Hemodynamic variations and anxiety during the surgical extraction of impacted lower third molars.

BACKGROUND: The surgical removal of an impacted third molar can cause patient anxiety. Such anxiety and the use of vasoconstrictor drugs and local anesthetics in turn can induce hemodynamic variations during the operation. A study is made of the variations in hemodynamic parameters (systolic and diastolic blood pressure and heart rate) and their correlation to patient gender and anxiety during surgical removal of an impacted lower third molar. MATERIAL AND METHODS: A prospective study was carried out in the Oral Surgery Unit of a university clinic, with the inclusion of 125 patients (mean age 24.9 years). Anesthesia was administered in the form of 4% articaine and adrenalin 1:200,000 for surgical removal of the impacted lower third molars. RESULTS: Women experienced greater anxiety than men. Systolic blood pressure showed few changes - the maximum and minimum values being recorded at the time of incision and upon suturing, respectively. Diastolic blood pressure in turn showed maximum and minimum values before the start of surgery and during extraction, respectively, while heart rate proved maximum during incision and minimum upon suturing. The differences in systolic and diastolic blood pressure, and heart rate, between men and women, and between patients with and without anxiety, failed to reach statistical significance. CONCLUSIONS: The fact that these were young patients could contribute to explain the absence of significant hemodynamic changes in our study. Key words:Anxiety, third molars, extraction, surgery.

Analysis of scientific production in spanish implantology.

BACKGROUND: The aim of the study was to quantify the scientific productivity of researchers, organizations, and regions in Spain that publish articles on implantology in dental journals indexed in Journal Citation Reports. MATERIAL AND METHODS: A search was conducted among the core collection of Thomson Reuters' Web of Science database, on the basis of its broad thematic and geographic coverage of health sciences. The search identified original articles - the main vehicle for the dissemination of research results. The search was conducted in July 2016, applying the truncated search term 'implant*' to locate original articles on implantology and its derivative forms. The search was conducted within the topic field (title, keywords and abstract) and two inclusion criteria were applied: documents denominated as articles were included; and articles categorized as Web of Science Medicine Dentistry and Oral Surgery. Finally only articles for which one of the participating organizations was located in Spain were selected. RESULTS: The final search identified a total of 774 records. The period 1988 to 2015 saw an exponential growth in scientific production, especially during the last 10 years. Clinical Oral Implants Research and Medicina Oral Patologia Oral y Cirugia Bucal (Oral Medicine, Oral Pathology, and Oral Surgery) were the most productive journals. Collaborative networks among authors and among institutions increased and this increase was related to the improving quality of the publications. CONCLUSIONS: Bibliometric analysis revealed a significant growth in the quantity and quality of Spanish implantology literature. Most key bibliometric indicators demonstrated upward trends. Key words:Bibliometric analysis, publication, keywords, implantology, implant.

Anxiety before extraction of impacted lower third molars

OBJECTIVES: Assess levels of trait anxiety, state anxiety and dental anxiety before extraction of lower third molars and check the correlation and reliability of the scales used for the measurement of preoperative anxiety. Study DESIGN: A prospective study of patients treated with extraction of a lower third molar between September2010 to December 2010 was carried out. A total of 125 patients were included in the study. All of them were patients of the Oral Surgery and Implantology Department (Valencia University Medical and Dental School, Valencia, Spain). Before surgery, patients had to complete a preoperative protocol with 4 scales: the STAI-T (State-Trait Anxiety Inventory-Trait) for measuring trait anxiety, the STAI-S (State-Trait Anxiety Inventory-State) for measuring state anxiety, and DAS (Dental anxiety Scale of N. Corah) and APAIS (Amsterdam Preoperative anxiety and Information Scale) for measuring dental anxiety. RESULTS: Patients undergoing extractions of an impacted lower third molar showed low levels of trait anxiety and moderate levels of state anxiety and dental anxiety. Higher levels of trait anxiety were obtained for older patients. Women had higher mean levels of dental anxiety and state anxiety that men with a statistically significant difference in STAI-S scales, DAS, and APAIS. Patients with higher trait anxiety and state anxiety showed higher levels of dental anxiety. A significant correlation (p ≤ 0.01) (p = 0.00) was found between the four scales used to measure anxiety. The scale showed higher correlation was STAI-S scale. The 4 scales showed high reliability (alpha of C.> 0.80).CONCLUSIONS: Patients with highest levels of trait anxiety and state anxiety, had more dental anxiety. The STAI-T,STAI-S, DAS and APAIS scales provided useful information about anxiety before the extraction of lower impacted third molars. The STAI-S is the scale with highest correlation and reliability

Anxiety before extraction of impacted lower third molars.

