Exploring the relationship between anxiety, patient characteristics and pain outcomes in oral surgery under local anesthesia: The measurement problem.

BACKGROUND: Anxiety during oral surgery can impact patient homeostasis, increase the difficulty of the procedure and create additional stress for the surgeon. Furthermore, it has been associated with more intense and prolonged pain during and after dental treatment. OBJECTIVES: The aim of the study is to evaluate the relationship between anxiety, patient characteristics and pain outcomes in oral surgery, as well as to verify the impact of anxiety on patient's perception of pain during and after oral surgery. MATERIAL AND METHODS: This is a prospective observational study. Several variables were evaluated during the course of the oral surgery. Anxiety levels were assessed using the State-Trait Anxiety Inventory (STAI), Corah's Dental Anxiety Scale (DAS), the Interval Scale of Anxiety Response (ISAR), and Patient SelfRated Anxiety (PAnx) during the procedure. RESULTS: General anxiety measures (STAI) were not associated with specific dental anxiety or external observations of anxiety. Anxiety levels varied according to gender and body mass index (BMI), and were correlated with increased heart rate (HR) (with variability among assessment tools). Odontectomy, ostectomy and an increased volume of anesthesia were associated with higher anxiety levels (with variability among the assessment tools). There was a correlation between pain and anxiety, with anxiety contributing to approx. 12% of the variability in postoperative pain. CONCLUSIONS: Dental anxiety is a complex, multidimensional mental phenomenon characterized by high variability due to the influence of several dynamic factors.

Single-channel electroencephalography and its associations with anxiety and pain during oral surgery: a preliminary report.

BACKGROUND: This study aimed to assess the course of anxiety and pain during lower third molar (LTMo) surgery and explore the role of mobile and single-channel electroencephalography under clinical and surgical conditions. METHODS: The State-Trait Anxiety Inventory (STAI), Corah's Dental Anxiety Scale (DAS), and Interval Scale of Anxiety Response (ISAR) were used. The patient self-rated anxiety (PSA), the pain felt during and after surgery, EEG, heart rate (HR), and blood pressure (BP) were assessed. RESULTS: The Attention (ATT) and Meditation (MED) algorithms and indicators evaluated in this study showed several associations. ATT showed interactions and an association with STAI-S, pain during surgery, PSA level, HR, and surgical duration. MED showed an interaction and association with DAS, STAI-S, and pain due to anesthesia. Preclinical anxiety parameters may influence clinical perceptions and biological parameters during LTMo surgeries. High STAI-Trait and PSA scores were associated with postoperative pain, whereas high STAI-State scores were associated with more pain during anesthesia and surgery, as well as DAS, which was also associated with patient interference during surgery due to anxiety. CONCLUSIONS: The findings suggest that single-channel EEG is promising for evaluating brain responses associated with systemic reactions related to anxiety, surgical stress, and pain during oral surgery.

Classic Kaposi's sarcoma (non-Hiv-associated) of oral cavity: a case report

Kaposi's sarcoma (KS) is a locally aggressive multicentric mucocutaneous malignant neoplasm. The aim of this article is to report and discuss the immunohistochemical profile of a rare case of classic primary Oral Kaposi's sarcoma presenting on the hard palate of a female patient which was non-HIV and was not immunocompromised (AU)

Reabilitação de mandíbula edêntula utilizando a técnica de "Tent Pole" / Rehabilitation of the mandible using the Tent Pole technique

A reabilitação protética de mandíbulas edêntulas muitas vezes torna-se insatisfatória em função da falta de tecido de suporte para utilização de prótese. A falta de estabilidade protética ocasiona perda de qualidade de vida, pois geralmente resulta em limitação funcional e social além de trauma físico crônico. Além disso, a perda de tecido de suporte pode predispor a mandíbula a fraturas espontâneas. Várias técnicas de reconstrução para mandíbulas edêntulas severamente reabsorvidas são relatadas na literatura, todas com suas vantagens e desvantagens. Este artigo descreve um caso clínico onde a reabilitação mandibular foi realizada com prótese fixa do tipo protocolo Branemark, após cirurgia pré-protética reconstrutora com a utilização de enxerto ósseo autógeno e implantes osseointegráveis pela técnica "Tent Pole".

The prosthetic rehabilitation of an atrophic mandible usually is unsatisfactory due the lack of the support tissues including bone and keratinized mucosa. The prosthetic instability leads a social and functional limitation and chronic physical trauma decreasing the patient's life quality. ln accentuated degrees of atrophy the placement of osseous-integrated implants can expose the mandible to spontaneous fracture in the literature many preprosthetic reconstructive surgeries techniques were proposed for atrophic mandible rehabilitation each one with their advantages and disadvantages. ln this article the authors present a case where an atrophic mandible was rehabilitated following the Brememark protocol after preprosthetic reconstructive surgery by "Tent Pole" technique.