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BMC Oral Health
Published in: BMC Oral Health 1/2020

Open Access 01-12-2020 | Fentanyl | Research article

Conscious sedation for the management of dental anxiety in third molar extraction surgery: a systematic review

Authors: Matteo Melini, Andrea Forni, Francesco Cavallin, Matteo Parotto, Gastone Zanette

Published in: BMC Oral Health | Issue 1/2020

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Abstract

Background

Dental anxiety is a condition associated with avoidance of dental treatment and increased medical and surgical risks. This systematic review aims to summarize available evidence on conscious sedation techniques used for the management of Dental anxiety in patients scheduled for third molar extraction surgery, to identify best approaches and knowledge gaps.

Methods

A comprehensive search was conducted including MEDLINE/Pubmed, EMBASE, SCOPUS, clinicaltrials.​gov and the Cochrane Database of Systematic Reviews through March 2019. Only randomized controlled trials were included. PRISMA guidelines were followed. Risk of bias was appraised as reported in the Cochrane Handbook for Systematic Reviews of Interventions.

Results

Seventeen RCTs with a total of 1788 patients were included. Some aspects limited the feasibility of a meaningful meta-analysis, thus a narrative synthesis was conducted. Conscious sedation was associated with improvement in Dental anxiety in six studies. One study reported lower cortisol levels with midazolam vs. placebo, while another study found significant variation in perioperative renin levels with remifentanil vs. placebo.

Conclusions

This review found inconclusive and conflicting findings about the role of Conscious sedation in managing Dental anxiety during third molar extraction surgery. Relevant questions remain unanswered due to the lack of consistent, standardized outcome measures. Future research may benefit from addressing these limitations in study design.
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Metadata
Title
Conscious sedation for the management of dental anxiety in third molar extraction surgery: a systematic review
Authors
Matteo Melini
Andrea Forni
Francesco Cavallin
Matteo Parotto
Gastone Zanette
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Oral Health / Issue 1/2020
Electronic ISSN: 1472-6831
DOI
https://doi.org/10.1186/s12903-020-01136-0

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