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The influence of anxiety on pain perception and its repercussion on endodontic treatment: a systematic review

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Abstract

Objective

To evaluate the influence of dental anxiety on the perception of pain before and during endodontic treatments.

Materials and methods

The PRISMA checklist was followed. A search was conducted in Scopus, Medline/PubMed, The Cochrane Library, and Web of Science databases. Based on PECOS criteria, the first outcome was a possible association between pre-operative pain and anxiety. The second outcome was a possible association between intraoperative pain and anxiety. The type of studies was observational. The JBI Critical Appraisal Checklist was used to evaluate the methodological quality of articles. The certainty of the evidence was analyzed using the GRADE approach.

Results

Four articles were included with a total of 471 patients. Two studies found a positive association between pain and pre-endodontic treatment anxiety. Three studies investigated the relationship between anxiety and intraoperative pain; two identified an extremely significant positive association. One article noted that anxiety influences pain expectancy. The studies were of good quality as assessed by the JBI Critical Appraisal Checklist for cross-sectional studies. However, the certainty of the evidence was considered low and very low.

Conclusions

Dental anxiety can be directly associated with pre- and intraoperative pain during endodontic procedures.

Clinical relevance

It is necessary to identify patients with dental anxiety to employ therapies to bring their anxiety under control, avoiding the increase of endodontic infections, and the postponement and evasion of endodontic treatments.

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Acknowledgements

Belmiro Cavalcanti do Egito Vasconcelos is a CNPq productivity fellow.

Author information

Authors and Affiliations

  1. Department of Oral and Maxillofacial Pathology, School of Dentistry, University of Pernambuco (UPE), Rua Arnóbio Marquês, 310 - Santo Amaro, Recife, PE, 50100-130, Brazil

    Zilda Betânia Barbosa Medeiros de Farias & Márcia Maria Fonseca da Silveira

  2. Department of Hebiatrics, Determinants of Health in Adolescence, School of Dentistry, University of Pernambuco (UPE), Recife, Brazil

    Camilla Porto Campello

  3. Department of Prosthodontics, School of Dentistry, University of Pernambuco (UPE), Recife, Brazil

    Sandra Lúcia Dantas Moraes

  4. Department of Oral and Maxillofacial Surgery, School of Dentistry, University of Pernambuco (UPE), Recife, Brazil

    Belmiro Cavalcanti do Egito Vasconcelos

  5. Department of Dental Materials and Prosthodontics, Dental School of Araçatuba, São Paulo State University (UNESP), José Bonifacio street 1193, Araçatuba, São Paulo, 1605000, Brazil

    Eduardo Piza Pellizzer

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  1. Zilda Betânia Barbosa Medeiros de Farias
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  2. Camilla Porto Campello
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  3. Márcia Maria Fonseca da Silveira
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Contributions

Study conception and design: Zilda Betânia Barbosa Medeiros de Farias and Camilla Porto Campello. Material preparation, data collection and analysis: Zilda Betânia Barbosa Medeiros de Farias and Camilla Porto Campello. First draft of the manuscript: Zilda Betânia Barbosa Medeiros de Farias, Camilla Porto Campello and Eduardo Piza Pellizzer. Final approval of the manuscript: Zilda Betânia Barbosa Medeiros de Farias, Camilla Porto Campello, Márcia Maria Fonseca da Silveira, Sandra Lúcia Dantas Moraes, Belmiro Cavalcanti do Egito Vasconcelos, Eduardo Piza Pellizzer.

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Correspondence to Márcia Maria Fonseca da Silveira.

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Farias, Z.B.B.M., Campello, C.P., da Silveira, M.M.F. et al. The influence of anxiety on pain perception and its repercussion on endodontic treatment: a systematic review. Clin Oral Invest 27, 5709–5718 (2023). https://doi.org/10.1007/s00784-023-05181-1

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