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Huang JIS, Chang HH, Liao WC, Lin CP, Kao CT, Huang TH. Blood pressure reduction in patients with irreversible pulpitis teeth treated by non-surgical root canal treatment. J Dent Sci 2017; 12:382-387. [PMID: 30895079 PMCID: PMC6395357 DOI: 10.1016/j.jds.2017.05.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2017] [Indexed: 11/05/2022] Open
Abstract
Background/purpose The hypotension in patients during non-surgical root canal treatment (NSRCT) has not yet investigated. This study aimed to assess the mean systolic blood pressure (MSBP), mean diastolic blood pressure (MDBP), and mean arterial blood pressure (MABP) reduction percentages in patients with irreversible pulpitis teeth treated by NSRCT. Materials and methods We prospectively recruited 111 patients with a total of 138 irreversible pulpitis teeth. All patients underwent two NSRCT sessions. The first NSRCT session involved mainly the removal of vital pulp tissue with the direct stimulation of the dental branches of the trigeminal nerve, and the second NSRCT session included the root canal debridement and enlargement with minimal disturbance to the dental nerves. The blood pressure of each patient was recorded before and during both NSRCT sessions. Results There were significantly higher reduction percentages of MSBP, MDBP, and MABP in the first NSRCT session than in the second NSRCT session for all treated patients (all the P-values < 0.001). If the patients were divided into 2 or more groups according to the clinical variables including the patients' gender, age, tooth type, and anesthesia type, we also found significantly higher reduction percentages of MSBP, MDBP, and MABP in the first NSRCT session than in the second NSRCT session for all treated patients except for patients below 40 years of age and for patients with lower anterior teeth treated (all the P-values < 0.05). Conclusion The decrease in blood pressure in patients receiving vital pulpal extirpation is a relatively common phenomenon.
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Affiliation(s)
- James I-Sheng Huang
- School of Dentistry, College of Oral Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Hao-Hueng Chang
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan.,Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Wan-Chuen Liao
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan.,Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chun-Pei Lin
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan.,Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chia-Tze Kao
- School of Dentistry, College of Oral Medicine, Chung Shan Medical University, Taichung, Taiwan.,Department of Oral Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Tsui-Hsien Huang
- School of Dentistry, College of Oral Medicine, Chung Shan Medical University, Taichung, Taiwan.,Department of Oral Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
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Santana MDR, Martiniano EC, Monteiro LRL, Oliveira MDSSD, Valenti VE, Garner DM, Vanderlei FM, Abreu LCD. Cortisol Levels and Autonomic Control of Heart Rate in Healthy Subjects. ACTA MEDICA MARTINIANA 2017. [DOI: 10.1515/acm-2017-0006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Introduction: There is an increase in level of stress in the general population because of the social, personal and professional demands. Currently, there are only simple tools that can safely measure this stress such as levels of cortisol and heart rate variability (HRV). Objective: To analyze the relationship between salivary cortisol and the cardiac autonomic modulation. Methods: A total of fifty-one male and female subjects between 18 and 40 years old were evaluated. Saliva collection was achieved for the salivary cortisol dosage. The collection was performed through the SalivetteR tube. After this collection, the median cortisol levels (0.24 ug/dl) were analyzed and the volunteers were divided into two groups: i) cortisol below the mediane ii) cortisol above the median. After this division, each group consisted of 25 volunteers and then was verified the following information: age, gender, weight, height, body mass index (BMI), blood pressure. Shortly thereafter was assessment of cardiac autonomic modulation por meio da HRV. The Polar RS800cx heart rate receiver was placed on the chest of the volunteers, in the vicinity of the distal third of the sternum. The volunteers were instructed to remain in rest with spontaneous breathing in dorsal position for 20 minutes. HRV analysis included geometric, time and frequency domain indices. Results: There were no statistical differences for the two groups regarding systolic and diastolic blood pressure, heart rate, RR intervals or linear and frequency indices for the volunteers. In addition, also there was no correlation the cortisol with the analyzed variables (SAP, p=0.460; DAP, p = 0.270; HR, p = 0.360; RR, p = 0.380; SDNN, p = 0.510; rMSSD, p = 0.660; pNN50, p = 0.820; RRtri, p = 0.170; TINN, p = 0.470; SD1, p = 0.650; SD2, p = 0.500; LF [ms2], p = 0.880; LF [nu], p = 0.970; HF [ms2], p = 0.870; HF [nu], p = 0.960; LF/HF, p = 0.380 Conclusion: Heart rate variability autonomic control was unchanged in healthy subjects with physiological distribution of salivary cortisol levels. There was no association between normal salivary cortisol and resting autonomic regulation of heart rate.
