Farias Zilda Betânia Barbosa Medeiros de, Campello Camilla Porto, da Silveira Márcia Maria Fonseca, Moraes Sandra Lúcia Dantas, do Egito Vasconcelos Belmiro Cavalcanti, Pellizzer Eduardo Piza
Department of Oral and Maxillofacial Pathology, School of Dentistry, University of Pernambuco (UPE), Rua Arnóbio Marquês, 310 - Santo Amaro, Recife, PE, 50100-130, Brazil.
Department of Hebiatrics, Determinants of Health in Adolescence, School of Dentistry, University of Pernambuco (UPE), Recife, Brazil.
Clin Oral Investig. 2023 Oct;27(10):5709-5718. doi: 10.1007/s00784-023-05181-1. Epub 2023 Aug 1.
To evaluate the influence of dental anxiety on the perception of pain before and during endodontic treatments.
The PRISMA checklist was followed. A search was conducted in Scopus, Medline/PubMed, The Cochrane Library, and Web of Science databases. Based on PECOS criteria, the first outcome was a possible association between pre-operative pain and anxiety. The second outcome was a possible association between intraoperative pain and anxiety. The type of studies was observational. The JBI Critical Appraisal Checklist was used to evaluate the methodological quality of articles. The certainty of the evidence was analyzed using the GRADE approach.
Four articles were included with a total of 471 patients. Two studies found a positive association between pain and pre-endodontic treatment anxiety. Three studies investigated the relationship between anxiety and intraoperative pain; two identified an extremely significant positive association. One article noted that anxiety influences pain expectancy. The studies were of good quality as assessed by the JBI Critical Appraisal Checklist for cross-sectional studies. However, the certainty of the evidence was considered low and very low.
Dental anxiety can be directly associated with pre- and intraoperative pain during endodontic procedures.
It is necessary to identify patients with dental anxiety to employ therapies to bring their anxiety under control, avoiding the increase of endodontic infections, and the postponement and evasion of endodontic treatments.
评估牙科焦虑症对牙髓治疗前及治疗过程中疼痛感知的影响。
遵循PRISMA清单。在Scopus、Medline/PubMed、Cochrane图书馆和Web of Science数据库中进行检索。根据PECOS标准，第一个结果是术前疼痛与焦虑之间可能存在的关联。第二个结果是术中疼痛与焦虑之间可能存在的关联。研究类型为观察性研究。使用JBI批判性评价清单来评估文章的方法学质量。采用GRADE方法分析证据的确定性。
纳入4篇文章，共471例患者。两项研究发现疼痛与牙髓治疗前焦虑之间存在正相关。三项研究调查了焦虑与术中疼痛之间的关系；两项研究确定存在极其显著的正相关。一篇文章指出焦虑会影响疼痛预期。根据JBI横断面研究批判性评价清单评估，这些研究质量良好。然而，证据的确定性被认为较低和非常低。
牙科焦虑症可能与牙髓治疗过程中的术前和术中疼痛直接相关。
有必要识别出患有牙科焦虑症的患者，采用疗法控制其焦虑，避免牙髓感染增加以及牙髓治疗的推迟和逃避。