OBJETIVES: Assess levels of trait anxiety, state anxiety and dental anxiety before extraction of lower third molars and check the correlation and reliability of the scales used for the measurement of preoperative anxiety. STUDY DESIGN: A prospective study of patients treated with extraction of a lower third molar between September 2010 to December 2010 was carried out. A total of 125 patients were included in the study. All of them were patients of the Oral Surgery and Implantology Department (Valencia University Medical and Dental School, Valencia, Spain). Before surgery, patients had to complete a preoperative protocol with 4 scales: the STAI-T (State-Trait Anxiety Inventory-Trait) for measuring trait anxiety, the STAI-S (State-Trait Anxiety Inventory-State) for measuring state anxiety, and DAS (Dental anxiety Scale of N. Corah) and APAIS (Amsterdam Preoperative anxiety and Information Scale) for measuring dental anxiety. RESULTS: Patients undergoing extractions of an impacted lower third molar showed low levels of trait anxiety and moderate levels of state anxiety and dental anxiety. Higher levels of trait anxiety were obtained for older patients. Women had higher mean levels of dental anxiety and state anxiety that men with a statistically significant difference in STAI-S scales, DAS, and APAIS. Patients with higher trait anxiety and state anxiety showed higher levels of dental anxiety. A significant correlation (p ≤ 0.01) (p = 0.00) was found between the four scales used to measure anxiety. The scale showed higher correlation was STAI-S scale. The 4 scales showed high reliability (α of C.> 0.80). CONCLUSIONS: Patients with highest levels of trait anxiety and state anxiety, had more dental anxiety. The STAI-T, STAI-S, DAS and APAIS scales provided useful information about anxiety before the extraction of lower impacted third molars. The STAI-S is the scale with highest correlation and reliability.

Comparative study of mandibular linear measurements obtained by cone beam computed tomography and digital calipers.

OBJECTIVES: Cone beam computed tomography (CBCT) is an innovative dental of imaging system characterized by rapid volumetric imaging with patient exposure to a single dose of radiation. The present study was carried out to compare the linear measurements obtained with CBCT and digital caliper in 20 mandibles from human cadavers. STUDY DESIGN: A total of 4800 linear measurements were measured between different mandibular anatomical points with CBCT and digital caliper. The real measurements were defined as those obtained with the digital caliper. Posteriorly, the mandibles were scanned to obtain the CBCT images, with software-based measurements of the distances. RESULTS: The measurements obtained with the digital caliper were greater. The CBCT technique underestimated distances greater than 100 mm. CONCLUSIONS: CBCT allows to obtain linear mandibular anatomical measurements equivalent to those obtained with digital caliper. The differences existing between both methods were clinically acceptable. Key words:Computed tomography, cone beam CT, accuracy, reliability, digital caliper.

Relationship between indication for tooth extraction and outcome of immediate implants: A retrospective study with 5 years of follow-up.

OBJECTIVES: The aims of this retrospective study were to evaluate the survival rate of a series of immediate implants after 3 years of follow-up and to study the relationship between survival and indication for tooth extraction. STUDY DESIGN: A retrospective study of patients treated with immediate implants between January 2003 and December 2008 was carried out. All patients receiving at least one post-extraction implant and a minimum follow-up of 5 years were included. RESULTS: After 60 months, 30 immediate implants had been lost in 17 patients, yielding a total implant success rate of 93.8%. None of the implants placed failed after the extraction of included canines (100% success rate). In 20 failed implants the reason for extraction had been severe periodontal disease (91.8% SR), in 4 endodontic failure (88.6%SR), in 3 unrestorable caries (95.9% SR), in 1 untreatable fracture (95.2% SR) and in 2 improvement of prosthetic design (98.1% SR). No statistically significant influence was found between immediate implant failure and the reason for tooth extraction (p=0.11). CONCLUSIONS: The use of immediate implants is a successful alternative to replace missing teeth for severe periodontal disease, periapical pathology or by decay or untreatable fractures. Some reasons, such as periodontal disease itself is associated with a success rate significantly below the overall average. Similarly, the prosthetic design is associated with a better prognosis than all other reasons. Key words:Tooth extraction, immediate implants, success rate.