Predictive and Relative factors of Dental Anxiety among Third Molar Disimpaction Patients in a Northern Nigerian Hospital.

INTRODUCTION: Various factors influence the expression of dental anxiety (DA) among patients. Knowledge of these factors may aid the management of mandibular third molar (M3) dis-impaction patients. AIM: The study aimed to determine the predictive and relative factors of DA among Mandibular third molar (M3) dis-impaction patients at the Aminu Kano Teaching Hospital (AKTH), Kano, Nigeria. METHODOLOGY: The study was a cross-sectional type conducted at the Oral Surgery clinic of AKTH, Kano among M3 dis-impaction patients between September 2016 and August 2017. Biodata and information on the past dental history of the participants were collected and recorded. The level of anxiety of participants was assessed with the Modified Dental Anxiety Scale (MDAS). Data were analyzed using Statistical Package for Social Sciences (SPSS) for windows (IBM SPSS statistic version 23). The significance level in the study was set at p ≤ 0.05. RESULTS: One hundred and sixteen patients comprising 62(55.2%) males and 54(44.8%) females were recruited. The sample's median age was 27 years and the majority of the participants were students (n=49,42.2%). The participants' MDAS scores ranged from 5 to 22 with a median score of 11. Females (median MDAS score of 12.50) were significantly (p<0.0001) more anxious than males (median MDAS score of 9.00). Bivariate analysis showed statistically significant differences in DA of the categories of the following independent variables - gender (p<0.0001), ethnicity (p=0.041), occupational status (p=0.044), previous surgical extraction experience (p=0.006), previous bad dental treatment experience (p<0.0001) and history of postponement of dental treatment due to anxiety(p<0.0001). Binary logistic regression analysis with these variables as independent predictors of DA showed that only gender (p=0.013) and previous surgical extraction experience (p=0.042) had statistically significant odds of predicting dental anxiety among the patients. Females had significantly higher odds of being anxious than males [adjusted odds ratio (OR) = 4.180, 95% Confidence Interval (CI)=1.359 to 12.852] and patients with previous surgical extraction experience had higher odds of being anxious than those without surgical extraction experience [adjusted OR=3.65, 95% CI=1.02 to 13.03]. CONCLUSION: The predictors of DA in the study are female gender and previous surgical extraction experience. These and other DA-related factors such as patients' occupation and previous bad dental treatment experiences should be considered preoperatively to identify and manage anxious M3 dis-impaction patients.

INTRODUCTION: Divers facteurs influencent l'expression de l'anxiété dentaire (AD) chez les patients. La connaissance de ces facteurs peut aider à la prise en charge des patients subissant l'extraction des troisièmes molaires mandibulaires (M3). OBJECTIF: L'étude visait à déterminer les facteurs prédictifs et relatifs de l'AD chez les patients subissant l'extraction des troisièmes molaires mandibulaires (M3) à l'Hôpital Universitaire Aminu Kano (AKTH) de Kano, au Nigeria. MÉTHODOLOGIE: L'étude était de type transversal et a été menée à la clinique de chirurgie buccale de l'AKTH, à Kano, auprès de patients subissant l'extraction des M3 entre septembre 2016 et août 2017. Les données biométriques et les antécédents dentaires des participants ont été recueillis et enregistrés. Le niveau d'anxiété des participants a été évalué à l'aide de l'Échelle d'Anxiété Dentaire Modifiée (MDAS). Les données ont été analysées à l'aide du logiciel Statistical Package for Social Sciences (SPSS) pour Windows (version IBM SPSS 23). Le seuil de signification de l'étude a été fixé à p ≤ 0,05. RÉSULTATS: Cent seize patients, dont 62 (55,2 %) hommes et 54 (44,8 %) femmes, ont été recrutés. L'âge médian de l'échantillon était de 27 ans et la majorité des participants étaient des étudiants (n=49, 42,2 %). Les scores MDAS des participants variaient de 5 à 22, avec un score médian de 11. Les femmes (score MDAS médian de 12,50) étaient significativement (p<0,0001) plus anxieuses que les hommes (score MDAS médian de 9,00). L'analyse bivariée a montré des différences statistiquement significatives dans l'AD des catégories des variables indépendantes suivantes : le sexe (p<0,0001), l'ethnicité (p=0,041), le statut professionnel (p=0,044), l'expérience d'extraction chirurgicale antérieure (p=0,006), l'expérience antérieure de mauvais traitement dentaire (p<0,0001) et l'histoire du report du traitement dentaire en raison de l'anxiété (p<0,0001). L'analyse de régression logistique binaire avec ces variables comme prédicteurs indépendants de l'AD a montré que seul le sexe (p=0,013) et l'expérience d'extraction chirurgicale antérieure (p=0,042) avaient des cotes de prédiction statistiquement significatives de l'anxiété dentaire chez les patients. Les femmes avaient des chances significativement plus élevées d'être anxieuses que les hommes [rapport de cotes ajusté (OR) = 4,180, intervalle de confiance à 95 % (IC) = 1,359 à 12,852] et les patients ayant déjà subi une extraction chirurgicale avaient des chances plus élevées d'être anxieux que ceux n'ayant pas d'expérience d'extraction chirurgicale [OR ajusté = 3,65, IC à 95 % = 1,02 à 13,03]. CONCLUSION: Les facteurs prédictifs de l'AD dans l'étude sont le sexe féminin et l'expérience antérieure d'extraction chirurgicale. Ces facteurs liés à l'AD et d'autres facteurs tels que l'occupation des patients et les expériences antérieures de mauvais traitement dentaire devraient être pris en compte en préopératoire pour identifier et prendre en charge les patients anxieux subissant l'extraction des M3. Mots-clés: anxiété dentaire, facteurs, troisième molaire, extraction.

