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Effects of Virtual Reality Content on Anxiety During Third Molar Surgery

13 de setembro de 2026 atualizado por: İsmail Burak HALAT, Recep Tayyip Erdogan University

A Comparative Evaluation of the Effects of Different Virtual Reality (VR) Content on Patient Anxiety During Impacted Mandibular Third Molar Surgery

This randomized controlled study evaluated whether the content of an immersive virtual reality environment influenced anxiety in adults undergoing surgical removal of an impacted mandibular third molar. A total of 75 patients aged 18-40 years with elevated dental anxiety were randomly assigned in a 1:1:1 ratio to a nature-based virtual reality group, an art-gallery virtual reality group, or a control group receiving conventional care without virtual reality.

Participants in the two virtual reality groups wore the same headset and headphones and viewed standardized 360-degree content from the beginning of surgery until completion of the procedure. Anxiety was assessed using the Modified Dental Anxiety Scale, the State-Trait Anxiety Inventory-State subscale, and an 11-point numerical anxiety rating scale. Systolic and diastolic blood pressure, heart rate, and peripheral oxygen saturation were also recorded. Measurements were obtained before local anesthesia, after local anesthesia but before surgery and virtual reality exposure, and immediately after wound closure, as applicable. The study compared changes in anxiety and physiological measures among the three groups and examined whether nature-based and art-gallery virtual reality content produced different responses.

Visão geral do estudo

Tipo de estudo

Intervencional

Inscrição (Real)

75

Estágio

  • Não aplicável

Contactos e Locais

Esta seção fornece os detalhes de contato para aqueles que conduzem o estudo e informações sobre onde este estudo está sendo realizado.

Locais de estudo

    • Rize Province
      • Rize, Rize Province, Turquia (Türkiye), 53020
        • Recep Tayyip Erdogan University Faculty of Dentistry

Critérios de participação

Os pesquisadores procuram pessoas que se encaixem em uma determinada descrição, chamada de critérios de elegibilidade. Alguns exemplos desses critérios são a condição geral de saúde de uma pessoa ou tratamentos anteriores.

Critérios de elegibilidade

Idades elegíveis para estudo

  • Adulto

Aceita Voluntários Saudáveis

Não

Descrição

Inclusion Criteria:

  • Age between 18 and 40 years
  • American Society of Anesthesiologists (ASA) physical status I
  • Presence of an impacted mandibular third molar for which surgical removal was indicated
  • Pell and Gregory Class II, position B impaction
  • Vertical or mesioangular impaction according to Winter's classification
  • Preoperative Modified Dental Anxiety Scale (MDAS) score of 11 or higher
  • Ability to understand the study procedures and complete the questionnaires
  • Provision of written informed consent

Exclusion Criteria:

  • A systemic or psychiatric condition considered likely to influence anxiety responses
  • Regular use of medication that could alter anxiety or autonomic responses
  • Use of antipsychotic or anxiolytic medication
  • Smoking 10 or more cigarettes per day
  • Previous surgical removal of an impacted tooth
  • Acute infection in the operative region
  • Pregnancy
  • Severe visual or hearing impairment that could prevent adequate virtual reality exposure
  • Inability to tolerate or correctly use the virtual reality headset
  • Surgical duration exceeding 30 minutes
  • Withdrawal of consent at any stage of the study

Plano de estudo

Esta seção fornece detalhes do plano de estudo, incluindo como o estudo é projetado e o que o estudo está medindo.

Como o estudo é projetado?

Detalhes do projeto

  • Finalidade Principal: Cuidados de suporte
  • Alocação: Randomizado
  • Modelo Intervencional: Atribuição Paralela
  • Mascaramento: Nenhum (rótulo aberto)

Armas e Intervenções

Grupo de Participantes / Braço
Intervenção / Tratamento
Experimental: Nature-Based Virtual Reality
Participants viewed standardized investigator-developed nature-based 360-degree immersive content using a virtual reality headset and headphones from the beginning of surgery until completion of the procedure. Exposure duration was determined by surgical duration and did not exceed 30 minutes.
Participants viewed standardized investigator-developed nature-based 360-degree immersive content using a virtual reality headset and headphones. The intervention began at the start of surgery and continued until completion of the procedure. Exposure duration was determined by surgical duration and did not exceed 30 minutes.
Experimental: Art-Gallery Virtual Reality
Participants viewed standardized investigator-developed art-gallery 360-degree immersive content using the same virtual reality headset, headphones, audiovisual settings, and exposure period as the nature-based virtual reality group. Exposure continued from the beginning of surgery until completion of the procedure and did not exceed 30 minutes.
Participants viewed standardized investigator-developed art-gallery 360-degree immersive content using the same virtual reality headset, headphones, audiovisual settings, and exposure period as the nature-based virtual reality group. The intervention began at the start of surgery and continued until completion of the procedure. Exposure duration was determined by surgical duration and did not exceed 30 minutes.
Sem intervenção: Conventional Care Without Virtual Reality
Participants underwent the same standardized surgical procedure and received conventional clinical care without a virtual reality headset or an alternative audiovisual intervention.

O que o estudo está medindo?

