The effect of virtual reality on reducing patients' anxiety and pain during dental implant surgery.

BACKGROUND: Dental anxiety and pain pose serious problems for both patients and dentists. One of the most stressful and frightening dental procedures for patients is dental implant surgery; that even hearing its name causes them stress. Virtual reality (VR) distraction is an effective intervention used by healthcare professionals to help patients cope with unpleasant procedures. Our aim is to evaluate the use of high-quality VR and natural environments on dental implant patients to determine the effect on reducing pain and anxiety. METHODS: Seventy-three patients having two dental implant surgeries participated in a randomized controlled trial. One surgery was with VR, and one was without. Anxiety was measured with the the State-Trait Anxiety Inventory and the Modified Dental Anxiety Scale tests. The pain was measured with the Numerical Rating Scales. Patient satisfaction, surgeon distress, memory vividness, and time perception were evaluated. Physiological data were collected with biofeedback and neurofeedback device. RESULTS: VR effectively reduced anxiety and pain compared to no VR. Physiological data validated the questionnaire results. Patient satisfaction increased, with 90.4% willing to reuse VR. VR reduced time perception and memory vividness. CONCLUSION: Psychometric and psychophysiological assessments showed that VR successfully reduced patient pain and anxiety. More dental clinicians should use VR technology to manage patient anxiety and pain.

A Randomized Triple-Blind Clinical Trial of the Effect of Low-Level Laser Therapy on Infiltration Injection Pain in the Anterior Maxilla

Abstract Objective: To evaluate the level of pain experienced during infiltration anesthesia of the anterior maxilla following low-level laser therapy (LLLT) with 810-980 nm wavelengths. Material and Methods: In the current triple-blind clinical trial, 84 patients received a total of 168 infiltration anesthesia injections (1.8 mL of 2% lidocaine plus 1:100,000 epinephrine) in the anterior maxilla. Each patient received two injections into the buccal mucosa of the right and left central incisors with a two-week interval. One injection was performed after LLLT, while the other injection was administered conventionally without laser. The pain level was measured immediately after injection using a visual analog scale (VAS). Results: There was a significant difference in the pain level experienced with and without LLLT, such that the mean pain score following LLLT was significantly lower than that without LLLT (p<0.05). No significant difference was found in the pain level between laser and no laser groups in males, but the difference in this regard was significant in females (p<0.05) and female patients experienced a significantly lower level of pain following LLLT. Conclusion: The low-level laser therapy can be successfully used to decrease the level of pain experienced during infiltration anesthesia of the anterior maxilla (AU).

A PRISMA-compliant meta-analysis on association between X-ray repair cross complementing (XRCC1, XRCC2, and XRCC3) polymorphisms and oral cancer susceptibility.

BACKGROUND: Oral Cancer (OC) is one of the leading causes of death and the disease mainly occurs over 50 years of age. Herein, a meta-analysis aimed to assess the association between X-ray repair cross complementing (XRCC) polymorphisms and OC risk. METHODS: Four databases were searched extensively until June 5, 2020. Subgroup analysis, meta-regression, and funnel plots, as well as the quality assessment were estimated. RESULTS: Fifteen studies were entered to the analysis. With regards to allele, homozygote, heterozygote, recessive, and dominant models, the pooled ORs for XRCC1 rs1799782 polymorphism were 1.51 (P = 0.01), 1.45 (P = 0.11), 1.45 (P = 0.0003), 1.44 (P = 0.0002), and 1.29 (P = 0.26); for XRCC1 rs1799782 polymorphism were 1.65 (P = 0.11), 1.50 (P = 0.33), 1.06 (P = 0.83), 1.57 (P = 0.12), and 1.32 (P = 0.45); for XRCC1 rs25489 polymorphism were 0.01 (P = 0.19), 1.44 (P = 0.48), 1.21 (P = 0.72), 1.17 (P = 0.19), and 1.38 (P = 0.54); for XRCC2 rs2040639 polymorphism were 0.68 (P = 0.0002), 0.63 (P = 0.02), 0.95 (P = 0.92), 0.79 (P = 0.49), and 0.61 (P = 0.005); and for XRCC3 rs861539 polymorphism were 1.24 (P = 0.20), 1.28 (P = 0.48), 0.99 (P = 0.95), 1.15 (P = 0.46), and 1.52 (P = 0.15), respectively. CONCLUSIONS: The T allele and CT genotype of XRCC1 rs1799782 polymorphism had an elevated risk, whereas the G allele and GG genotype of XRCC2 rs2040639 polymorphism had a protective role in OC.