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Affiliation(s)
- Milana Drumond Ramos Santana
- Laboratory of Study Design and Scientific Writing, Faculdade de Medicina do ABC, Santo André , SP, Brazil
- Faculty of Juazeiro do Norte, Juazeiro do Norte , CE, Brazil
- Post-Doctoral Program of the Faculty of Medicine of ABC, Santo André , SP, Brazil
- Faculdade de Juazeiro do Norte. Rua Sao Francisco, 1224, Juazeiro do Norte , CE, Brazil
| | | | | | | | - Vitor E. Valenti
- Post-Graduate Program in Physiotherapy, UNESP, Presidente Prudente , SP, Brazil
| | - David M. Garner
- Cardiorespiratory Research Group, Department of Biological and Medical Sciences, Faculty of Health and Life Sciences, Oxford Brookes University, Gipsy Lane, Oxford OX3 0BP, United Kingdom of Great Britain and Northern Ireland
| | | | - Luiz Carlos De Abreu
- Laboratory of Study Design and Scientific Writing, Faculdade de Medicina do ABC, Santo André , SP, Brazil
- Post-Doctoral Program of the Faculty of Medicine of ABC, Santo André , SP, Brazil
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Musical Auditory Stimulation Influences Heart Rate Autonomic Responses to Endodontic Treatment. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2017; 2017:4847869. [PMID: 28182118 PMCID: PMC5274691 DOI: 10.1155/2017/4847869] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 10/20/2016] [Accepted: 11/17/2016] [Indexed: 01/27/2023]
Abstract
We aimed to evaluate the acute effect of musical auditory stimulation on heart rate autonomic regulation during endodontic treatment. The study included 50 subjects from either gender between 18 and 40 years old, diagnosed with irreversible pulpitis or pulp necrosis of the upper front teeth and endodontic treatment indication. HRV was recorded 10 minutes before (T1), during (T2), and immediately (T3 and T4) after endodontic treatment. The volunteers were randomly divided into two equal groups: exposed to music (during T2, T3, and T4) or not. We found no difference regarding salivary cortisol and anxiety score. In the group with musical stimulation heart rate decreased in T3 compared to T1 and mean RR interval increased in T2 and T3 compared to T1. SDNN and TINN indices decreased in T3 compared to T4, the RMSSD and SD1 increased in T4 compared to T1, the SD2 increased compared to T3, and LF (low frequency band) increased in T4 compared to T1 and T3. In the control group, only RMSSD and SD1 increased in T3 compared to T1. Musical auditory stimulation enhanced heart rate autonomic modulation during endodontic treatment.
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Khorshidi H, Lavaee F, Ghapanchi J, Golkari A, Kholousi S. The relation of preoperative stress and anxiety on patients' satisfaction after implant placement. Dent Res J (Isfahan) 2017; 14:351-355. [PMID: 29109751 PMCID: PMC5654231 DOI: 10.4103/1735-3327.215968] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Background: There are some factors which can affect preoperative patient anxiety such as the necessity of procedure, postoperative pain, and patient's conception of his body image. The aim of this study was to assess the relation of patients' preoperative anxiety and postoperative patients' satisfaction in dental implant surgery. Materials and Methods: Dental implants were placed in 40 patients (19 male and 21 female) who were referred to Dental Implant Surgery Department in Imam Reza clinic, during March–December of 2014 in Shiraz. The procedures were performed with or without bone regeneration. Preoperative anxiety was evaluated using Corah Dental Anxiety Scale, and postoperative satisfaction was determined on the basis of pain intensity, bleeding tendency, inability to eating, and overall satisfaction by filling a questionnaire in the 2nd or 3rd week after surgery. Data were collected and analyzed using Mann-Whitney test. Results: Preoperative anxiety was detected as high in 10%, mild in 85%, and moderate in 5% of patients. Anxiety and depression score did not differ in both genders. There was no statistical difference between neither level of anxiety nor depression in both high and low educated patients. Postoperative bleeding, difficulty in eating, and overall satisfaction was nearly the same in both genders. Statistical analysis demonstrated a lower pain level and higher pain threshold in men than women (P = 0.007). Patients' age was not related to anxiety, depression, amount of bleeding, pain, and difficulty in eating. Overall dental care satisfaction was similar in both men and women. Conclusion: The results of the study indicated that while anxiety does play a role in the perception of pain by patients undergoing implant surgery, overall patient satisfaction and post surgical outcomes did not significantly differ.
