title: Does Psychological Profile Influence Third Molar Extraction and Postoperative Pain?
abstract: OBJECTIVE
  Our purposes were to determine the influence of psychological profile on hemodynamic changes in patients who undergo surgical removal of the third molars under intravenous sedation and to evaluate the effect on patients' anxiety and postoperative recovery.
  
  
  METHODS
  We performed a prospective study of 100 patients (American Society of Anesthesiologists classes I and II; aged ≥18 years) seen in the CIMIVClinic (Department of Oral Surgery, Casa de Salud University Hospital, Valencia, Spain) who underwent extractions of all third molars under intravenous sedation. All patients were administered the Symptom Checklist 90 Revised (SCL-90-R). The following parameters were monitored at different times during the surgical interventions: systolic blood pressure, diastolic blood pressure, oxygen saturation, and heart rate. Position and depth of impaction of the tooth (Pell and Gregory classification and Winter classification), surgery duration, and surgical technique also were recorded. Finally, the degree of pain experienced the week after the surgical intervention was measured using a visual analog scale.
  
  
  RESULTS
  Patients' anxiety levels preoperatively were significantly higher in patients with psychological distress (P = .023). Postoperative pain significantly decreased from the first day to the seventh day in healthy patients but not in patients with altered psychological conditions (P < .05). Nevertheless, the hemodynamic changes were not correlated with the psychological impairment.
  
  
  CONCLUSIONS
  Intravenous sedation enables the control of hemodynamic changes in all patients independently of their psychological profile. Patients with psychological distress present with higher levels of dental anxiety and postoperative pain. Future studies are needed to further clarify this interaction.
authors.affiliation: Professor, Dentistry Department, Health Sciences Faculty, CEU Cardenal Herrera University, Valencia, Spain; Oral Surgeon, CIMIVClinic, Oral Surgery and Implantology Department, University Hospital Casa de Salud, Valencia, Spain. Electronic address: dra.gonzalez@cimiv.es.
authors.forename: Raquel
authors.initials: R
authors.lastname: González-Martínez
authors.affiliation: Director, Dentistry Department, Health Sciences Faculty, CEU Cardenal Herrera University, Valencia, Spain.
authors.forename: María Del Mar
authors.initials: MD
authors.lastname: Jovani-Sancho
authors.affiliation: Professor, Biomedical Sciences Department, Health Sciences Faculty, CEU Cardenal Herrera University, Valencia, Spain; Director, CIMIVClinic, Oral Surgery and Implantology Department, University Hospital Casa de Salud, Valencia, Spain.
authors.forename: Isidoro
authors.initials: I
authors.lastname: Cortell-Ballester
mesh_terms: D000328:Adult; D000766:Anesthesia, Dental; D016854:Dental Anxiety / Q000523:psychology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D001523:Mental Disorders / Q000523:psychology*; D008964:Molar, Third / Q000601:surgery*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000523:psychology*; D011446:Prospective Studies; D013030:Spain; D011795:Surveys and Questionnaires; D014081:Tooth Extraction; D014095:Tooth, Impacted / Q000601:surgery*