The potential of heart rate variability for exploring dental anxiety in mandibular third molar surgery

Le, Son Hoang; Tonami, Ken‐ichi; Umemori, Sachi; Nguyen, Ly Thi‐Bich; Ngo, Lan Thi‐Quynh; Mataki, Shiro

doi:10.1016/j.ijom.2018.01.019

Cited by 26 publications

(25 citation statements)

References 37 publications

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“…Pell-Gregory classification including erupted direction, impacted depth and available space is a conventional method to predict the surgical difficulty in the majority of MTM studies 8,[15][16][17] . Among those factors, the impacted depth was proved to be correlated with lingual nerve damage in previous studies 18,19 .…”

Section: Discussionmentioning

confidence: 99%

The vulnerability of lingual plate of the mesioangular impacted mandibular third molars: a measurement on CBCT images

Nguyen

et al. 2020

Oral Surgery

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Objectives: The innate fragility of lingual plate (LP) is assumed to be the main reason leading to injuries of lingual neurovascular bundles and surrounding fascial spaces during mandibular third molar (MTM) surgery. The aim of this study was to assess the LP and lingual cortical plate (LCP) thickness of mesioangular impacted MTM. Methods: A total of 130 cone beam computed topography images were collected and studied. The related landmarks of MTM roots and LP were identified for measurements. At three positions of each root, including middle third, apical third and apex, the integrity of LP together with thickness of LP and LCP were evaluated. Results: The results showed that mean values of LP and LCP thickness of the most lingual root at apical third were 0.89 and 0.57 mm respectively. The average values of LP and LCP thickness surrounding mesial root were significantly smaller than those of distal root at all examined positions, except LP thickness at the apex. Moreover, the thickness of LP presumably increased together with the horizontal and vertical impacted levels according to Pell-Gregory classification. The percentage of losing LP integrity was determined as 89.5%, 93.4% and 77.4% at middle third, apical third and apex, respectively. Conclusion: In conclusion, LP surrounding the mesioangular impacted MTM is considerably thin, which can be the reason of lingual neurovascular bundles traumas and fascial spaces damages, especially at the apical third of the mesial root and in class A MTM. Clinical relevance Scientific rationale for studyThe width of lingual plate (LP) is one of the most vital factors associated with lingual nerve trauma and tooth displacement to submandibular spaces in third molars extraction. Principle findingsLingual plate surrounding mesioangular impacted third molars is particularly thin in the majority of cases. LP of mesioangular impacted tooth is more vulnerable than that of distoangular one. The thickness of LP is also correlated to vertical and horizontal levels of impaction by Pell-Gregory classification.

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Section: Discussionmentioning

confidence: 99%

The vulnerability of lingual plate of the mesioangular impacted mandibular third molars: a measurement on CBCT images

Nguyen

et al. 2020

Oral Surgery

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“…(13,14,(16)(17)(18)(19)(20) In our study, in the accordance with some researchers, no statistically significant relation was found between the dental anxiety and age or gender of individuals. (13,21) It is expected that the anxiety level of an individual who had undergone dental surgery before would decrease in the subsequent procedures. 9 Positive dental procedure experiences will decrease anxiety, while negative experiences will increase anxiety.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Dental Anxiety in Patients Undergoing Second-Stage Implant Surgery with Er,Cr: YSGG Laser Treatment: Randomized Clinical Trial

