Dental Anxiety, Impacted Mandibular Third Molar Extraction
Conditions
Keywords
Surgical Information Video, Dental Anxiety, Impacted Third Molar, Vital Signs
Brief summary
This study evaluates whether physician-guided visual information provided before impacted mandibular third molar surgery can improve hemodynamic stability during the perioperative period. Participants are assigned to one of three preoperative information methods: standard verbal information, real surgical video information, or 3D animation video information. Changes in systolic blood pressure, diastolic blood pressure, heart rate, and oxygen saturation are assessed at multiple perioperative time points to determine whether visual information reduces stress-related physiologic responses. The study also examines whether these information methods influence preoperative dental fear.
Detailed description
Impacted mandibular third molar surgery is a common oral surgical procedure that is frequently associated with patient stress, fear, and physiologic fluctuations during the perioperative period. In addition to subjective anxiety, these stress responses may be reflected in hemodynamic parameters such as systolic blood pressure, diastolic blood pressure, heart rate, and oxygen saturation. This randomized controlled study was designed to investigate whether physician-guided visual information can improve perioperative hemodynamic stability compared with standard verbal information alone. Participants undergoing impacted mandibular third molar surgery are assigned to one of three preoperative information approaches: standard verbal information, real surgical video information, or 3D animation video information. The primary objective is to compare the effects of these information modalities on perioperative hemodynamic responses measured at predefined time points, including baseline, after local anesthesia, during tooth luxation, after suturing, and during the early recovery period. The secondary objective is to evaluate the effect of these information methods on dental fear using a validated psychometric scale. The study is based on the hypothesis that visually supported preoperative information, when delivered in a structured and physician-guided manner, may reduce stress-related physiologic fluctuations during surgery and may also influence patients' self-reported dental fear. By comparing verbal, real video, and animation-based information methods, the study aims to clarify whether visual information contributes to better physiologic regulation and patient preparation before third molar surgery.
Interventions
BEHAVIORALStandard Verbal Information
Participants receive standard physician-delivered verbal preoperative information before impacted mandibular third molar surgery.
BEHAVIORALReal Surgical Video Information
Participants receive physician-guided preoperative information using a real surgical video before impacted mandibular third molar surgery.
BEHAVIORAL3D Animation Video Information
Participants receive physician-guided preoperative information using a 3D animation video before impacted mandibular third molar surgery.
Sponsors
Recep Tayyip Erdogan University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
SINGLE (Investigator)
Masking description
The operating clinician/investigator was blinded to group assignment during the surgical procedure. Participants were aware of the type of preoperative information they received; therefore, participant masking was not possible.
Intervention model description
Participants are assigned in parallel to 1 of 3 groups: standard verbal information, real surgical video information, or 3D animation video information before impacted mandibular third molar surgery.
Eligibility
Sex/Gender
ALL
Age
18 Years to 50 Years
Healthy volunteers
No
Inclusion criteria
* Age between 18 and 50 years * ASA physical status I or II * Radiographic evidence of an impacted mandibular third molar classified as Pell-Gregory Class I or II and Position A or B * Presence of mandibular third molar (tooth 38 or 48) in a vertical or mesioangular position according to Winter's classification * Indication for impacted mandibular third molar extraction * Willingness to participate and provide written informed consent
Exclusion criteria
* Active smoking or alcohol consumption * Bleeding/coagulation disorders or any systemic disease/medication use that could impair wound healing * Pregnancy or lactation * Local pathologies associated with the impacted tooth, such as cysts or tumors * History of severe anxiety disorder or known psychiatric illness * Known allergy to local anesthetics or planned postoperative medications * Presence of uncontrolled active periodontal disease * Inability or unwillingness to comply with follow-up procedures
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Systolic Blood Pressure (SBP) | Assessed at 5 specific time points: from baseline (preoperative) up to 15 minutes postoperatively | Systolic blood pressure is measured in millimeters of mercury (mmHg) to evaluate hemodynamic stability. The measurements are recorded at five specific time points: at baseline (T0), after local anesthesia (T1), during tooth luxation (T2), after suturing (T3), and 15 minutes postoperatively (T4). |
| Change in Diastolic Blood Pressure (DBP) | Assessed at 5 specific time points: from baseline (preoperative) up to 15 minutes postoperatively | Diastolic blood pressure is measured in millimeters of mercury (mmHg) to evaluate hemodynamic stability. The measurements are recorded at five specific time points: at baseline (T0), after local anesthesia (T1), during tooth luxation (T2), after suturing (T3), and 15 minutes postoperatively (T4). |
| Change in Heart Rate (HR) | Assessed at 5 specific time points: from baseline (preoperative) up to 15 minutes postoperatively | Heart rate is measured in beats per minute (bpm) to evaluate physiological stress response. The measurements are recorded at five specific time points: at baseline (T0), after local anesthesia (T1), during tooth luxation (T2), after suturing (T3), and 15 minutes postoperatively (T4). |
| Change in Oxygen Saturation (SpO₂) | Assessed at 5 specific time points: from baseline (preoperative) up to 15 minutes postoperatively | Peripheral oxygen saturation is measured as a percentage (%) to evaluate respiratory stability. The measurements are recorded at five specific time points: at baseline (T0), after local anesthesia (T1), during tooth luxation (T2), after suturing (T3), and 15 minutes postoperatively (T4) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Modified Dental Fear Survey (MDFS) Score | Assessed once, immediately after the preoperative information intervention (just prior to surgery) | Dental fear is assessed using the Modified Dental Fear Survey (MDFS). The survey consists of 20 items, with each item scored on a 5-point Likert scale (from 1 = not at all, to 5 = very much). The total score ranges from a minimum of 20 to a maximum of 100. Higher scores indicate a higher level of dental fear and anxiety, which represents a worse outcome. |
Countries
Turkey (Türkiye)
Participant flow
Recruitment details
Participants were recruited from patients presenting to the Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Recep Tayyip Erdoğan University, for impacted mandibular third molar surgery. Eligible patients were screened according to the predefined inclusion and exclusion criteria and enrolled after providing written informed consent.
Pre-assignment details
After eligibility assessment and written informed consent, participants were randomized using the sealed-envelope method. No participants withdrew before assignment.
Baseline characteristics
| Characteristic | — |
|---|---|
| Age, Customized 18-20 years | 13 Participants |
| Age, Customized 21-23 years | 20 Participants |
| Age, Customized 24-33 years | 22 Participants |
| Race and Ethnicity Not Collected | 0 Participants |
| Sex: Female, Male Female | 46 Participants |
| Sex: Female, Male Male | 10 Participants |
| Tooth Number 38 | 27 Participants |
| Tooth Number 48 | 45 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk |
|---|---|---|---|
| deaths Total, all-cause mortality | 0 / 24 | 0 / 24 | 0 / 24 |
| other Total, other adverse events | 0 / 24 | 0 / 24 | 0 / 24 |
| serious Total, serious adverse events | 0 / 24 | 0 / 24 | 0 / 24 |
Outcome results
None listed