Yamashita Kaoru, Kibe Toshiro, Aoyama Kanae, Ohno Sachi, Kohjitani Atsushi, Sugimura Mitsutaka
Assistant Professor, Department of Dental Anesthesiology, Field of Oral Maxillofacial Rehabilitation, Developmental Therapeutics Course, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.
Assistant Professor, Department of Oral and Maxillofacial Surgery, Field of Oral and Maxillofacial Surgery, Developmental Therapeutics Course, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.
J Oral Maxillofac Surg. 2020 Apr;78(4):538-544. doi: 10.1016/j.joms.2019.11.030. Epub 2019 Dec 3.
Dental anxiety about extraction of impacted mandibular third molars changes the activity of the autonomic nervous system. Thus, to provide safe dental treatment, it is important that a surgeon be aware of a patient's pretreatment anxiety and autonomic nervous system state. Therefore, we analyzed how a scheduled treatment to extract mandibular third molars affects the pretreatment electroencephalogram (EEG), autonomic nervous system, and psychological state of patients. We compared their findings with those of volunteers not scheduled to undergo dental treatment.
The study enrolled 30 patients who were scheduled to undergo impacted mandibular third molar extraction (ie, pretreatment group) and 30 volunteers who were not (ie, control group). Heart rate variability and an EEG were recorded during the experiment. The State Anxiety Inventory-State Anxiety scale (STAI-S) scores were recorded before the procedure. For the statistical analysis, P < .05 was deemed statistically significant.
High-frequency (HF) variability was significantly decreased and the STAI-S score was significantly increased in the pretreatment group compared with the control group (P < .01 for both). The low frequency (LF)/HF ratio and alpha-wave activity showed a significant negative correlation on both sides in the control group (P < .01); however, no correlation existed in the pretreatment group. The LF/HF ratio and STAI-S score showed a significant positive correlation in the pretreatment group (P < .05); however, no correlation existed in the control group.
Predicting a patient's autonomic nervous system state before dental treatment based on the EEG was difficult. The STAI-S psychological test was a useful method.
对拔除下颌阻生第三磨牙的牙科焦虑会改变自主神经系统的活动。因此,为了提供安全的牙科治疗,外科医生了解患者治疗前的焦虑和自主神经系统状态非常重要。因此,我们分析了计划进行的下颌第三磨牙拔除治疗如何影响患者治疗前的脑电图(EEG)、自主神经系统和心理状态。我们将他们的研究结果与未计划接受牙科治疗的志愿者的结果进行了比较。
该研究招募了30名计划接受下颌阻生第三磨牙拔除术的患者(即治疗前组)和30名未计划接受该手术的志愿者(即对照组)。实验期间记录心率变异性和脑电图。在手术前记录状态焦虑量表-状态焦虑量表(STAI-S)得分。对于统计分析,P <.05被认为具有统计学意义。
与对照组相比,治疗前组的高频(HF)变异性显著降低,STAI-S得分显著升高(两者均P <.01)。对照组两侧的低频(LF)/HF比值与α波活动呈显著负相关(P <.01);然而,治疗前组不存在相关性。治疗前组的LF/HF比值与STAI-S得分呈显著正相关(P <.05);然而,对照组不存在相关性。
基于脑电图预测牙科治疗前患者的自主神经系统状态很困难。STAI-S心理测试是一种有用的方法。