The effect of dental anxiety on surgical time of mandibular third molar disimpaction.

BACKGROUND: Dental treatment of anxious patients induces stress due to the patients' expectation of pain. This may prolong treatment due to such patients' inability to cooperate during treatment. AIM: The aim of the study was to determine the effect of dental anxiety on surgical time of mandibular third molar (M3) disimpactions at a Nigerian hospital. SUBJECTS AND METHODS: A prospective study was conducted at the Oral Surgery clinic of Aminu Kano Teaching Hospital, Kano, between October 2016 and September 2017 to assess the effect of dental anxiety on surgical time of M3 disimpactions using the Modified Dental Anxiety Scale (MDAS). The Patients' biodata, clinical and M3 radiologic data were recorded. Surgical durations were also recorded. Data were analyzed with Statistical Package for Social Sciences for Windows (IBM statistics 23 software). RESULTS: One hundred and sixteen subjects (64 males, 52 females) were studied. Forty-two subjects (36.2%) were mildly anxious, 67 (57.8%) were moderately anxious, and 7 (6.0%) were highly anxious. The females were more anxious and the overall surgical time (OST) of disimpaction correlated with the anxiety levels of the subjects. The OST increased by approximately 0.8 min with every unit rise in the anxiety score. Other factors that affected OST in the study were M3 depth, type of impaction, and root curvature. CONCLUSION: The patients' dental anxiety increased the surgical time of M3 disimpactions. Clinicians should consider the patients' anxiety among the factors that affect the surgical time of M3 disimpactions. Verbally soothing anxious patients and administering anxiolytic when necessary, may help to reduce the patients' anxiety, and hence, prevent surgical time prolongation.

Effect of autogenous crack self-healing on mechanical strength recovery of cement mortar under various environmental exposure.

While research on self-healing of cement-based materials has recently gained considerable attention and made sizable progress, there is still ongoing debate and controversy regarding the effect of crack closing induced by autogenous self-healing on mechanical strength recovery. Despite that several techniques have been used to capture and quantify the self-healing of surface cracks, the resulting effect on mechanical strength has not, to date, been explored and quantified in a rigorous and systematic manner. Therefore, in this study, a broad array of multi-scale techniques including non-destructive shear wave velocity, high-resolution X-ray computed tomography (µCT), and 3D image analysis was deployed to examine the effects of autogenous crack self-healing on the mechanical strength recovery in various mortar specimens. The influence of microstructural changes induced by additives such as swelling compounds, silica-based additions, and carbonating minerals on strength recovery under diverse environmental exposures was further explored. The results capture the relationship between the crack closing mechanism imparted by self-healing and mechanical strength recovery, therefore elucidating the discrepancies in mechanical strength recovery results reported in the open literature.