Influence of an Audiovisual Resource on the Preoperative Anxiety of Adult Endodontic Patients: A Randomized Controlled Clinical Trial.

INTRODUCTION: The expectation of undergoing endodontic treatment can cause anxiety in patients. Anxiety is described as a transient emotional state closely related to pain, fear, and imbalance of the organism. The clinician commonly must use some type of tool to alleviate the patient's preoperative anxiety before treatment can be applied. The aim of this study was to evaluate the influence of an audiovisual resource on the preoperative anxiety of adult patients undergoing endodontic treatment. METHODS: One hundred sixty endodontic patients were randomly divided into experimental and control groups (n = 80) and then assessed at 2 preoperative time points separated by a 10-minute interval. After the first assessment, the patients in the experimental group watched a video of their own choice obtained from the Internet to provide them with a relaxing experience. In both groups and at both time points, the assessments consisted of collecting the patients' vital signs (diastolic blood pressure, systolic blood pressure, and heart rate) and data regarding their subjective perception of anxiety using a visual analog scale. RESULTS: There were no significant differences between the groups regarding the vital sign variation observed between the 2 assessment time points. However, the variation in the scores obtained on the visual analog scale was significantly greater in the experimental group (P < .05), indicating a greater reduction in the level of preoperative anxiety in this group. CONCLUSIONS: The preoperative use of an audiovisual resource was associated with a decrease in the perception of anxiety by patients undergoing endodontic treatment.

Influence of coronal restoration and root canal filling quality on periapical status: clinical and radiographic evaluation.

INTRODUCTION: The purpose of this study was to evaluate the relationship between periapical status and the quality of coronal restoration and of root canal filling, assessed both clinically and radiographically, in a cohort of Brazilian patients. METHODS: A total of 523 teeth from 337 patients submitted to endodontic treatment were clinically and radiographically reexamined 2-10 years postoperatively. Restoration and root canal filling quality were classified according to modified criteria from Tronstad et al. Periapical status was evaluated according to periapical index scores. Mann-Whitney and Friedman tests were used to conduct the descriptive analysis. Correlations were analyzed by using simple and multivariate logistic regression analysis. RESULTS: No significant difference was observed between the rates of apical periodontitis for adequate or inadequate coronal restorations assessed clinically (12.8% versus 19.4%), whereas these rates were significantly different when the restoration quality was assessed radiographically (11.6% versus 28.7%, P < .001). The rates of apical periodontitis in teeth with inadequate root canal filling, with or without adequate restoration, were significantly higher than in teeth with adequate canal filling, with or without adequate restoration (38.6% and 48.4% versus 6.5% and 14.6%, respectively; P < .0001). CONCLUSIONS: Using either a radiographic or clinical assessment alone was not a reliable method to ascertain whether restoration quality could be correlated with postoperative periapical status. Poor root canal filling quality was a prognostic determinant of endodontic treatment failure, whereas coronal restoration quality had a lesser impact on the outcome of the endodontic treatment.