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Hutajulu JM, Agustiani H, Setiawan AS. Special Characteristics of Alpha Generation Children Behavior in Dentistry: A Literature Review. Eur J Dent 2024; 18:743-765. [PMID: 38198815 PMCID: PMC11290924 DOI: 10.1055/s-0043-1776336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2024] Open
Abstract
Technological developments and advances have influenced the emergence of a new generation, known as Generation Alpha. This generation comprises those born between 2010 and 2025. Born into a digital-savvy era, this generation has different characteristics from previous generations. This study aims to identify their special characteristics so that an approach can be taken, especially in managing children of the alpha generation in dentistry. A systematic search for articles, published between 2013 and 2023 analyzing the characteristics and behavior of the alpha generation and management behavior found in dentistry was conducted through PubMed, Google Scholar, SCOPUS, and EBSCO. The final analysis was carried out on 47 articles consisting of 10 articles discussing the characteristics of the alpha generation in general and 37 articles discussing the management of their behavior in dentistry. All the published articles found that an alpha child's characteristics are closely related to behavior management in dentistry. The ease with which alpha children adapt to technology is one of the strategies for managing the behavior of alpha children. However, apart from this, the alpha children tend to be unappreciative of the process, which can affect dental behavior management. Specific characteristics of the alpha generation, such as increased exposure to technology, digital media consumption habits, and lack of respect for the process, have important implications for communication and adaptation to patient behavior management in dentistry. Understanding these characteristics is crucial for designing an effective communication strategy and adjusting appropriate behavior management to maintain the quality of dental care for this generation in the dentistry environment.
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Affiliation(s)
- Jose Mario Hutajulu
- Dental Education Program, Faculty of Dentistry, Universitas Padjadjaran, Bandung, Indonesia
| | - Hendriati Agustiani
- Department of Developmental Psychology, Faculty of Psychology, Universitas Padjadjaran, Bandung, Indonesia
| | - Arlette Suzy Setiawan
- Department of Pediatric Dentistry, Faculty of Dentistry, Universitas Padjadjaran, Bandung, Indonesia
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Almarzouq SSFS, Chua H, Yiu CKY, Lam PPY. Effectiveness of Nonpharmacological Behavioural Interventions in Managing Dental Fear and Anxiety among Children: A Systematic Review and Meta-Analysis. Healthcare (Basel) 2024; 12:537. [PMID: 38470648 PMCID: PMC10931341 DOI: 10.3390/healthcare12050537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 02/03/2024] [Accepted: 02/13/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Non-pharmacological behavioural interventions (NPBIs) have been employed by dentists to alleviate dental fear and anxiety (DFA) among preschool and school children. The aim of this systematic review and meta-analysis was to investigate the effectiveness of different NPBIs in reducing DFA among children aged below 12. METHOD A comprehensive search was conducted using four electronic databases to identify randomised controlled trials that assess the effectiveness of NPBIs among preschool and school children. Two reviewers independently screened and selected the relevant studies, evaluated the risk of bias, and extracted relevant data for qualitative and quantitative syntheses. RESULT A total of 66 articles were included in the study. Except during more invasive dental procedures, the use of distraction techniques was found to result in significantly lower self-rated anxiety, better cooperation, and lower pulse rate compared to the tell-show-do method. However, inconsistent results were reported regarding the efficacy of virtual reality, modelling, visual pedagogies, tell-show-do and other NPBIs in reducing DFA among children. CONCLUSIONS The studies exhibited substantial heterogeneity due to varying age groups, methods of implementing NPBIs, dental treatments performed, and measurement scales employed in the evaluation of DFA.
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Affiliation(s)
| | - Helene Chua
- National Healthcare Group Polyclinics, Singapore 308433, Singapore
| | - Cynthia K. Y. Yiu
- Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong (C.K.Y.Y.)
| | - Phoebe P. Y. Lam
- Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong (C.K.Y.Y.)
