稿）。两卡的 canonical 边界：归该卡的是——疗程有哪几关、每一关做什么、骨结合要等多久、总疗程为何没有通用月数；归本卡的是——术中不适与术后疼痛的测量与曲线、疼痛的影响因素、复诊与立即就医的分级判准。
• 同族术后卡：种植牙后多久能吃东西？咖啡跟茶可以喝吗？（KM-DENTAL-20，草稿）。该卡管术后饮食时间轴与咖啡、茶、酒精、吸烟的逐项答案；本卡与该卡共用 PMID 26970296 这条患者自述结局锚，英文 span 逐字一致，但取用面向不同（该卡取愈合比较与冰敷，本卡取测量设计、曲线下面积与并发症比例）。
• 并发症正典卡：植骨粉会有后遗症吗？失败了会怎样？（KM-DENTAL-28，草稿）。植骨的并发症、伤口裂开与骨粉颗粒外露等红旗以该卡为准，本卡不重写；本卡只处理「有没有植骨会不会改变疼痛」这一问。
• 决策前的期望校正：种植牙会后悔吗？网友的惨痛经验是真的吗？（KM-DENTAL-07，草稿）。长期并发症与后悔情绪的整理在该卡。

发布闸门提醒：本卡为 draft。四语（zh-Hans／en／ja）未产前不得进 km_entries；本卡含红旗判准（神经感觉异常、术后感染走势反转），依审核链规格需 GM 第三意见（高风险卡）通过后才进终审。