MONITORING OF VITAL SIGNS AND HEMODYNAMIC CHANGES IN PATIENTS UNDERGOING TOOTH EXTRACTION AND THIRD MOLAR SURGERY - LITERATURE REVIEW

This study aimed to evaluate cardiac activity changes during lower third molar surgery concerning gender and anxiety levels. Thirty healthy subjects who required lower third molar surgery filled out Norman Corah dental anxiety scale (DAS) before surgery. A patch ECG device (Savvy, Institute ''Jožef Stefan'', Ljubljana, Slovenia) was applied to the patient to evaluate heart rate (HR) and heart rhythm. These parameters were assessed in 8 different intervals. Periods of the highest mean HR values—incision and flap elevation compared to the period with minimal mean HR values—during suturing showed statistical significance difference (p<0.05). The most common outstanding ECG finding was sinus tachycardia, especially in anxious compared to non-anxious patients. Extraction difficulty score was correlated with the procedure duration time and with the abnormal ECG findings in the period of tooth extraction. Significant cardiac activity changes are detected during surgery. Physiological manifestations of anxiety may be evaluated successfully using a patch ECG device.

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Risk factors of neurosensory deficits in lower third molar surgery: a literature review of prospective studies

International Journal of Oral and Maxillofacial Surgery ◽

10.1016/j.ijom.2011.03.015 ◽

2011 ◽

Vol 40 (9) ◽

pp. 1003 ◽

Cited By ~ 2

Author(s):

Eduard Valmaseda-Castellón

Keyword(s):

Risk Factors ◽

Literature Review ◽

Prospective Studies ◽

Third Molar ◽

Third Molar Surgery

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Anestesia transcortical em exodontias simples e complexas

Research Society and Development ◽

10.33448/rsd-v9i10.8109 ◽

2020 ◽

Vol 9 (10) ◽

pp. e9039108109

Author(s):

Haline Alves da Silva ◽

Mirelle de Sousa Soares ◽

Paulo Ronaldo Sousa Texeira ◽

Marcelo Bruno Meneses Mendes ◽

Maria Cândida de Almeida Lopes

Keyword(s):

Tooth Extraction ◽

Oral Surgery ◽

Third Molar ◽

Third Molar Surgery ◽

Mandibular Third Molar ◽

Intraosseous Injection ◽

Mandibular Third Molar Surgery

Anestesia transcortical consiste no depósito da solução anestésica no osso esponjoso adjacente ao dente a ser anestesiado. O objetivo desse trabalho é apresentar um levantamento retrospectivo científico sobre a eficácia clínica da anestesia transcortical aplicada às exodontias simples e complexa através de revisão de literatura. Foi realizada uma pesquisa nas bases Pubmed, SciELO e Scopus, usando as combinações de palavras-chave “intraosseous injection AND oral surgery”, “tooth extraction AND intraosseous anesthesia”, “mandibular third molar surgery AND intraosseous injection” e “tooth extraction AND transcortical anesthesia”. Foram incluídos estudos clínicos publicados no período de 2000 a 2020, em inglês. Foram excluídos estudos laboratoriais, estudos em animais, casos clínicos e revisões de literatura. Quanto aos resultados, foram localizados 92 aplicando-se as palavras-chave, dos quais 7 foram incluídos após critérios de inclusão e exclusão, através de leitura dos títulos, resumos e textos completos. A maioria (n=6) era estudos clínicos, dos quais 5 eram randomizados. Todos os estudos avaliaram o sistema QuickSleeper, incluindo comparação a anestesia transcortical com a técnica de bloqueio do nervo alveolar inferior (n=3). A percepção dolorosa (n=3) e a eficácia (n=4) foram os fatores mais avaliados nos trabalhos. A anestesia transcortical é uma alternativa às técnicas convencionais e pode ser aplicada em casos de falhas ou insuficiências da anestesia convencional em exodontias simples e complexas.

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Assessment of patient’s anxiety and expectation associated with hemodynamic changes during surgical procedure under local anesthesia

Revista de Odontologia da UNESP ◽

10.1590/1807-2577.02917 ◽

2017 ◽

Vol 46 (5) ◽

pp. 299-306

Author(s):

Marcos Vinícius Mendes DANTAS ◽

Bianca NESSO ◽

Daniel Sagawa MITUUTI ◽

Marisa Aparecida Cabrini GABRIELLI

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Dental Anxiety ◽

Third Molar ◽

Vital Signs ◽

Correlation Coefficients ◽

Hemodynamic Changes ◽

Emergency Situations ◽

Third Molar Extraction ◽

Molar Extraction

Abstract Introduction The dental patient’s anxiety and expectation may significantly alter their vital signs. The use of local anesthetics associated with a vasoconstrictor may also alter the vital signs of these patients, promoting hemodynamic changes that may result in emergency situations. Objective To evaluate the influence of anxiety of patients submitted to third molar extraction and the use of different anesthetic substances with adrenaline on their vital signs (oxygen saturation, heart rate, and systolic and diastolic blood pressure) in different moments. Material and method Forty patients answered the questionnaire of the Dental Anxiety Scale (Corah’s Scale) and fear (KleinKnecht’s Scale) and were submitted to third molar extraction in two surgical times for the use of articaine or mepivacaine, both associated with adrenaline. The results were analyzed by ANOVA followed by Tukey post hoc test, Student's t test, and Pearson's correlation coefficients (α=0.05). Result There was no significant differences in saturation or heart rate. The blood pressure showed significant variations during time for both anesthetics, however mepivacaine resulted in a longer postoperative time to restore blood pressure. Patients with high or moderate anxiety and high fear index were those who had positive correlations with the highest blood pressure values. Conclusion Anxiety and fear positively influence the increase in blood pressure. Mepivacaine promoted a greater resistance to the return of normal vital signs, especially blood pressure levels.