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Bahrololoomi Z, Zein Al-Din J, Maghsoudi N, Sajedi S. Efficacy of Virtual Reality Distraction in Reduction of Pain and Anxiety of Pediatric Dental Patients in an Iranian Population: A Split-Mouth Randomized Crossover Clinical Trial. Int J Dent 2024; 2024:1290410. [PMID: 38250512 PMCID: PMC10798833 DOI: 10.1155/2024/1290410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 11/08/2023] [Accepted: 11/29/2023] [Indexed: 01/23/2024] Open
Abstract
Materials and Methods This crossover clinical trial was conducted with eligible 6-8-year-old children requiring bilateral mandibular molar pulpotomy. At the first treatment visit, pulpotomy was performed for 15 children using VR glasses distraction while the other 15 children received a pulpotomy without any VR glasses; this trend was reversed at the second session and pulpotomy was performed for the contralateral tooth. Pulse rate (PR) and Modified Child Dental Anxiety Scale (MCDAS) measured the anxiety levels. Wong-Baker Faces Pain Scale (WBFP) assessed the pain perception before and after the intervention. Data were analyzed by Statistical Package for the Social Sciences version 25 using the Mann-Whitney and χ2 tests. Results The mean PR was not significantly different between the two groups. However, the test group showed significantly lower scores of MCDAS (P value = 0.02) and WBFP (P value = 0.001) compared with the control group. Conclusion The present results suggest that VR headsets can decrease the level of pain and anxiety of patients during primary mandibular pulpotomy. This trial is registered with IRCT20200315046782N1.
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Affiliation(s)
- Zahra Bahrololoomi
- Department of Pediatrics, School of Dentistry, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Javad Zein Al-Din
- Department of Pediatrics, School of Dentistry, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Nahid Maghsoudi
- Department of Pediatrics, School of Dentistry, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Samira Sajedi
- Department of Pediatrics, School of Dentistry, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Barros Padilha DXD, Veiga NJ, Mello-Moura ACV, Nunes Correia P. Virtual reality and behaviour management in paediatric dentistry: a systematic review. BMC Oral Health 2023; 23:995. [PMID: 38087294 PMCID: PMC10717698 DOI: 10.1186/s12903-023-03595-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 10/29/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Virtual reality (VR) has emerged as an innovative tool in medicine and dentistry, improving anxiety and pain management in children. The immersive and interactive environments of VR technology facilitate positive engagement of young patients during dental procedures via distraction, potentially reducing anxiety levels and improving treatment experience. The aim of this review was to provide current evidence-based guidance on the usage of VR in the clinical practice of paediatric dentistry. METHODS A systematic review was conducted according to the PRISMA guidelines with the following research question using the PICO format: Does VR (I) effectively manage anxiety and pain (O) during a paediatric dental consultation (P) compared to alternative behavioural control techniques (C)? PubMed/Medline®, SCOPUS and Web of Science databases were searched and analysed. RESULTS A total of 22 randomised control trials were included in this review. These studies have shown that VR is a highly effective method of behaviour management, successfully alleviating pain and anxiety in children during dental treatment, surpassing traditional tools. Selected studies included participants with a large age range and dental procedures varied greatly, from first consultations to infiltration of local anaesthetic and other invasive procedures. VR was mostly used during treatment delivery and different immersive VR techniques were considered. Behaviour, anxiety and pain scales were used to determine efficacy and patient satisfaction. CONCLUSIONS VR offers an engaging and immersive experience, effectively diverting patients' attention away from the clinical environment, fostering a positive and enjoyable treatment experience. However, it is important to acknowledge the limitations of existing studies and the need for further research to enhance the understanding of VR's full potential in paediatric dentistry.
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Grants
- UIDB/04279/2020. This work is financially supported by National Funds through FCT - Fundação para a Ciência e a Tecnologia, I.P., under the project
- UIDB/04279/2020. This work is financially supported by National Funds through FCT - Fundação para a Ciência e a Tecnologia, I.P., under the project
- UIDB/04279/2020. This work is financially supported by National Funds through FCT - Fundação para a Ciência e a Tecnologia, I.P., under the project
- UIDB/04279/2020. This work is financially supported by National Funds through FCT - Fundação para a Ciência e a Tecnologia, I.P., under the project
- This work is financially supported by National Funds through FCT – Fundação para a Ciência e a Tecnologia, I.P., under the project
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Affiliation(s)
| | - Nélio Jorge Veiga
- Faculty of Dental Medicine, Universidade Católica Portuguesa, 3504-505, Viseu, Portugal
- Centre for Interdisciplinary Research in Health (CIIS), Universidade Católica Portuguesa, 3504-505, Viseu, Portugal
| | - Anna Carolina Volpi Mello-Moura
- Faculty of Dental Medicine, Universidade Católica Portuguesa, 3504-505, Viseu, Portugal
- Centre for Interdisciplinary Research in Health (CIIS), Universidade Católica Portuguesa, 3504-505, Viseu, Portugal
| | - Patrícia Nunes Correia
- Faculty of Dental Medicine, Universidade Católica Portuguesa, 3504-505, Viseu, Portugal.
