Evaluation of the Effect of Relaxation Exercise and Virtual Reality Application After Impacted Third Molar Dental Surgery

February 19, 2026 updated by: Emre Serdar Atalay, Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey

Evaluation of the Effect of Relaxation Exercise and Virtual Reality Application on Pain, Trismus, Sleep, Kinesiophobia and Anxiety Level After Impacted Third Molar Dental Surgery

Impacted tooth extractions are the most frequently performed procedure in oral surgery. Complications such as pain and trismus are frequently observed after surgery. Pain, especially after surgery, causes serious discomfort to the individual. These complications negatively affect the daily lives of individuals. Decreased sleep quality, increased anxiety, fear of moving the jaw joint, decreased quality of life, and loss of labor are among the examples that can be given. It is important for individuals to have a more comfortable process in the early period after surgery. During this period, individuals receive pharmacological treatment; however, non-pharmacological approaches should not be ignored. Evaluation of the effects of relaxation exercise and virtual reality application applied after impacted third molar surgery on pain, trismus, sleep, kinesiophobia, and anxiety levels.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Impacted third molar surgery is one of the most common procedures performed by oral, dental and maxillofacial surgeons. During surgical removal of teeth, trauma may occur due to the narrowing of the area and insufficient visibility, the position of the teeth and the hardness of the bone structure. In addition, this surgical procedure leads to various complications since it requires intraoral intervention. It has also been stated that most complications are triggered by the inflammatory process after surgery and are reported with varying frequencies. As a result of trauma that may occur in soft and bone tissue, symptoms such as pain, swelling and trismus may occur. Post-surgical pain is an acute type of pain that begins with surgical trauma, gradually decreases and ends with tissue healing. This pain triggers a stress response in the sympathetic nervous system, causing an increase in muscle tension. Another situation encountered after surgery is an increase in anxiety. Anxiety is a distinct state of restlessness caused by fear, distress or apprehension. Individuals are afraid of surgery even if they think surgery is necessary to regain their health or improve their quality of life. The incidence of complications is higher in individuals with high levels of anxiety after surgery.

In the evaluation; Modified Dental Anxiety Scale, Visual Analog Scale, Maximum Active Mouth Opening Measurement, The Tampa Scale for Kinesiophobia for Temporomandibular Disorders, Electromyography (EMG), Turkish version of the Visual Analog Sleep Scale, State and Trait Anxiety Scale will be used.

Individuals participating in the study will be included in one of 3 groups. Group 1 will be Relaxation Exercise, Group 2 will be Virtual Reality Application in addition to Relaxation Exercise, and Group 3 will be the control group.

Study Type

Interventional

Enrollment (Actual)

36

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Turkey (Türkiye)
    • Kecioren
      • Ankara, Kecioren, Turkey (Türkiye), 06610
        • University of Health Sciences

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • Being between the ages of 18-35
  • According to the Pell and Gregory classification; Having undergone surgery on a mandibular third molar with Class 2-3, Position B and C impaction degree
  • Being systemically healthy (ASA 1)
  • Not having high dental anxiety according to the Modified Dental Anxiety Scale (<19)
  • Individuals who have undergone bone removal during surgery
  • Individuals who do not have any psychiatric problems
  • Presence of pain <3 months

Exclusion Criteria:

  • Presence of myofascial pain affecting the temporomandibular joint
  • Presence of tumoral structure related to the impacted third molar
  • Presence of acute pericoronitis
  • Presence of bruxism
  • Presence of vertigo, seizures, epilepsy, active nausea and vomiting
  • Having a beard but not preferring to shave (shaved skin is required for accurate EMG measurement)
  • Pregnancy
  • Smoking and alcohol addiction
  • Individuals with sleep disorders

