Raocharernporn Somchart, Boonsiriseth Kiatanant, Khanijou Manop, Wongsirichat Natthamet
Department of Oral Maxillofacial Surgery, Faculty of Dentistry, Mahidol University, Bangkok, Thailand.
J Dent Anesth Pain Med. 2017 Jun;17(2):105-111. doi: 10.17245/jdapm.2017.17.2.105. Epub 2017 Jun 29.
Dental fear is usually associated with hemodynamic changes. Fear of pain during the surgical removal of a lower impacted third molar might cause patients anxiety, thereby leading to avoidance of any future dental therapy. This study aimed to determine the effect of experiencing a surgical impacted-tooth removal on the pain perception-related anxiety and hemodynamic status.
Twenty-seven healthy patients aged 15-30 years (mean age, 24 years), for whom surgical removal of bilateral lower third molars was advised, were included. This prospective, randomized, controlled, split-mouth study involved operations on both sides of the mandibular arch, with a 1-month washout period in between. Blood pressure and heart rate were measured before the surgical procedure, during and after the injection, preoperatively, and postoperatively. Pain perception was evaluated using a 100-mm visual analog scale during the injection, preoperatively, and postoperatively after the numbness disappeared. Differences in the blood pressure, heart rate, and pain perception between the two appointments were analyzed using the paired t-test. For all statistical analyses, SPSS version 11.5 was used.
The mean pain perception values during the injection and preoperatively showed no significant differences between the two appointments (P > 0.05); however, significant differences in the blood pressure and heart rate were noted before the surgical procedure; preoperatively, the blood pressure alone showed a significant difference (P < 0.05).
There was a significant decrease in the blood pressure and heart rate preoperatively; hence, experiencing a surgical impacted-tooth removal can reduce the subsequent preoperative anxiety in healthy patients.
牙科恐惧通常与血流动力学变化相关。在下颌阻生第三磨牙手术拔除过程中对疼痛的恐惧可能会导致患者焦虑,从而使其避免未来的任何牙科治疗。本研究旨在确定经历手术拔除阻生牙对疼痛感知相关焦虑和血流动力学状态的影响。
纳入27名年龄在15 - 30岁(平均年龄24岁)的健康患者,他们被建议进行双侧下颌第三磨牙的手术拔除。这项前瞻性、随机、对照、双颌研究涉及下颌牙弓两侧的手术,中间有1个月的洗脱期。在手术前、注射期间和之后、术前以及术后测量血压和心率。在注射期间、术前以及术后麻木消失后,使用100毫米视觉模拟量表评估疼痛感知。使用配对t检验分析两次就诊之间血压、心率和疼痛感知的差异。所有统计分析均使用SPSS 11.5版。
两次就诊期间注射时和术前的平均疼痛感知值无显著差异(P > 0.05);然而,在手术前血压和心率存在显著差异;术前,仅血压显示出显著差异(P < 0.05)。
术前血压和心率显著降低;因此,经历手术拔除阻生牙可以减轻健康患者随后的术前焦虑。