- Centre for Interdisciplinary Research in Health (CIIS), Universidade Católica Portuguesa, 3504-505, Viseu, Portugal.
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Fan L, Zeng J, Ran L, Zhang C, Wang J, Yu C, Zhao N. Virtual reality in managing dental pain and anxiety: a comprehensive review. Front Med (Lausanne) 2023; 10:1285142. [PMID: 38131048 PMCID: PMC10736194 DOI: 10.3389/fmed.2023.1285142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 11/09/2023] [Indexed: 12/23/2023] Open
Abstract
Objectives This study aimed to identify, analyze, and summarize the clinical efficacy of virtual reality (VR) distraction therapy for oral treatment in different hospital settings in contrast to medical interventions that induce anxiety and pain. Furthermore, this review aimed to determine the implications for research and clinical practice of VR distraction therapy. Data This review investigated the clinical efficacy of VR in the oral treatment of procedural pain or anxiety. Quality assessment of the included studies was conducted. A narrative synthesis of the collected data was performed. Sources Literature studies from six electronic databases were searched for a comprehensive review, namely, the Cochrane Oral Health's Trials Register, Cochrane Central Register of Controlled Trials (Central), MEDLINE (PubMed), EMBASE, Scopus, and Web of Science. Study selection One thousand five hundred twenty-two patients aged between 0 and 60 years who used VR during dental treatment were included in this review. Among these studies, 8 and 14 studies comprised adult and pediatric patients. Conclusion Overall, the reviewed studies underscore the efficacy of VR to mitigate pain and anxiety in the context of dental treatment. VR is an innovative pain and anxiety management approach that facilitates dental treatment patients to immerse themselves in a virtual world while using distractions to reduce pain and anxiety. Clinical significance VR is an effective and novel non-pharmacological method of behavioral management that contributes to improving medication safety for dental patients. VR as a distractive approach can reduce the fear associated with medical interventions and prevent severe pain sensitivity, anxiety, and medical avoidance among adults and children.
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Affiliation(s)
- Lin Fan
- Department of Anesthesiology, Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Jie Zeng
- Department of Anesthesiology, Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Longkuan Ran
- Department of Anesthesiology, Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Chao Zhang
- Department of Anesthesiology, Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Jing Wang
- Department of Anesthesiology, Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Cong Yu
- Department of Anesthesiology, Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Nan Zhao
- Department of Anesthesiology, Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
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Almajed OS, Alhujhuj R, Alshaheen E, Almujhim A, Albutayh M, Raghunath RG, Lele G. The Effectiveness of Virtual Reality in Controlling Pain and Anxiety Levels in Four-to-Six-Year-Old Children During Dental Treatment. Cureus 2023; 15:e51099. [PMID: 38274902 PMCID: PMC10809031 DOI: 10.7759/cureus.51099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/26/2023] [Indexed: 01/27/2024] Open
Abstract
Background and objective Oral health is critical for children's overall well-being; however, dental anxiety often leads to the avoidance of necessary dental care among children. Virtual reality (VR) has emerged as a successful adjunctive tool in various clinical settings, including pain management. This cohort study explores the use of VR technology in reducing anxiety and pain perception during dental procedures for children. The primary objective of this study was to assess the efficacy of VR distraction in managing pain and anxiety levels in children aged four to six years during dental procedures. Additionally, the study aimed to compare children's anxiety levels with and without VR eyeglasses. Methodology This single-blind, crossover clinical trial was conducted at the Dental Complex of King Faisal University, Al Ahsa, Kingdom of Saudi Arabia. Of the 200 children screened initially, 20 aged four to six years who met the inclusion criteria were selected, and ethical approval for the study was obtained. The study comprised two groups: a control group and an experimental group. Dental procedures were conducted both with and without the use of VR, employing a split-mouth design. Results Our findings provide important insights into the clinical impact of using VR technology to alleviate children's anxiety during dental clinic visits. In our study, we used ANOVA and Tukey's post hoc test to evaluate the effect of VR glasses on vital metrics in children during dental procedures. Our results showed no significant differences before and after using the VR glasses, indicating limited effectiveness in reducing anxiety in this context. Conclusion Based on our findings, we reject the assumption that VR devices are highly effective in diverting children's attention and reducing their anxiety and pain during dental procedures; we recommend further investigations to identify potential confounding factors that could modulate the utility of VR in medical settings.
