Use of Virtual Reality for the Management of Anxiety and Pain in Dental Treatments: Systematic Review and Meta-Analysis.

(1) Background: Dental treatments often cause pain and anxiety in patients. Virtual reality (VR) is a novel procedure that can provide distraction during dental procedures or prepare patients to receive such type of treatments. This meta-analysis is the first to gather evidence on the effectiveness of VR on the reduction of pain (P) and dental anxiety (DA) in patients undergoing dental treatment, regardless of age. (2) Methods: MEDLINE, CENTRAL, PubMed, EMBASE, Wiley Library and Web of Science were searched for scientific articles in November 2019. The keywords used were: "virtual reality", "distraction systems", "dental anxiety" and "pain". Studies where VR was used for children and adults as a measure against anxiety and pain during dental treatments were included. VR was defined as a three-dimensional environment that provides patients with a sense of immersion, transporting them to appealing and interactive settings. Anxiety and pain results were assessed during dental treatments where VR was used and in standard care situations. (3) Results: 32 studies were identified, of which 8 met the inclusion criteria. The effect of VR in children was significant, both for anxiety (standardized mean difference (SMD) = -1.75) and pain (SMD = -1.46). (4) Conclusions: The findings of the meta-analysis show that VR is an effective distraction method to reduce pain and anxiety in patients undergoing a variety of dental treatments; however, further research on VR as a tool to prepare patients for dental treatment is required because of the scarcity of studies in this area.

Retraction: López-Valverde, N.; et al. Use of Virtual Reality for the Management of Anxiety and Pain in Dental Treatments: Systematic Review and Meta-Analysis. J. Clin. Med. 2020, 9, 1025.

The authors of a recent published paper [...].

Use of Virtual Reality for the Management of Anxiety and Pain in Dental Treatments: Systematic Review and Meta-Analysis.

BACKGROUND: Dental treatments often cause pain and anxiety in patients. Virtual reality (VR) is a novel procedure that can provide distraction during dental procedures or prepare patients to receive such type of treatments. This meta-analysis is the first to gather evidence on the effectiveness of VR on the reduction of pain (P) and dental anxiety (DA) in patients undergoing dental treatment, regardless of age. METHODS: MEDLINE, CENTRAL, PubMed, EMBASE, Wiley Library and Web of Science were searched for scientific articles in November 2019. The keywords used were: "virtual reality", "distraction systems", "dental anxiety" and "pain". Studies where VR was used for children and adults as a measure against anxiety and pain during dental treatments were included. VR was defined as a three-dimensional environment that provides patients with a sense of immersion, transporting them to appealing and interactive settings. Anxiety and pain results were assessed during dental treatments where VR was used, and in standard care situations. RESULTS: 31 studies were identified, of which 14 met the inclusion criteria. Pain levels were evaluated in four studies (n = 4), anxiety levels in three (n = 3) and anxiety and pain together in seven (n = 7). Our meta-analysis was based on ten studies (n = 10). The effect of VR was studied mainly in the pediatric population (for pain SMD = -0.82). In the adult population, only two studies (not significant) were considered. CONCLUSIONS: The findings of the meta-analysis show that VR is an effective distraction method to reduce pain and anxiety in patients undergoing a variety of dental treatments; however, further research on VR as a tool to prepare patients for dental treatment is required because of the scarcity of studies in this area.

Gingival hyperplasia as an early manifestation of acute myeloid leukemia. A retrospective review.

BACKGROUND: We study the prevalence of acute myeloid leukemia (AML) among patients with severe gingival enlargement. MATERIAL AND METHODS: We retrospective reviewed the clinical records of patients with severe gingival enlargement, between 2011 and 2018. The Saxer and Mühlemann index were used to measure inflammation and gingival bleeding. The degree of dental mobility was measured by the Nyman and Lindhe technique. RESULTS: A correlation analysis was carried out to test whether there were any associations among the different variables. In the sample of 117 patients the mean gingival bleeding index was ≥3 and the degree of dental mobility ≥2.3. 1.7% of patients, with severe gingival hyperplasia were diagnosed with AML. We found a significant association between gingival bleeding and aging (p<0.001) and a trend (0.54) between bleeding and suffering from AML. CONCLUSIONS: Severe gingival enlargement, abundant gingival bleeding, and dental mobility could be early manifestations of a blood dyscrasia. Key words:Acute myeloblastic leukemia, gingival hyperplasia, bleeding, tooth motility, oral health.

Effect of Strontium-Coated Titanium Implants on Osseointegration in Animal Models: A Literature Systematic Review.

PURPOSE: This study represents a systematic review of the literature to assess the effectiveness of strontium-coated titanium surfaces on osseointegration in experimental assays with healthy, nonosteoporotic and/or nonosteopenic animals. MATERIALS AND METHODS: An electronic search was conducted of the databases MEDLINE/PubMed, Wiley Library, and Web of Science through 2018, with the aim of identifying studies on the osseointegration of titanium implants modified with strontium. RESULTS: A total of 255 papers were found, of which 11 were included in this systematic review. The primary result was the percentage of bone-to-implant contact (BIC) around the titanium implants with or without a strontium-coated surface. The different techniques used to coat titanium surfaces with strontium recorded significant results in terms of the improvement in the implant's quality, as they increased its contact with the bone, bone area, and bone formation, as well as enhanced its biomechanical properties. CONCLUSION: Nine of 11 studies reported that titanium implants coated with strontium showed significantly higher BIC (P < .001 to P < .05). This coating also improved the implants' biomechanical properties.

Results of the Use of a Simulator for Training in Anesthesia and Regional Analgesia Guided by Ultrasound.

Show the learning results obtained by a simulation tool used by students of an online course on anesthesia techniques and regional analgesia guided by ultrasound. A satisfaction survey generated with a form of Google Forms was carried out in September 2018 with 14 questions related to the quality, ease and capacity of the learning obtained after the use of the nerve blocks Simulator, which was firstly published on the first edition of the course for 34 students. An average of 7.3 attempts of resolution have been made per practice and per student in the simulator. The students are, in their immense majority, habitual users of the ICTs and 73% of them consider that their experience with the simulator has been satisfactory and that their learning has been favored by this fact. The authors have verified that the ultrasound simulator contributes to the learning of skills for the practice of nerve blocks and, furthermore, it helps to ensure that theoretical knowledge is carried out in a more productive and efficient way.

Study of the uses of Information and Communication Technologies by Pain Treatment Unit Physicians.

Adequate use of Information and Communication Technologies (ICTs) in health has been shown to save the patient and caregiver time, improve access to the health system, improve diagnosis and control of disease or treatment. All this results in cost savings, and more importantly, they help improve the quality of service and the lives of patients. The purpose of this study is to analyse the differences in the uses of this ICTs between those physicians that belong to Pain Treatment Units (PU) and other physicians that work in pain not linked to these PUs. An online survey, generated by Netquest online survey tool, was sent to both groups of professionals and the data collected was statistical analysed through a logistic regression methodology which is the Logit binomial model. Our results show that those physicians that belong to PUs use ICTs more frequently and consider it more relevant to their clinical practice.