The Effect of Conscious Sedation on Acute Stress

University of Beykent

Status: Completed

Conditions: Dental Anxiety; Dental Fear; Tooth Extraction Status Nos

Treatments: Procedure: Procedures of wisdom tooth removal surgery under local anesthesia; Procedure: Procedures of wisdom tooth removal surgery under conscious sedation

Study type: Interventional

Funder types: Other

Identifiers

NCT04207515

2018/24

Details and patient eligibility

About

The specific aims of the present study were to evaluate sAA responses to impacted third molar extractions at different time points in the patients under conscious sedation with local anesthesia and to examine the relationship between sAA, conscious sedation and dental anxiety. The null hypothesis was that conscious sedation could be considered to reduce salivary alpha amylase level during the wisdom tooth surgery.

Full description

In oral and maxillofacial surgery, surgical extraction of impacted third molars is one of the most common surgical techniques performed in the oral cavity. Conscious intravenous sedation could be administered for the patients to provide anxiolysis, sedation, and analgesia for the patient. Salivary alpha-amylase (sAA) which reflect stress-related changes in the autonomic nervous system (ANS), has been proposed as a non-invasive stress biomarker. The aim of the present study was to investigate whether salivary alpha amylase (sAA) levels could be decreased by conscious sedation in the patients undergoing impacted third molar extraction. A total of 18 male patients were recruited. All patients were administered Modified Dental Anxiety Scale (MDAS) test. Patients were divided into two groups: test group (procedures under sedation) and control group (procedures under local anesthesia). The following parameters were monitored at different study time-points: systolic blood pressure (SBP), diastolic blood pressure (DBP), oxygen saturation (SO2), and heart rate (HR). Five samples of saliva were taken from each patient: the first time patient came to clinic, the patient sat in the chair for extraction, before local anesthesia, immediately after extraction, at 4 h after extraction. The concentrations of sAA were measured and compared across the different stages of the study between two groups.

Enrollment: 20 patients

Sex: Male

Ages: 19 to 33 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Man
• 18-35 years
• individuals without chemotherapy or radiotherapy history
• individuals without antibiotics and NSAIDs history in the last month
• individuals without any medications that affect saliva content in the last 1 month
• individuals without corticosteroid treatment history
• nonsmokers
• wisdom tooth which is indicated to extract
• individuals without acute infectious lesion in the mouth
• individuals without alcohol or substance abuse
• individuals without inflammatory bone disease

Exclusion criteria

• Woman
• individuals with any systemic disorders
• individuals with chemotherapy and radiotherapy history
• individuals with antibiotics and NSAIDs history in the last month
• individuals with use of antibiotics and NSAIDs history in the last month
• individuals with corticosteroid treatment history
• Smokers
• individuals with acute infectious lesion in the mouth
• individuals with inflammatory bone disease
• individuals with alcohol or substance abuse

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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20 participants in 2 patient groups

Removal of wisdom tooth under conscious sedation

Experimental group

Description:

patients were asked to fill MDAS form which consists of five questions. Systolic blood pressure, diastolic blood pressure, oxygen saturation , and heart rate were monitored at different time points: preoperative time ; intraoperative time-after local anesthesia , intraoperative time-after extraction , postoperative time . In this group removal of wisdom teeth was done under conscious sedation. During surgery procedures five saliva samples were collected. Due to the localization and position of the third molar, osteotomy was performed using a 20,000-rpm hand piece under irrigation for all patients. Some cases required tooth sectioning. 3-0 silk suture was used at the end of the surgery. Ibuprofen (600 mg every 8 h for 7 days) and amoxicillin/clavulanate (875 mg/125 mg every 8 h for 5 days) were prescribed. Detailed explanation of oral hygiene techniques and recommendations for the postoperative period were given to each patient.

Treatment:

Procedure: Procedures of wisdom tooth removal surgery under conscious sedation

Removal of wisdom tooth under local anesthesia

Active Comparator group

Description:

patients were asked to fill MDAS form which consists of five questions. Systolic blood pressure, diastolic blood pressure , oxygen saturation , and heart rate were monitored at different time points: preoperative time ; intraoperative time-after local anesthesia, intraoperative time-after extraction, postoperative time. In this group, removal of wisdom teeth was done under local anesthesia. During surgery procedures five saliva samples were collected. Due to the localization and position of the third molar, osteotomy was performed using a 20,000-rpm hand piece under irrigation for all patients. Some cases required tooth sectioning. 3-0 silk suture was used at the end of the surgery. Ibuprofen (600 mg every 8 h for 7 days) and amoxicillin/clavulanate (875 mg/125 mg every 8 h for 5 days) were prescribed. Detailed explanation of oral hygiene techniques and recommendations for the postoperative period were given to each patient.

Treatment:

Procedure: Procedures of wisdom tooth removal surgery under local anesthesia