Purpose: The aim of this study was to compare the pain experienced after implant placement with 2 different surgical procedures: a flapless surgical procedure using an image-guided system based on a template and an open-flap procedure. materials and methods: The study population consisted of 60 patients who were referred for implant placement. One group consisted of 30 patients who were referred for the placement of 80 implants and treated with a flapless procedure. The other group consisted of 30 patients who were referred for the placement of 72 implants with a conventional procedure. Patients were selected randomly. They were requested to fill out a questionnaire using a visual analog scale (VAS) to assess the pain experienced and to indicate the number of analgesic tablets taken every postoperative day from the day of the surgery (D0) to 6 days after surgery (D6). Results: The results showed a significant difference in pain measurements, with higher scores on the VAS with open-flap surgery (P .01). Pain decreased faster with the flapless procedure (P = .05). The number of patients who felt no pain (VAS = 0) was higher with the flapless procedure (43% at D0 versus 20%). With the flapless procedure, patients took fewer pain tablets (P = .03) and the number of tablets taken decreased faster (P = .04). Discussion: Minimally invasive procedures may be requested by patients to reduce their anxiety and the pain experienced and thus increase the treatment acceptance rate. Conclusion: With the flapless procedure, patients experienced pain less intensely and for shorter periods of time. Keywords: computer-aided surgery, dental implants, minimally invasive surgical procedures, pain