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Affiliation(s)
- Houman Khorshidi
- Department of Periodontology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fatemeh Lavaee
- Oral and Dental Disease Research Center and Oral and Maxillofacial Medicine Department, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Janan Ghapanchi
- Oral and Dental Disease Research Center and Oral and Maxillofacial Medicine Department, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Golkari
- Department of Dental Public Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sara Kholousi
- Student, Shiraz University of Medical Sciences, Shiraz, Iran
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Wada M, Miwa S, Mameno T, Suganami T, Ikebe K, Maeda Y. A prospective study of the relationship between patient character and blood pressure in dental implant surgery. Int J Implant Dent 2016; 2:21. [PMID: 27807782 PMCID: PMC5093099 DOI: 10.1186/s40729-016-0054-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2016] [Accepted: 10/20/2016] [Indexed: 11/10/2022] Open
Abstract
Background Patients often suffer from physical and mental stress in dental implant surgery. The aim of this prospective study is to investigate the relationship between patient character and blood pressure in dental implant surgery. Methods Fifteen patients were recruited for the present study. All patients had never received implant treatment in the past. To evaluate the patients’ personality trait, NEO-Five Factor Inventory (NEO-FFI) was used. All patients answered 50 questions at the first visit and divided in five dimensions: neuroticism, extraversion, openness, agreeableness, and conscientiousness. The index of physical stress was evaluated by blood pressure and pulse rate. Results Ten females and five males (mean 55.5 ± 10.6 years) were evaluated in this study. A significant positive correlation was found between elevation rate of diastolic blood pressure/mean blood pressure and neuroticism score (rs = 0.584, 0.526, p < 0.05). On the other hand, there was no significant correlation between systolic blood pressure elevation and neuroticism score. Conclusions In this limited study, there was significant correlation between neuroticism character and diastolic blood pressure or mean blood pressure rising in patients who received implant surgery.
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Affiliation(s)
- Masahiro Wada
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan.
| | - Syunta Miwa
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Tomoaki Mameno
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Tohru Suganami
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Kazunori Ikebe
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Yoshinobu Maeda
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan
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Santana MDR, Pita Neto IC, Martiniano EC, Monteiro LRL, Ramos JLS, Garner DM, Valenti VE, Abreu LCD. Non-linear indices of heart rate variability during endodontic treatment. Braz Oral Res 2016; 30:S1806-83242016000100220. [PMID: 26910016 DOI: 10.1590/1807-3107bor-2016.vol30.0029] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Accepted: 10/14/2015] [Indexed: 11/22/2022] Open
Abstract
Dental treatment promotes psychosomatic change that can influence the procedure and compromise the general well-being of the patient. In this context, it highlights the importance of evaluating the function of the autonomic nervous system in individuals undergoing endodontic treatment. Thus, this manuscript aimed to analyse cardiac autonomic modulation, through non-linear indices of heart rate variability (HRV) during endodontic treatment. Analysis of 50 subjects of either sex aged between 18 and 40 years diagnosed with irreversible pulp necrosis of lower molars undergoing endodontic treatment was undertaken. We carried out fractal and symbolic analysis of HRV, which was recorded in the first session of the endodontic treatment at four intervals: T1: 0-10 min before the onset of the treatment session; T2: 0-10 min after the application of anaesthesia; T3: throughout the period of treatment; and T4: 0-30 min after the end of the treatment session. There was reduction of α1 in T2 compared to T1 and T4 (p < 0.0001). The α2 index also reduced in T2 compared to T3 (p = 0.0035). There was an increase in the α1/α2 ratio in T4 compared to T2 and T3 (p = 0.0003). It was found that 0V% was significantly lower in T2 (p = 0.002), while 2UV% was significantly higher (p < 0.0001) when compared to other points in time. In conclusion, HRV is reduced during endodontic treatment, and after applying local anaesthetic the parasympathetic component of HRV increases. These data indicate that endodontic treatment acutely overcharges the heart, supporting the stress involved in this situation.
