Can Music Decrease Anxiety and Pain During Dental Implant Surgery? A Randomized Clinical Trial.

PURPOSE: Music has proven to be an effective tool in the management of anxiety during some surgical procedures. The aim of this study was to test the effect of baroque (BM) and classical era music (CM) as a nonpharmacological therapy on the control of anxiety and pain levels among patients undergoing dental implant placement surgery. METHODS: A randomized controlled clinical trial of patients attending a dental clinic was conducted. Patients with psychiatric disorders were excluded. Twenty six patients of Spanish nationality requiring single-tooth dental implant were included. Each patient was assigned to 1 of the 3 experimental groups, which acted as an independent variable: Group I (n = 8) listened to BM; Group II (n = 10) listened to CM; and Group III (n = 8) did not listen to music and was the control group (C). The dependent variables were divided into physiological variables and psychological variables. The physiological dependent variables analysed were systolic and diastolic blood pressure, heart rate, and oxygen saturation, recorded at 4 different times during surgery. The Kruskal-Wallis test compared each of these variables between the 3 experimental groups. The psychological dependent variable analyzed was the degree of anxiety, measured by the self-completed Modified Dental Anxiety Scale and Visual Analog Scale (measured before and after surgery). The Wilcoxon statistical test compared degree of anxiety before and after surgery. In all cases, the level of statistical significance was set at P < .05. RESULTS: The mean age of the sample was 46.5 ± 10.6 (range, 24-69 years), 50% male and 50% female. Statistically significant differences in degree of anxiety before and after surgery were found in the BM (P = .027, confidence interval [CI] = 0.146-6.104; BM before = 4.25 ± 3.91 and BM after = 1.13 ± 1.45) and CM groups (P = .044, CI = 0.161-3.039; CM before = 3.10 ± 2.88 and CM after = 1.50 ± 1.43) and were not found in group C (P = .180, CI = 1.104-3.604; C before = 2.63 ± 3.62 and C after = 1.38 ± 1.99). When comparing the perceived pain after the intervention among the 3 groups (C, BM, and CM), no significant differences were observed between them (P = .319; CI = -0.58-1.96; C = 0.75 ± 1.75, BM = 1.25 ± 1.75, and CM = 1.70 ± 1.70). CONCLUSION: Listening to BM and CM reduces anxiety in patients undergoing dental implant placement surgery. Musical flow should be applied in this practice.

Effectiveness of Nd:YAG Laser on the elimination of debris and Smear Layer. A comparative study with two different irrigation solution: EDTA and QMix® in addition to NaOCl.

BACKGROUND: The aim of this study was to evaluate the effectiveness in dentin debris and smear layer removal from root canal walls using EDTA and QMix® alone and also activated with Nd:YAG laser. MATERIAL AND METHODS: 50 single-rooted teeth were instrumented and divided in 5 groups according to irrigation protocol: 17% EDTA, QMix®, Nd:YAG laser alone, and combination of 17% EDTA - Nd:YAG laser and QMix® - Nd:YAG laser. Samples were evaluated using SEM. Statistical analysis was done using Chi-Square Fisher exact test and McNemar test. RESULTS: Dentinal debris analysis showed statistically significant differences when comparing 17% EDTA vs Laser and Laser vs QMix® in combination with Laser at the apical third. The Smear Layer analysis also showed statistically significant differences at the apical third when comparing 17% EDTA vs Laser, QMix® vs QMix® in combination with Laser and Laser vs QMix® in combination with Laser. CONCLUSIONS: 17% EDTA was the most efficient irrigant showing the best results. Laser alone was not effective removing either dentinal debris or smear layer. Key words:Laser, endodontics, Smear Layer.