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Affiliation(s)
- Omar S Almajed
- Pediatric Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, SAU
- Dental Public Health, King's College London, London, GBR
| | - Rakan Alhujhuj
- Dental Department, King Abdulaziz National Guard Hospital, Al Hofuf, SAU
| | | | | | | | - Ravi G Raghunath
- Department of Preventive Dental Sciences, King Faisal University, Al Ahsa, SAU
| | - Gauri Lele
- Pediatric and Preventive Dentistry, Navrachana University, Gujarat, IND
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Kjeldgaard Pedersen L, Fisker LYV, Rölfing JD, Ahlburg P, Veien M, Vase L, Møller-Madsen B. Virtual reality increases pressure pain threshold and lowers anxiety in children compared with control and non-immersive control-A randomized, crossover trial. Eur J Pain 2023. [PMID: 36897663 DOI: 10.1002/ejp.2108] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 02/20/2023] [Accepted: 03/08/2023] [Indexed: 03/11/2023]
Abstract
BACKGROUND Virtual reality (VR) is a promising non-pharmacological pain intervention because it may not only distract but also modulate pain by immersing the user in a three-dimensional 360° alternate reality. In children, VR has been reported to reduce clinical pain and anxiety during medical procedures. However, the effect of immersive VR on pain and anxiety remains to be investigated in randomized controlled trials (RCT). The aim of the present crossover RCT was to assess the effect of VR on pressure pain threshold (PPT) and anxiety level measured with the modified Yale Preoperative Anxiety Scale (mYPAS) in children in a controlled experimental setting. METHODS Seventy-two children (mean age 10.2 (6-14) years) were randomized to 24 sequences of four interventions (immersive VR Game, immersive VR video, tablet: 2D video and control: small talk). Outcome measures PPT, mYPAS and heart rate were assessed before and after each intervention. RESULTS PPT increased significantly during VR game (PPTdiff): 136 kPa (CI 112; 161), p < 0.0001 and VR Video (PPTdiff): 122 kPa (CI 91; 153), p < 0.0001. Also, anxiety levels significantly decreased during both VR game (mYPASdiff: -7 points (-8 to -5), p < 0.0001) and VR video (mYPASdiff: -6 points (CI -7; -4), p < 0.0001). CONCLUSIONS VR had a marked beneficial effect on PPT and anxiety compared with the control interventions: 2D video and small talk. Thus, immersive VR had a distinct modulatory effect on pain and anxiety in a well-controlled experimental setting. Immersive VR was effective and feasible in children and can act as a valid tool for non-pharmacological pain and anxiety management. SIGNIFICANCE Paediatric immersive VR seems to be beneficial although well-controlled studies are pending. We investigated whether immersive VR can modulate children's threshold for pain and anxiety level in an experimental well-controlled setting. We document a modulatory pain threshold increase and anxiety level decrease compared with extensive control conditions. Paediatric immersive VR is effective, feasible and valid for non-pharmacological pain and anxiety management. All efforts to reach the goal that no child should experience pain or anxiety when exposed to medical procedures.