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Relaxation Exercise
Consist of participants who underwent Relaxation Exercise and Patient Education
Other: Relaxation Exercise
Jacobson muscle relaxation technique
Other: Patient Education
Participants will be informed about oral care, food consumption, nutrition and sleeping position.
Experimental: Virtual Reality Application in Addition to the Relaxation Exercise
Consist of participants who underwent Relaxation Exercise and Virtual Reality Application and Patient Education
Other: Relaxation Exercise
Jacobson muscle relaxation technique
Other: Patient Education
Participants will be informed about oral care, food consumption, nutrition and sleeping position.
Other: Virtual Reality Application
Virtual Reality Application will be done using virtual reality glasses
Other: Control Group
Consist of participants who underwent Patient Education
Other: Patient Education
Participants will be informed about oral care, food consumption, nutrition and sleeping position.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Dental Anxiety
Time Frame: Before impacted third molar extraction
Modified Dental Anxiety Scale: The lowest total score to be received on the entire survey is 5, the highest score is 25. A high score denoted a high anxiety response.
Before impacted third molar extraction
Pain Level
Time Frame: Before the impacted third molar extraction - within 30 minutes after impacted third molar extraction - post-operative 2nd and 7th day
Visual Analog Scale: At the left end of the scale (0 cm) is "no pain"; at the right end (10 cm) is "worst pain". (0: no pain, 10: unbearable pain). The higher the score, the higher the pain level.
Before the impacted third molar extraction - within 30 minutes after impacted third molar extraction - post-operative 2nd and 7th day
Maximum Active Mouth Opening
Time Frame: Before the impacted third molar extraction - within 30 minutes after impacted third molar extraction - post-operative 2nd and 7th day
Therabite Range of Motion Scale: According to the measurement results made with the ruler, the value obtained will increase as the mouth opening distance increases.
Before the impacted third molar extraction - within 30 minutes after impacted third molar extraction - post-operative 2nd and 7th day
Kinesiophobia Level
Time Frame: Before the impacted third molar extraction - within 30 minutes after impacted third molar extraction - post-operative 2nd and 7th day
The Tampa Scale for Kinesiophobia for Temporomandibular Disorders: 12-48 points are received on this scale. The higher the score the person receives, the higher the level of kinesiophobia
Before the impacted third molar extraction - within 30 minutes after impacted third molar extraction - post-operative 2nd and 7th day
Muscle Activity
Time Frame: Before the impacted third molar extraction - within 30 minutes after impacted third molar extraction - post-operative 2nd and 7th day
Electromyography
Before the impacted third molar extraction - within 30 minutes after impacted third molar extraction - post-operative 2nd and 7th day
Sleep Quality
Time Frame: Before the impacted third molar extraction - within 30 minutes after impacted third molar extraction - post-operative 2nd and 7th day
Turkish version of the Visual Analog Sleep Scale: The scale is scored between 0 and 1000. The higher the score received from the scale indicates that the quality of sleep has decreased.
Before the impacted third molar extraction - within 30 minutes after impacted third molar extraction - post-operative 2nd and 7th day
Anxiety Level
Time Frame: Before the impacted third molar extraction - within 30 minutes after impacted third molar extraction - post-operative 2nd and 7th day
State-Trait Anxiety Inventory: The highest score is 80, the lowest score is 20. The higher the total anxiety score, the higher the anxiety level of the person filling out the scale.
Before the impacted third molar extraction - within 30 minutes after impacted third molar extraction - post-operative 2nd and 7th day

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey

Collaborators

Saglik Bilimleri Universitesi

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

November 1, 2024

Primary Completion (Actual)

December 1, 2025

Study Completion (Actual)

January 1, 2026

Study Registration Dates

First Submitted

March 28, 2025

First Submitted That Met QC Criteria

April 5, 2025

First Posted (Actual)

April 9, 2025

Study Record Updates

Last Update Posted (Actual)

February 20, 2026

Last Update Submitted That Met QC Criteria

February 19, 2026

Last Verified

February 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 2024/001
  • Academician (Other Identifier: University of Health Sciences Turkiye)

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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