Effects of Preoperative Information Formats in Third Molar Surgery

Clinician-Guided Preoperative Information Formats and Perioperative Physiological Responses in Impacted Mandibular Third Molar Surgery: A Three-Arm Randomized Controlled Trial

This study evaluates whether physician-guided visual information provided before impacted mandibular third molar surgery can improve hemodynamic stability during the perioperative period. Participants are assigned to one of three preoperative information methods: standard verbal information, real surgical video information, or 3D animation video information. Changes in systolic blood pressure, diastolic blood pressure, heart rate, and oxygen saturation are assessed at multiple perioperative time points to determine whether visual information reduces stress-related physiologic responses. The study also examines whether these information methods influence preoperative dental fear.

Impacted mandibular third molar surgery is a common oral surgical procedure that is frequently associated with patient stress, fear, and physiologic fluctuations during the perioperative period. In addition to subjective anxiety, these stress responses may be reflected in hemodynamic parameters such as systolic blood pressure, diastolic blood pressure, heart rate, and oxygen saturation.

This randomized controlled study was designed to investigate whether physician-guided visual information can improve perioperative hemodynamic stability compared with standard verbal information alone. Participants undergoing impacted mandibular third molar surgery are assigned to one of three preoperative information approaches: standard verbal information, real surgical video information, or 3D animation video information.

The primary objective is to compare the effects of these information modalities on perioperative hemodynamic responses measured at predefined time points, including baseline, after local anesthesia, during tooth luxation, after suturing, and during the early recovery period. The secondary objective is to evaluate the effect of these information methods on dental fear using a validated psychometric scale.

The study is based on the hypothesis that visually supported preoperative information, when delivered in a structured and physician-guided manner, may reduce stress-related physiologic fluctuations during surgery and may also influence patients' self-reported dental fear. By comparing verbal, real video, and animation-based information methods, the study aims to clarify whether visual information contributes to better physiologic regulation and patient preparation before third molar surgery.

Inclusion Criteria:

• Age between 18 and 50 years
• ASA physical status I or II
• Radiographic evidence of an impacted mandibular third molar classified as Pell-Gregory Class I or II and Position A or B
• Presence of mandibular third molar (tooth 38 or 48) in a vertical or mesioangular position according to Winter's classification
• Indication for impacted mandibular third molar extraction
• Willingness to participate and provide written informed consent

Exclusion Criteria:

• Active smoking or alcohol consumption
• Bleeding/coagulation disorders or any systemic disease/medication use that could impair wound healing
• Pregnancy or lactation
• Local pathologies associated with the impacted tooth, such as cysts or tumors
• History of severe anxiety disorder or known psychiatric illness
• Known allergy to local anesthetics or planned postoperative medications
• Presence of uncontrolled active periodontal disease
• Inability or unwillingness to comply with follow-up procedures