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Affiliation(s)
- L Kjeldgaard Pedersen
- Department of Children's Orthopaedic Surgery, Aarhus University Hospital, Aarhus, Denmark
- Danish Paediatric Orthopaedic Research; Department of Orthopaedic Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - L Y V Fisker
- Danish Paediatric Orthopaedic Research; Department of Orthopaedic Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - J D Rölfing
- Department of Children's Orthopaedic Surgery, Aarhus University Hospital, Aarhus, Denmark
- Danish Paediatric Orthopaedic Research; Department of Orthopaedic Surgery, Aarhus University Hospital, Aarhus, Denmark
- Corporate HR, MidtSim, Central Denmark Region, Aarhus, Denmark
| | - P Ahlburg
- Department of Children's Anaesthesiology, Aarhus University Hospital, Aarhus, Denmark
| | - M Veien
- Department of Children's Anaesthesiology, Aarhus University Hospital, Aarhus, Denmark
| | - L Vase
- Department of Psychology and Behavioural Sciences; Department of Psychology and Neuroscience, Aarhus University, Aarhus, Denmark
| | - B Møller-Madsen
- Department of Children's Orthopaedic Surgery, Aarhus University Hospital, Aarhus, Denmark
- Danish Paediatric Orthopaedic Research; Department of Orthopaedic Surgery, Aarhus University Hospital, Aarhus, Denmark
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Yan X, Yan Y, Cao M, Xie W, O'Connor S, Lee JJ, Ho MH. Effectiveness of virtual reality distraction interventions to reduce dental anxiety in paediatric patients: A systematic review and meta-analysis. J Dent 2023; 132:104455. [PMID: 36842625 DOI: 10.1016/j.jdent.2023.104455] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 02/10/2023] [Accepted: 02/15/2023] [Indexed: 02/28/2023] Open
Abstract
OBJECTIVES To analyse the effectiveness of virtual reality (VR) distraction intervention for the management of dental anxiety in paediatric patients. DATA Randomised controlled trials (RCTs) of VR distraction interventions for reducing anxiety in paediatric patients, published in English were included. SOURCES Seven databases, including PubMed, Web of Science, Scopus, MEDLINE via ProQuest, EMBASE, CINAHL and Cochrane Central Register of Controlled Trials, covering the period between January 2000 and September 2022 were searched. STUDY SELECTION A total of 12 RCTs involving 818 participants were included. Quality appraisal was undertaken using the Cochrane risk-of-bias tool for randomised trials by two authors independently. Random-effects model was used to summarise the effects of the interventions and pool data. CONCLUSIONS Results showed that VR distraction interventions were effective in reducing the dental anxiety of paediatric patients. In meta-analysis, the VR distraction interventions had a significant effect on reducing paediatric patients' anxiety (SMD = -1.74, 95%CI = -2.46, -1.02, p < 0.001, I² = 95%), pain (SMD = -1.57, 95%CI = -2.22, -0.91, p < 0.001, I² = 91%) and heart rate (MD = -10.54, 95%CI = -20.26, -0.81, p = 0.03, I² = 99%) during dental treatment. However, the evidence of VR in managing dental anxiety would become weak because of the publication bias. CLINICAL SIGNIFICANCE VR distraction interventions could be an effective approach to alleviate the dental anxiety of paediatric patients. Additional well-designed and high-quality RCTs with larger sample sizes are needed to determine the optimal way to deliver VR interventions in paediatric dental clinics.
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Affiliation(s)
- Xinyi Yan
- School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, 3 Sassoon Road, Hong Kong, China
| | - Yongyang Yan
- School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, 3 Sassoon Road, Hong Kong, China
| | - Mengyao Cao
- School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, 3 Sassoon Road, Hong Kong, China
| | - Wenxuan Xie
- School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, 3 Sassoon Road, Hong Kong, China
| | - Siobhán O'Connor
- Division of Nursing, Midwifery and Social Work, The University of Manchester, Oxford Road, Manchester, United Kingdom
| | - Jung Jae Lee
- School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, 3 Sassoon Road, Hong Kong, China.
