The blood pressure is considered to be affected by many factors, including physical and psychological stress in dental treatment. From a physical aspect, there are many reports about the relationship between blood pressure and local anesthesia or pain [8–11].

In fact, Tsuchihashi et al. reported that there was a correlation between increased blood pressure and infiltrated anesthesia amount [12].

On the other hand, there are not so many studies about the blood pressure change affected by the psychological aspect.

In this study, we found that neuroticism is significantly correlated with DBP and MBP increase. Ploubidis et al. reported that a person with a high degree of neuroticism assessed with the Eysenck Personality Inventory tended to self-select situations likely to lead to adversity and distress [13]. Guasti et al. also found that there was a positive correlation between provoked stress and blood pressure change using mental arithmetic stress test [14]. In addition, Eli et al. found that a patient’s anxiety was highest immediately before a surgical procedure compared to immediately post-operatively and at 4 weeks post-operative follow-up [15]. These results are similar to our findings. It is thought that increase of blood pressure sometimes causes hematoma formation and increases circulation blood volume. As a result, the burden to physical condition including cardiac function is expected. Rate pressure product (RPP), which had no correlation with personal traits in this study, is also a reliable predictor of myocardial oxygen consumption, and RPP >12,000 bpm × mmHg is associated with myocardial ischemia [16–18].

There were no severe problems during the implant surgery because the patients in this study did not have moderate or severe hypertension or cardiovascular system disease. However, we should pay enough consideration to elder people or patients who have these systemic diseases and neuroticism or extraversion character during implant surgery. Applications such as nitrous oxide or intravenous sedation may be desirable for these patients. In fact, Ichinobe et al. reported that intravenous sedation stabilized measureable changes in blood pressure and pulse rate due to fear and anxiety about dental treatment [19].