Serum and salivary interleukin-4 levels in patients with oral lichen planus: A systematic review and meta-analysis.

OBJECTIVE: Cytokines have an important role in keratinocyte immune damage and can act in the pathogenesis of different cutaneous diseases. Accordingly, in the literature, interleukin 4 (IL-4) concentration has been previously investigated in patients affected by oral lichen planus (OLP). STUDY DESIGN: The present meta-analysis evaluated the serum and salivary levels of IL-4 in connection with several OLP variants. The search was performed from 1995 in Cochrane Library and 1983 in Scopus, PubMed, and Web of Science to September 2018. The quality of the studies included in the meta-analysis was assessed using the Newcastle-Ottawa Scale assessment. The analyses were done by Review Manager 5.3 using mean difference (MD) and 95% confidence intervals (CIs). RESULTS: Out of 108 studies retrieved in the databases, only 10 were included and analyzed in quantitative synthesis. The pooled MD of the serum and salivary IL-4 levels in OLP patients compared with the controls was 6.36 picograms/milliliter (pg/mL) (95% CI: 1.47, 11.24; P = .01) and 2.67 pg/mL (95% CI: 2.66, 2.68; P < .00001), respectively. In addition, the pooled MD of serum and salivary IL-4 level was 1.30 pg/mL (95% CI: -0.35, 2.95; P = .12) and 1.83 pg/mL (95% CI: 0.26, 3.40; P = .02), respectively, in patients with erosive, erythematous, bullous, and ulcerative variants of OLP compared with patients with reticular OLP. CONCLUSIONS: This meta-analysis found that OLP patients present elevated serum and salivary IL-4 levels, thus indicating that IL-4 may represent a potential salivary biomarker for the disease. By contrast, clinicians must be aware that even other factors (e.g., secondary infection) may influence its concentration.

Applying the Taguchi Method to the Optimization of Anticancer Activity of Bacterial Alginate-CuO Bionanocomposite.

AIM: In recent decades, despite various types of cancer inflicting many people worldwide, the existing therapies are not satisfactory and have many side effects. The present study was conducted to optimise the synthesis of novel alginate-CuO nanocomposite with utmost anticancer activity. METHODS: In this study, 9 nanocomposites were designed using Taguchi method and three factors including copper oxide nanoparticles, alginate biopolymer and stirring times were assessed at three different levels. The anticancer activity of the synthesised nanocomposites was evaluated on the MCF-7 cell line using the MTT method. Using the Qulitek-4 software, we determined the optimum conditions for the synthesis of alginate-CuO nanocomposite with the highest anticancer activity. RESULTS: The results indicated that all three factors (copper oxide, alginate and stirring time) were effective on the anticancer activity of the alginate-CuO nanocomposite. Also, the nanocomposite produced under the conditions of experiment 9 (8 mg/ml of copper oxide, 2 mg/ml of alginate and 60 min of stirring time) provided the highest growth inhibition rate as 75.63% against cancer cells. CONCLUSION: The synthesised alginate-copper oxide nanocomposites in this study showed a significant anticancer effect. Therefore, the synthesised nanocomposite under optimal conditions can be used in the design of new anticancer drugs.

Evaluation of serum and salivary interferon-γ levels in patients with oral lichen planus: a systematic review and meta-analysis of case-control studies.

OBJECTIVE: Cytokines have regulatory and leading roles in the immunopathogenesis of oral lichen planus (OLP). Here, we present the findings of a meta-analysis that evaluated serum and salivary interferon-γ (IFN-γ) levels in patients with OLP compared with those in controls and the correlation of this cytokine with the progression of OLP. STUDY DESIGN: Four databases-PubMed, Web of Science, Scopus, and Cochrane Library-were searched, from their start dates to November 2017, for reports in all languages on the effect of OLP on salivary and serum IFN-γ. RESULTS: Eleven studies were included and analyzed in this meta-analysis. The pooled mean difference (MD) values were estimated to be 3.60 pg/mL (P = .23) and -0.02 pg/mL (P = 1.00) for serum and salivary levels of IFN-γ, respectively, in the patients with OLP compared with controls. The pooled MD values were -2.52 pg/mL (P = .03) and -2.01 pg/mL (P = .20) for serum and salivary IFN-γ levels in the erosive type, respectively, compared with the nonerosive type. CONCLUSIONS: According to the results of meta-analysis, there was no statistically significant differences in IFN-γ levels between the OLP group and the control group both in serum and salivary levels and also between erosive and nonerosive types of OLP at the salivary level; so this cytokine is not considered to have an important role in the pathogenesis or severity of OLP.