| | - Mu-Hsing Ho
- School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, 3 Sassoon Road, Hong Kong, China
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Zaidman L, Lusky G, Shmueli A, Halperson E, Moskovitz M, Ram D, Fux-Noy A. Distraction With Virtual Reality Goggles in Paediatric Dental Treatment: A Randomised Controlled Trial. Int Dent J 2022; 73:108-113. [PMID: 35940954 PMCID: PMC9875280 DOI: 10.1016/j.identj.2022.06.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 06/01/2022] [Accepted: 06/06/2022] [Indexed: 01/29/2023] Open
Abstract
AIM The aim of this study was to examine whether screening content through virtual reality (VR) goggles can diminish pain perception during local anaesthesia administered using the inferior alveolar nerve block technique and rubber dam placement in routine paediatric dental treatment. MATERIALS AND METHODS This is a crossover study of healthy 4- to 12-year-old children who were scheduled to receive local anaesthesia administered using the inferior alveolar nerve block technique and rubber dam placement in 2 visits. The participants were randomly assigned to undergo 1 treatment performed with Oculus GO VR goggles and the other treatment without. Pain was evaluated using the Wong-Baker FACES Pain Rating Scale and the Modified Behavioral Pain Scale (MBPS). RESULTS The study group included 29 children with a mean age of 8.29 years (SD, 1.96). Whilst administering local anaesthesia, no significant difference was observed in the Wong-Baker FACES Pain Rating Scale and in MBPS movements between visits with and without the VR goggles. However, significantly lower pain perception was observed in the other parameters of MBPS when using the VR goggles: Face (P = .007) and Cry (P = .046). During placement of a rubber dam, significantly less pain was reported by the patients (P = .005) and observed by the assessor (Face [P = .005], Cry [P = .029], and Movement [P = 0.028]) when the VR goggles were used. CONCLUSIONS VR can decrease pain perception during rubber dam placement in children, but it has limited benefit during administration of local anaesthesia.
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Affiliation(s)
| | | | | | | | | | | | - Avia Fux-Noy
- Corresponding author. Department of Pediatric Dentistry, Hadassah Medical Center, Faculty of Dental Medicine, Hebrew University of Jerusalem, P.O. Box 12272, Jerusalem 9112102, Israel.
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10
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Almedhesh SA, Elgzar WT, Ibrahim HA, Osman HA. The effect of virtual reality on anxiety, stress, and hemodynamic parameters during cesarean section: A randomized controlled clinical trial. Saudi Med J 2022; 43:360-369. [PMID: 35414614 PMCID: PMC9998068 DOI: 10.15537/smj.2022.43.4.20210921] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 03/21/2022] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES To investigate the effect of virtual reality (VR) on anxiety, stress, and hemodynamic parameters during cesarean section (CS). METHODS This is a randomized controlled clinical trial conducted at the operating theatre / Maternal and Children Hospital, Najran, Saudi Arabia from February to October 2021. The study comprised a random sample of 351(176 study and 175 control) low-risk pregnant women undergoing elective CS with regional anesthesia. Data collection was carried out using 5 instruments. Basic and clinical data sheet, maternal hemodynamic parameters assessment sheet, brief measure of preoperative emotional stress, a novel visual facial anxiety scale, and maternal satisfaction scale. Virtual reality group exposed to 3D natural videos associated with calm Quran or music voices via phone using VR glasses immediately after anesthesia until completion of skin suture. The control group left for routine hospital care. RESULTS The VR group showed significantly lower stress and anxiety levels immediately after skin suture and 2h postoperative (p=0.000). Maternal satisfaction 2 hours after CS showed that 58% of the VR group were completely satisfied compared to 11.3% of the control group (FET=135.359 p=0.000). Virtual reality have an impact on hemodynamic parameters at some time points while peripheral oxygen saturation did not differ significantly (p>0.05). CONCLUSION Virtual reality significantly reduced anxiety and stress among women undergoing CS under regional anesthesia. Virtual reality may be added to the routine intraoperative techniques that help induce patient relaxation and increase satisfaction.
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Affiliation(s)
- Sultan A. Almedhesh
- From the Department of Pediatric And Pediatric Cardiologist (Almedhesh), College of
Medicine; from the Department of Maternity and Childhood Nursing (Elgzar, Ibrahim),
Nursing College Najran University; and from the Department of Obstetrics and Gynecology
(Osman), Maternity and Children Hospital, Najran, Kingdom of Saudi Arabia.
| | - Wafaa T. Elgzar
- From the Department of Pediatric And Pediatric Cardiologist (Almedhesh), College of
Medicine; from the Department of Maternity and Childhood Nursing (Elgzar, Ibrahim),
Nursing College Najran University; and from the Department of Obstetrics and Gynecology
(Osman), Maternity and Children Hospital, Najran, Kingdom of Saudi Arabia.
| | - Heba A. Ibrahim
- From the Department of Pediatric And Pediatric Cardiologist (Almedhesh), College of
Medicine; from the Department of Maternity and Childhood Nursing (Elgzar, Ibrahim),
Nursing College Najran University; and from the Department of Obstetrics and Gynecology
(Osman), Maternity and Children Hospital, Najran, Kingdom of Saudi Arabia.
| | - Hiba A. Osman
- From the Department of Pediatric And Pediatric Cardiologist (Almedhesh), College of
Medicine; from the Department of Maternity and Childhood Nursing (Elgzar, Ibrahim),
Nursing College Najran University; and from the Department of Obstetrics and Gynecology
(Osman), Maternity and Children Hospital, Najran, Kingdom of Saudi Arabia.
