Comparison of the effects of computer-assisted local anesthesia and conventional local anesthesia on pain, anxiety and hemodynamic changes during impacted mandibular third molar surgery

Objective: The aim of this study is to comparatively and multidimensionally examine the levels of pain and anxiety associated with computer-assisted local anesthesia (CALAS) and conventional local anesthesia (CLA), along with physiological responses, in mandibular impacted third molar surgery, one of the most challenging procedures. Materials and Methods: In this prospective, split-mouth, randomized controlled clinical trial, 40 patients were assigned to BDLAS and KLA groups. Anxiety levels were assessed pre-anesthesia and post-operatively using the Visual Analog Scale (VAS), State-Characteristic Anxiety Inventory (STAI-S and STAI-T), Modified Dental Anxiety Scale (MDAS), and Dental Fear Scale (DFS). Additionally, patients in both study groups completed a satisfaction questionnaire. Physiological parameters (Respiratory Rate, Pulse Rate, Systolic and Diastolic Blood Pressure, Oxygen Saturation) were recorded in eight phases. Results: While there was no statistically significant difference in pre-operative anxiety scores between the two groups (p>0.05), post-operative scores were significantly higher in the KLA group compared to the BDLAS group on all scales (p<0.05). The KLA group showed significantly higher pre- and post-operative anxiety scores on all scales (p=0.000), while this increase was limited in the BDLAS group and no statistically significant difference was observed (p>0.05). Statistically significant differences were observed between the groups at different stages in all hemodynamic parameters (p<0.05). In both groups, significant differences were observed in respiratory rate, pulse, and systolic blood pressure measurements compared to post-operative measurements in within-group comparisons (p<0.05). Conclusion: The findings of this study suggest that BDLAS applied prior to third molar surgery may be effective in limiting pain and anxiety, that hemodynamic changes may be more limited, and that it is a first step towards a comfortable surgical procedure. Keywords: Bilgisayar destekli lokal anestezi; üçüncü molar cerrahisi; ağrı; anksiyete; hemodinamik değişiklikler.