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A Comparative Study of Difficulty Prediction Indices in Lower Third Molar Surgery

10.46715/ijcsci2021.10.1000107 ◽

2021 ◽

pp. 1-8

Author(s):

Jorge Arnulfo Carrillo Rivera ◽

Javier González Bello

Keyword(s):

Tooth Extraction ◽

Strong Association ◽

Third Molar ◽

Third Molar Surgery ◽

Asymmetric Distribution ◽

Test Results ◽

Chi Square ◽

Cross Sectional ◽

Chi Square Test ◽

Surgical Difficulty

In third molar surgery, it is important to take into account multiple clinical and radiographic variables that, grouped into indices and classifications, allow estimating the degree of surgical difficulty. The present study proposes to evaluate the efficacy and congruence of these indices. Material and methods: a cross-sectional retrospective study in 77 patients. 123 lower third molar surgeries were performed using the Pederson, WHARFE and Parant prediction indices; to know the efficacy of the classifications, a statistical analysis with measures of central tendency, association through chi-square test and tables of frequency distribution were used, as well as non-parametric tests when determining an asymmetric distribution in the data through the Kolmogorov and Kruskall-Wallis test. Results: Analyzing the correlation between the Pederson and WHARFE indices, a strong association of P = .906 (Gamma), P = .761 (Kendall’s Tau “C”) and P = .834 (Somers “D”) was found, accepting frequency correlation through chi-square test. X2 test (P = 0.000) was performed accepting association between the Parant and Pederson scale, as well as for the WHARFE and Parant scales, resulting positive with a strong intensity and a direct association with a P = 0.796 (Gamma). Discussion: The difficulty prediction indices evaluated in the present study proved to be congruent with each other, their predictions regarding the type of surgery performed allow estimate degrees of complexity, type of surgical procedure, approximate time and possible complications, thus improving treatment planning. Keywords: Third molars; degree of difficulty; surgical tooth extraction; prediction

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Risk factors of neurosensory deficits in lower third molar surgery: a literature review of prospective studies

International Journal of Oral and Maxillofacial Surgery ◽

10.1016/j.ijom.2010.09.005 ◽

2011 ◽

Vol 40 (1) ◽

pp. 1-10 ◽

Cited By ~ 51

Author(s):

Y.Y. Leung ◽

L.K. Cheung

Keyword(s):

Risk Factors ◽

Literature Review ◽

Prospective Studies ◽

Third Molar ◽

Third Molar Surgery

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Comparative study of hemodynamic changes caused by diazepam and midazolam during third molar surgery: a randomized controlled trial

Oral and Maxillofacial Surgery ◽

10.1007/s10006-015-0488-3 ◽

2015 ◽

Vol 19 (3) ◽

pp. 267-273 ◽

Cited By ~ 3

Author(s):

Hécio Henrique Araújo de Morais ◽

Jimmy Charles Melo Barbalho ◽

Ricardo José de Holanda Vasconcellos ◽

Fabricio Souza Landim ◽

Fábio Andrey da Costa Araújo ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Comparative Study ◽

Controlled Trial ◽

Third Molar ◽

Third Molar Surgery ◽

Hemodynamic Changes ◽

Randomized Controlled

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TRISMUS

The Professional Medical Journal ◽

10.29309/tpmj/2018.25.02.447 ◽

2018 ◽

Vol 25 (02) ◽

pp. 226-231

Author(s):

Alvina Ali Shaikh ◽

Salman Shafique ◽

Hassan Shahid

Keyword(s):

Tooth Extraction ◽

Oral Surgery ◽

Third Molar ◽

Third Molar Surgery ◽

Surgical Removal ◽

Exclusion Criteria ◽

Impacted Third Molar ◽

Group A ◽

Mandibular Teeth ◽

Teeth Extraction

Objectives: To compare trismus in surgical removal of impacted mandibularthird molar using comma incision and standard Wards incision. Study Design: Cross sectionalstudy. Setting: Dental OPD of Isra Dental College, Isra University. Period: 1st January to 30thJune 2016. Materials and Methods: A sample of 50 patients of impacted third molar wasselected by non-probability purposive sampling for tooth extraction either by conventionaltechnique or by coma shaped incision at the Department of Oral surgery, Isra Dental CollegeHospital. Patients were selected according to inclusion and exclusion criteria. Post-operativemeasurement of trismus was measured on 1st, 3rd and 7th day respectively. Results: Mean ±SD age in group A and B was noted as 28.5 ± 4.32 and 27.2 ± 4.39 years respectively. Maleand female in groups A and B were noted as 16 (64%) and 9 (36%), & 14 (56%) and 11 (44%)respectively. Right and left lower mandibular teeth extraction in groups A and B were noted 11and 14, & 10 and 15 respectively. Trismus was measured preoperatively and subsequently atday 1, day 3 and day 7. Conclusion: In conclusion, the Coma incision was preferable over theconventional method- the standard Ward`s incision because of lesser degree of trismus seen.Further research with newer flap designs and the comma design should be preferred by theclinicians for the extraction of impacted third molar surgery.

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