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Fagoonee S, Arigoni M, Manco M, Olivero M, Bizzaro F, Magagnotti C, Andolfo A, Miniscalco B, Forni M, Todeschi S, Tolosano E, Bocchietto E, Calogero R, Altruda F. Circulating Extracellular Vesicles Contain Liver-Derived RNA Species as Indicators of Severe Cholestasis-Induced Early Liver Fibrosis in Mice. Antioxid Redox Signal 2022; 36:480-504. [PMID: 34779230 PMCID: PMC8978575 DOI: 10.1089/ars.2021.0023] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Aims: Biliary diseases represent around 10% of all chronic liver diseases and affect both adults and children. Currently available biochemical tests detect cholestasis but not early liver fibrosis. Circulating extracellular vesicles (EVs) provide a noninvasive, real-time molecular snapshot of the injured organ. We thus aimed at searching for a panel of EV-based biomarkers for cholestasis-induced early liver fibrosis using mouse models. Results: Progressive and detectable histological evidence of collagen deposition and liver fibrosis was observed from day 8 after bile duct ligation (BDL) in mice. Whole transcriptome and small RNA sequencing analyses of circulating EVs revealed differentially enriched RNA species after BDL versus sham controls. Unsupervised hierarchical clustering identified a signature that allowed for discrimination between BDL and controls. In particular, 151 microRNAs (miRNAs) enriched in BDL-derived EVs were identified, of which 66 were conserved in humans. The liver was an important source of circulating EVs in BDL animals as evidenced by the enrichment of several hepatic mRNAs, such as Albumin and Haptoglobin. Interestingly, among experimentally validated miRNAs, miR192-5p, miR194-5p, miR22-3p, and miR29a-3p showed similar enrichment patterns also in EVs derived from 3,5-diethoxycarboncyl-1,4-dihydrocollidine-treated (drug-induced severe cholestasis) but not in mice with mild phenotype or non-cholestatic liver fibrosis. Innovation: A panel of mRNAs and miRNAs contained in circulating EVs, when combined, indicates hepatic damage and fibrosis in mice and represents promising biomarkers for human severe cholestasis-induced liver fibrosis. Conclusion: Analysis of EV-based miRNAs, in combination with hepatic injury RNA markers, can detect early cholestatic liver injury and fibrosis in mice. Antioxid. Redox Signal. 36, 480-504.
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Affiliation(s)
- Sharmila Fagoonee
- Department of Biological Sciences, Institute of Biostructure and Bioimaging, National Research Council, Molecular Biotechnology Center, Turin, Italy
| | - Maddalena Arigoni
- Department of Molecular Biotechnology and Health Sciences, Molecular Biotechnology Center, University of Turin, Turin, Italy
| | - Marta Manco
- Department of Molecular Biotechnology and Health Sciences, Molecular Biotechnology Center, University of Turin, Turin, Italy
| | | | | | - Cinzia Magagnotti
- ProMeFa, Proteomics and Metabolomics Facility, IRCCS, San Raffaele Scientific Institute, Milan, Italy
| | - Annapaola Andolfo
- ProMeFa, Proteomics and Metabolomics Facility, IRCCS, San Raffaele Scientific Institute, Milan, Italy
| | | | - Marco Forni
- Department of Molecular Biotechnology and Health Sciences, Molecular Biotechnology Center, University of Turin, Turin, Italy
| | | | - Emanuela Tolosano
- Department of Molecular Biotechnology and Health Sciences, Molecular Biotechnology Center, University of Turin, Turin, Italy
| | | | - Raffaele Calogero
- Department of Molecular Biotechnology and Health Sciences, Molecular Biotechnology Center, University of Turin, Turin, Italy
| | - Fiorella Altruda
- Department of Molecular Biotechnology and Health Sciences, Molecular Biotechnology Center, University of Turin, Turin, Italy
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