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Affiliation(s)
- Milana Drumond Ramos Santana
- Laboratório de Delineamento de Estudos e Escrita Científica, Faculdade de Medicina do ABC, Santo André, SP, Brazil
| | - Ivo Cavalcante Pita Neto
- Laboratório de Delineamento de Estudos e Escrita Científica, Faculdade de Medicina do ABC, Santo André, SP, Brazil
| | - Eli Carlos Martiniano
- Faculdade de Odontologia, Departamento de Saúde, Faculdade de Juazeiro do Norte, Juazeiro do Norte, CE, Brazil
| | | | - José Lucas Souza Ramos
- Faculdade de Odontologia, Departamento de Saúde, Faculdade de Juazeiro do Norte, Juazeiro do Norte, CE, Brazil
| | - David M Garner
- Department of Biological and Medical Sciences, Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, United Kingdom
| | - Vitor Engácia Valenti
- Centro de Estudos do Sistema Nervoso Autônomo, Faculdade de Filosofia e Ciências, Universidade Estadual Paulista, Marília, SP, Brazil
| | - Luiz Carlos de Abreu
- Laboratório de Delineamento de Estudos e Escrita Científica, Faculdade de Medicina do ABC, Santo André, SP, Brazil
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Dexmedetomidine Analgesia Effects in Patients Undergoing Dental Implant Surgery and Its Impact on Postoperative Inflammatory and Oxidative Stress. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2015; 2015:186736. [PMID: 26171113 PMCID: PMC4485522 DOI: 10.1155/2015/186736] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Accepted: 11/18/2014] [Indexed: 12/31/2022]
Abstract
The aim of the study was to determine whether or not dexmedetomidine- (DEX-) based intravenous infusion in dental implantation can provide better sedation and postoperative analgesia via suppressing postoperative inflammation and oxidative stress. Sixty patients were randomly assigned to receive either DEX (group D) or midazolam (group M). Recorded variables were vital sign (SBP/HR/RPP/SpO2/RR), visual analogue scale (VAS) pain scores, and observer's assessment of alertness/sedation scale (OAAS) scores. The plasma levels of interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-α), antioxidant superoxide dismutase (SOD), and the lipid peroxidation product malondialdehyde (MDA) were detected at baseline and after 2, 4, and 24 h of drug administration. The VAS pain scores and OAAS scores were significantly lower for patients in group D compared to group M. The plasma levels of TNF-α, IL-6, and MDA were significantly lower in group D patients than those in group M at 2 h and 4 h. In group M, SOD levels decreased as compared to group D at 2 h and 4 h. The plasma levels of TNF-α, IL-6, and MDA were positively correlated with VAS pain scores while SOD negatively correlated with VAS pain scores. Therefore, DEX appears to provide better sedation during office-based artificial tooth implantation. DEX offers better postoperative analgesia via anti-inflammatory and antioxidation pathway.
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Marrelli M, Gentile S, Palmieri F, Paduano F, Tatullo M. Correlation between Surgeon's experience, surgery complexity and the alteration of stress related physiological parameters. PLoS One 2014; 9:e112444. [PMID: 25379944 PMCID: PMC4224481 DOI: 10.1371/journal.pone.0112444] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Accepted: 10/15/2014] [Indexed: 01/16/2023] Open
Abstract
Introduction In the present work we analyzed the hormonal (salivary Cortisol; sC), immune (salivary Immunoglobulin A; sIgA) and cardiovascular (Heart rate, HR, and systolic blood pressure, SBP) responses induced by stress conditions in oral surgeons, randomly recruited according to their expertise level. Materials and methods Each surgeon performed three different surgical procedures with increasing degrees of technical difficulty and under time-limited conditions, to assess whether these variants may influence the risks of stress-induced secondary hypertension among the involved health professionals. sC and sIgA samples and cardiovascular function measurements were taken up before, during, and two hours after every surgery. Salivary samples and cardiovascular measurements were taken also during non-surgical days, as baseline controls. Results We observed that more experienced surgeons showed a higher stress management ability compared to those with less experience or, generally, younger, which are more exposed to the risks of developing secondary hypertension. Nevertheless, indipendently of sex and experience, oral surgeons are constantly exposed to high risks of developing stress-related diseases. Conclusions On the basis of the issues addressed and the results obtained, we have highlighted the importance of the investigated stress biomarkers to monitor and to prevent stress-related pathologies among oral surgeons. This approach is aimed to emphasize the significance of these specific stress-biomarkers, which represent a powerful instrument to evaluate stress levels in oral surgeons, and that may help to reduce the most severe life-threatening risks to which they are daily exposed. In conclusion, final goal of this study is to suggest an useful guideline to monitor the stress levels of oral and maxillofacial surgeons in order to improve their quality of life, which is inevitably reflected on the quality of the performances provided and, finally, to prevent possible mistakes in their daily activities.
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Affiliation(s)
- Massimo Marrelli
- Unit of Maxillofacial Surgery, Calabrodental, Crotone, Italy; Tecnologica Research Institute, Biomedical Section, Crotone, Italy
| | - Stefano Gentile
- Tecnologica Research Institute, Biomedical Section, Crotone, Italy
| | | | | | - Marco Tatullo
- Unit of Maxillofacial Surgery, Calabrodental, Crotone, Italy; Tecnologica Research Institute, Biomedical Section, Crotone, Italy
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