Dental anxiety is a common problem in oral surgery practices. Recently, interest has increased in non-pharmacological methods to reduce anxiety, such as auditory stimulation. This randomized controlled trial evaluated the effects of binaural beats (BB) and isochronic tones (IT), two forms of auditory stimulation, on dental anxiety and physiological parameters during impacted mandibular third molar surgery. Ninety patients were assigned equally to BB, IT, and control (no intraoperative auditory stimulation) groups. Anxiety levels were assessed using the MDAS, DFS, STAI-S, and a visual analogue scale pre- and postoperatively. The BB and IT group patients also completed a satisfaction questionnaire. Physiological parameters (respiratory rate, pulse rate, blood pressure [SBP, DBP], oxygen saturation) were recorded at eight surgical stages. No significant between-group differences were observed in the pre- or postoperative anxiety questionnaire scores. Isolated between-group differences in physiological parameters were observed: mean SBP at incision was lowest in the BB group (P = 0.041), while mean respiratory rate at anaesthesia was lowest in the IT group (P = 0.015). The majority of BB and IT group patients (78.3%) reported that they would prefer auditory stimulation in future dental treatments. The findings indicate that BB and IT have a limited effect on reducing dental anxiety during impacted mandibular third molar surgery and do not support a definitive anxiolytic benefit. Auditory stimulation may transiently influence certain stress-related physiological responses; however, further studies using objective neurophysiological measures and standardized protocols are required to clarify their role in oral surgery.
O. Akkurt, Ö. Ekici· International Journal of Ora...· 0 citations
INTRODUCTION
Impacted mandibular third molar surgery (IMTMS) is one of the dental surgical procedures where pain and anxiety are frequently encountered. The aim of this study was to compare the effects of the computer-assisted local anesthesia system (CALAS) and conventional local anesthesia (CLA) on pain, anxiety, and hemodynamic changes during IMTMS.
MATERIAL AND METHODS
This prospective, randomized, split-mouth clinical trial included 40 patients with bilateral impacted mandibular third molars. CALAS and CLA were administered in separate surgical sessions at least three weeks apart. Pain was assessed using the Visual Analog Scale for Pain (VAS-P), whereas anxiety was assessed using the Visual Analog Scale for Anxiety (VAS-A), the State-Trait Anxiety Inventory (STAI-S and STAI-T), the Modified Dental Anxiety Scale (MDAS), and the Dental Fear Scale (DFS). Postoperative satisfaction was evaluated using a four-item questionnaire. Hemodynamic parameters, including respiratory rate (RR), pulse rate (PR), systolic blood pressure, diastolic blood pressure, and oxygen saturation (SpO₂), were recorded at eight predefined stages of the surgical procedure.
RESULTS
Postoperative pain and anxiety scores were significantly higher in CLA sessions than in CALAS sessions. Postoperative VAS-P and VAS-A scores were also higher in CLA applications than in CALAS applications (VAS-P: 6.62±1.59 vs 1.90±0.87; VAS-A: 6.75±1.67 vs 2.40±1.79; p<0.001 for both). Similarly, higher values were observed for STAI-S, MDAS, and other psychometric measurements in CLA applications. In the hemodynamic assessment, pulse rate (PR), systolic blood pressure (SBP), and diastolic blood pressure (DBP) showed more pronounced increases during some surgical stages in CLA sessions, whereas inter-technique differences remained limited for respiratory rate (RR) and SpO₂. In the postoperative satisfaction survey, participants rated CALAS as more effective than CLA in reducing anxiety and pain (p=0.002 and p=0.001, respectively).
DISCUSSION
The findings suggest that CALAS may limit increases in pain and anxiety during IMTMS and may be associated with less pronounced physiological fluctuations during some surgical stages. Clinically, the potential advantage of CALAS appears to be related to more controlled anesthetic delivery rather than elimination of needle use. However, these findings should be interpreted cautiously because the study was based on a single-center split-mouth design with a limited sample size.
TRIAL REGISTRATION
NCT06852066.
İsmail Çalışkan, Ö. Ekici· Journal of Stomatology Oral...· 0 citations
