Audiovisual vs Verbal Information in Third Molar Surgery (AVID)

Effect of Audiovisual Versus Verbal Preoperative Information on Dental Anxiety and Hemodynamic Parameters in Patients Undergoing Impacted Mandibular Third Molar Surgery: A Randomized Controlled Trial

This study evaluates whether audiovisual (video-based) or verbal preoperative information is more effective in reducing dental anxiety and stabilizing physiological responses in patients undergoing impacted mandibular third molar surgery.

A total of 73 patients scheduled for third molar extraction were randomly assigned to receive either video-based information or standard verbal information before surgery. Anxiety levels were assessed using validated scales, and physiological parameters such as heart rate, blood pressure, and oxygen saturation were recorded at different stages of the surgical procedure.

The aim of this study is to determine whether the method of preoperative information has an effect on patients' anxiety levels and physiological stress responses during oral surgery.

Study Overview

• Status: Completed
• Conditions: Dental Anxiety; Impacted Mandibular Third Molar
• Intervention / Treatment: Behavioral: Audiovisual Information; Behavioral: Verbal Information

Detailed Description

This prospective randomized controlled clinical trial was conducted to evaluate the effects of audiovisual and verbal preoperative information on dental anxiety and hemodynamic parameters in patients undergoing impacted mandibular third molar surgery.

A total of 73 patients scheduled for impacted mandibular third molar extraction were included in the study and randomly assigned to one of two groups: an audiovisual information group (video-based information) and a verbal information group. The audiovisual group received a standardized video presentation explaining the surgical procedure, while the control group received standardized verbal information from the clinician.

Dental anxiety levels were assessed using validated psychometric scales, including the Modified Dental Anxiety Scale (MDAS) and the State-Trait Anxiety Inventory (STAI-S and STAI-T). In addition, physiological parameters such as heart rate, systolic and diastolic blood pressure, and oxygen saturation were recorded at standardized stages of the surgical procedure, including preoperative baseline, anesthesia administration, incision, tooth extraction, suturing, and postoperative period.

The primary objective of the study was to compare the effects of audiovisual and verbal information on dental anxiety levels. Secondary outcomes included the evaluation of hemodynamic parameters during different surgical stages. The study also explored the influence of demographic factors such as age and sex on anxiety and physiological responses.

This study was approved by the Ethics Committee of Gazi University (Decision No: E-77082166-302.08.01-848588), and all participants provided written informed consent prior to inclusion.

• Study Type: Interventional
• Enrollment (Actual): 73
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Ankara
    • Ankara, Ankara, Turkey (Türkiye), 06500
      • Gazi University Faculty of Dentistry

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Patients scheduled for impacted mandibular third molar extraction
• Age between 18 and 50 years
• Literate individuals
• Mentally healthy individuals
• Individuals without systemic disease
• Willingness to participate voluntarily and provide written informed consent

Exclusion Criteria:

• Age under 18 years
• Illiterate individuals
• Individuals with psychiatric disorders
• Individuals who declined to participate

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Audiovisual Information Group; Participants received a standardized video-based audiovisual explanation of the surgical procedure before the operation.	Behavioral: Audiovisual Information; Participants watched a standardized video explaining the impacted mandibular third molar surgery procedure, including the main surgical steps, before the operation.
Active Comparator: Verbal Information Group; Standardized verbal information about the surgical procedure was provided to participants by the clinician before surgery.	Behavioral: Verbal Information; Participants received standardized verbal information about the surgical procedure from the clinician before the operation.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
State Anxiety Level (STAI-S)	State anxiety was assessed using the State-Trait Anxiety Inventory-State (STAI-S), a validated 20-item questionnaire with scores ranging from 20 to 80, where higher scores indicate greater anxiety (worse outcome). Measurements were performed at baseline (preoperative) and after the intervention (preoperative, following audiovisual or verbal information.	Baseline (preoperative) and immediately after surgery
Dental Anxiety Level (MDAS)	Dental anxiety was assessed using the Modified Dental Anxiety Scale (MDAS), a validated 5-item questionnaire with scores ranging from 5 to 25, where higher scores indicate greater dental anxiety (worse outcome). Measurements were performed at baseline (preoperative) and immediately postoperatively.	Baseline (preoperative) and immediately postoperatively

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Heart Rate	Heart rate (beats per minute) was measured using a non-invasive patient monitoring device at standardized perioperative time points. Measurements were obtained at baseline (preoperative), during local anesthesia administration, surgical incision, tooth extraction, suturing, and immediately after completion of the procedure. Higher heart rate values indicate increased physiological stress response associated with the surgical intervention.	During the perioperative period (from baseline to immediately postoperatively)
Blood Pressure	Blood pressure (mmHg), including systolic and diastolic values, was measured using a non-invasive patient monitoring device at standardized perioperative time points, including baseline (preoperative), during local anesthesia administration, surgical incision, tooth extraction, suturing, and immediately after completion of the procedure. Higher values indicate increased cardiovascular response to surgical stress.	During the perioperative period (from baseline to immediately postoperatively)
Oxygen Saturation	Oxygen saturation (%) was measured using a non-invasive patient monitoring device at standardized perioperative time points, including baseline (preoperative), during local anesthesia administration, surgical incision, tooth extraction, suturing, and immediately after completion of the procedure. Values represent the percentage of oxygen-saturated hemoglobin in the blood. Lower values may indicate impaired oxygenation and altered physiological response, whereas higher values reflect adequate oxygenation status. Changes in oxygen saturation may also reflect physiological responses associated with perioperative stress.	During the perioperative period (from baseline to immediately postoperatively)

Collaborators and Investigators

• Sponsor: Gazi University
• Investigators: Principal Investigator: Hasan Ali A ÖZTAŞ, DDS, PhD, Gazi University

Study record dates

Study Major Dates

• Study Start (Actual): March 1, 2024
• Primary Completion (Actual): August 1, 2024
• Study Completion (Actual): October 15, 2024

Study Registration Dates

• First Submitted: April 1, 2026
• First Submitted That Met QC Criteria: April 9, 2026
• First Posted (Actual): April 14, 2026

Study Record Updates

• Last Update Posted (Actual): April 14, 2026
• Last Update Submitted That Met QC Criteria: April 9, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Keywords: Randomized Controlled Trial; Dental Anxiety; Third Molar Surgery; Hemodynamic Parameters; Audiovisual Information; Verbal Information
• Other Study ID Numbers: E-77082166-302.08.01-848588

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: De-identified individual participant data underlying the reported results, including demographic data, anxiety scale scores (MDAS, STAI-S, STAI-T), and hemodynamic parameters (heart rate, blood pressure, and oxygen saturation), will be shared upon reasonable request.
• IPD Sharing Time Frame: Data will be available beginning 6 months after publication and will be available for 5 years.
• IPD Sharing Access Criteria: Access to de-identified individual participant data will be granted to researchers who provide a reasonable scientific request. Requests should be directed to the corresponding author. Data will be shared after approval by the research team and in accordance with ethical and data protection regulations.
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No