Tunç¹,

Yaylı²,

Talmaç³

et al. 2020

Eastern J Med

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Oral surgical procedures cause high-pain expectation and consequent anxiety in patients. The aim of this study is to compare the effects of Er, Cr: YSGG laser and scalpel method on dental anxiety level during second-stage implant surgery. 96 patients with 304 osseointegrated implants were divided into two groups. Implants embedded under the oral mucosa were exposed with scalpel or laser surgery. Before the operation the patients were asked to fill the STAI and DAS while resting in the waiting room. In addition, postoperative daily analgesic use, VAS scores perioperativly and on the postoperative 1 st , 2 nd and 3 rd days and demographic information such as age and gender were also recorded. There was no statistically significant relationship between surgical m ethod and anxiety levels (p>0.05. Also, the differences between the scalpel and laser groups in terms of total DAS and STAI scores were statistically insignificant (p>0.05). But statistically significant difference was found between surgical method and the analgesic consumption (p<0.05). A higher rate of analgesic consumption was observed in the scalpel group. The use of Er,Cr;YSGG laser could reduce pain during minor oral surgical procedures but had no significant effect on dental anxiety. Different modalities that could provide additional benefits in overcoming this situation should be investigated.

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“…Changes in the autonomic nervous activity can be analyzed by assessing the heart rate variability (HRV). [8][9][10] This method has recently been used in a study where dental treatment was administered under intravenous sedation. 4 The power spectrum of heartbeat intervals is divided into low frequency (LF: 0.04-0.15 Hz) and high frequency (HF: 0.15-0.4 Hz) via frequency domain analysis.…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, the LF/HF is used as a sympathetic nerve index, and the HF is used as a parasympathetic nerve index. 11 Among the different types of dental treatments, extraction of the impacted mandibular third molar (IMTM) is associated with the highest anxiety [10][11][12][13] ; however, no study has investigated the changes in the autonomic nerve activity during this procedure when patients are under intravenous sedation. Therefore, we evaluated the effects of intravenous sedation on autonomic nerve activity, cardiovascular parameters, and the psychological state during IMTM extraction.…”

Section: Introductionmentioning

confidence: 99%

Effects of intravenous sedation on autonomic nerve activity and the psychological state during tooth extraction: A prospective non‐randomized controlled trial

Uchino

Yamashita

Kibe

et al. 2020

Oral Science International

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Purpose: Intravenous sedation is considered to decrease patient anxiety and tension during dental treatment, thereby reducing fluctuations in autonomic nerve activity and the risk of medical emergencies. We hypothesized that intravenous sedation would suppress the sympathetic nervous system during tooth extraction and relieve patient anxiety. Accordingly, the purpose of this study was to investigate the effects of intravenous sedation on autonomic nerve activity and psychological state during impacted mandibular third molar (IMTM) extraction. Methods: This prospective study included 40 healthy women scheduled for IMTM extraction under local anesthesia alone (control group; n = 20) or local anesthesia and intravenous sedation (sedation group; n = 20); of these, 34 women were evaluated. Heart rate variability (HRV) was analyzed to evaluate autonomic nerve activity. HRV and circulatory dynamics were measured during the treatment. The Modified Dental Anxiety scale and State-Trait Anxiety Inventory (STAI-S and STAI-T) scores were obtained before treatment. STAI-S scores were also obtained after treatment.Descriptive and bivariate statistical analyses were conducted, and a P-value <.05 was considered statistically significant. Results:The low-frequency/high-frequency ratio was lower in the sedation group than in the control group (P < .01). Compared with the control group, the sedation group showed a significantly greater decrease in post-treatment STAI-S scores relative to pre-treatment scores (P < .01). Conclusions:The findings suggest that sedation suppresses the sympathetic nervous system during IMTM extraction and decreases anxiety after the extraction. Further research should elucidate the mechanisms by which sedation suppresses the sympathetic nervous system.

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The potential of heart rate variability for exploring dental anxiety in mandibular third molar surgery

Cited by 26 publications

References 37 publications

The vulnerability of lingual plate of the mesioangular impacted mandibular third molars: a measurement on CBCT images

The vulnerability of lingual plate of the mesioangular impacted mandibular third molars: a measurement on CBCT images

Evaluation of Dental Anxiety in Patients Undergoing Second-Stage Implant Surgery with Er,Cr: YSGG Laser Treatment: Randomized Clinical Trial

Effects of intravenous sedation on autonomic nerve activity and the psychological state during tooth extraction: A prospective non‐randomized controlled trial

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