Purpose: To examine the association of preoperative dental anxiety with the severity of postoperative symptoms among patients undergoing lower third molar (LM3) extraction surgery.Materials and methods: We conducted a hospital-based prospective study with a sample size of 213 patients. All the patients underwent LM3 extraction surgery at the Stomatology Hospital of Tianjin Medical University. Preoperative dental anxiety was measured using the Dental Anxiety Scale for Third Molar Surgery (DAS-TMS) and classified into four categories: No anxiety, Some unease, Anxious, and Very anxious. The primary outcome was defined using the postoperative symptom severity scale on the seventh day after surgery. The patients' clinical characteristics, radiologic features, and surgery-related variables were used as control variables. Bivariate analysis involved Fisher's exact test and Kruskal–Wallis test. Multivariable logistic analysis was used to assess preoperative dental anxiety in relation to the severity of postoperative symptoms. We applied a two-piecewise regression model to examine the potential non–linear associations.Results: The mean (SD) dental anxiety score was 10.56 (3.84). The proportion of dental anxiety was as follows: No anxiety, 7.5%; Some unease, 46.9%; Anxious, 31.0%; Very anxious, 14.6%. The multivariable-adjusted ORs with 95% CIs of postoperative symptoms were 1.00 for No anxiety, 3.63 (0.90–14.68) for Some unease, 5.29 (1.25–22.33) for Anxious, and 4.75 (1.02–22.18) for Very anxious (P for trend = 0.047). The risk of serious postoperative symptoms increased with the dental anxiety level up to 7 points (adjusted OR 1.94, 95% CI 1.12–3.74; P = 0.012). When the dental anxiety level exceeded 7 points, the level of DAS-TMS was not associated with the risk of serious postoperative symptoms (OR 0.98, 95% CI 0.88–1.08; P = 0.756).Conclusions: Findings suggest that dental anxiety is associated with a risk of serious postoperative symptoms following LM3 removal. The degree of dental anxiety in patients before LM3 extraction surgery should be of concern to clinicians.

The aim of this study was to compare the apical and coronal extrusions by using two reciprocating and two rotary instrumentation systems. Eighty extracted human single-rooted anterior teeth were randomly assigned to four groups. Four different root canal instrumentation systems were used according to the manufacturers instructions, including two reciprocating single-file systems, Reciproc and WaveOne, and two full-sequence rotary BLX and ProTaper instruments. Debris collected from the coronal by the instruments and apical extrusions were quantified respectively. After drying the collections, the mean weight of debris collected from apical and coronal extrusions was assessed using an electronic balance and analyzed using the Kruskal–Wallis H and Mann–Whitney U tests. Statistically significant differences in the apical extrusion were observed among the four groups. Reciproc and WaveOne instruments produced significantly less debris than BLX and ProTaper instruments (P < 0.05). All of the systems produced apical extrusion of debris. However, reciprocating single-file systems produced less apical extrusion than full-sequence rotary systems. No relationship was observed between apical and coronal extrusions.

Operation time is independent associated with serious postoperative symptom in patients with mandibular third molar removal Feng Qiao, Lei Li, Jing Zhang, Rui Dong, Jun Sun

BACKGROUND Porphyromonas gingivalis (Pg) plays a significant role in the etiology of periodontitis and is frequently detected in atherosclerotic plaques. The current investigation was designed to analyze the associations among Pg concentration, periodontal status, and coronary artery disease (CAD). MATERIAL AND METHODS A total of 78 CAD patients and 53 non-CAD patients participated in the research. DNA was extracted from oral and blood samples. Pg DNA was quantified by qPCR. The associations among periodontal status, Pg concentration, and CAD were evaluated. RESULTS Multivariate logistic regression analysis suggested that all periodontal status indicators, except for the number of missing teeth, were significantly associated with an increased risk of CAD. The number of missing teeth, the percentage of teeth with mobility, and the percentage of plaque were significantly associated with the severity of CAD. Pg concentration, measured in blood samples, was significantly associated with an increased risk of CAD occurrence - odds ratio (OR)=1.058, 95% confidence interval (CI) 1.013-1.104, in Model 1, P<0.05; Model 2: OR=1.086, 95% CI 1.018-1.157, P<0.05. CONCLUSIONS The severity of periodontal status increased the risk of CAD and was correlated with the severity of CAD. High concentrations of Pg in plasma was a significant risk factor for CAD, with clinical significance in assessing the risk of CAD. Pg appeared to enhance the association between periodontitis and CAD.