Medidas de resultados primários

Medida de resultado
Descrição da medida
Prazo
Change in Modified Dental Anxiety Scale Score
Prazo: From before local anesthesia (T0) to immediately after wound closure and completion of the procedure (T2), during a single surgical visit
Dental anxiety was assessed using the five-item Modified Dental Anxiety Scale (MDAS). Each item is scored from 1 to 5, producing a total score ranging from 5 to 25, with higher scores indicating greater dental anxiety. The outcome was the change in total MDAS score from T0 to T2, calculated as the T2 score minus the T0 score.
From before local anesthesia (T0) to immediately after wound closure and completion of the procedure (T2), during a single surgical visit
Change in State-Trait Anxiety Inventory-State Subscale Score
Prazo: From before local anesthesia (T0) to immediately after wound closure and completion of the procedure (T2), during a single surgical visit
State anxiety was assessed using the 20-item State-Trait Anxiety Inventory-State subscale (STAI-S). Each item is scored from 1 to 4, producing a total score ranging from 20 to 80, with higher scores indicating greater state anxiety. The outcome was the change in total STAI-S score from T0 to T2, calculated as the T2 score minus the T0 score.
From before local anesthesia (T0) to immediately after wound closure and completion of the procedure (T2), during a single surgical visit

Medidas de resultados secundários

Medida de resultado
Descrição da medida
Prazo
Change in Anxiety Visual Analog Scale Score
Prazo: At three time points during a single surgical visit: before local anesthesia (T0), after local anesthesia but before surgery and virtual reality exposure (T1), and immediately after wound closure and completion of the procedure (T2)
Momentary anxiety was assessed using the study-designated Anxiety Visual Analog Scale (VAS-A), administered as an 11-point whole-number response scale ranging from 0 to 10. A score of 0 indicated no anxiety, whereas a score of 10 indicated the highest perceived anxiety. Changes in VAS-A scores across T0, T1, and T2 were compared among the study groups.
At three time points during a single surgical visit: before local anesthesia (T0), after local anesthesia but before surgery and virtual reality exposure (T1), and immediately after wound closure and completion of the procedure (T2)
Change in Systolic Blood Pressure
Prazo: At three time points during a single surgical visit: before local anesthesia (T0), after local anesthesia but before surgery and virtual reality exposure (T1), and immediately after wound closure and completion of the procedure (T2)
Systolic blood pressure was measured in millimeters of mercury (mmHg) using the same automated monitoring device during a standardized five-minute assessment period at each time point. Changes in systolic blood pressure across T0, T1, and T2 were compared among the study groups.
At three time points during a single surgical visit: before local anesthesia (T0), after local anesthesia but before surgery and virtual reality exposure (T1), and immediately after wound closure and completion of the procedure (T2)
Change in Diastolic Blood Pressure
Prazo: At three time points during a single surgical visit: before local anesthesia (T0), after local anesthesia but before surgery and virtual reality exposure (T1), and immediately after wound closure and completion of the procedure (T2)
Diastolic blood pressure was measured in millimeters of mercury (mmHg) using the same automated monitoring device during a standardized five-minute assessment period at each time point. Changes in diastolic blood pressure across T0, T1, and T2 were compared among the study groups.
At three time points during a single surgical visit: before local anesthesia (T0), after local anesthesia but before surgery and virtual reality exposure (T1), and immediately after wound closure and completion of the procedure (T2)
Change in Heart Rate
Prazo: At three time points during a single surgical visit: before local anesthesia (T0), after local anesthesia but before surgery and virtual reality exposure (T1), and immediately after wound closure and completion of the procedure (T2)
Heart rate was measured in beats per minute (bpm) using the same automated monitoring device during a standardized five-minute assessment period at each time point. Changes in heart rate across T0, T1, and T2 were compared among the study groups.
At three time points during a single surgical visit: before local anesthesia (T0), after local anesthesia but before surgery and virtual reality exposure (T1), and immediately after wound closure and completion of the procedure (T2)
Change in Peripheral Oxygen Saturation
Prazo: At three time points during a single surgical visit: before local anesthesia (T0), after local anesthesia but before surgery and virtual reality exposure (T1), and immediately after wound closure and completion of the procedure (T2)
Peripheral oxygen saturation was measured as a percentage (SpO2) using the same monitoring device during a standardized five-minute assessment period at each time point. Changes in peripheral oxygen saturation across T0, T1, and T2 were compared among the study groups.
At three time points during a single surgical visit: before local anesthesia (T0), after local anesthesia but before surgery and virtual reality exposure (T1), and immediately after wound closure and completion of the procedure (T2)

Colaboradores e Investigadores

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Datas de registro do estudo

Essas datas acompanham o progresso do registro do estudo e os envios de resumo dos resultados para ClinicalTrials.gov. Os registros do estudo e os resultados relatados são revisados ​​pela National Library of Medicine (NLM) para garantir que atendam aos padrões específicos de controle de qualidade antes de serem publicados no site público.

Datas Principais do Estudo

Início do estudo (Real)

1 de outubro de 2025

Conclusão Primária (Real)

30 de junho de 2026

Conclusão do estudo (Real)

30 de junho de 2026

Datas de inscrição no estudo

Enviado pela primeira vez

8 de setembro de 2026

Enviado pela primeira vez que atendeu aos critérios de CQ

8 de setembro de 2026

Primeira postagem (Real)

14 de setembro de 2026

Atualizações de registro de estudo

Última Atualização Postada (Real)

16 de setembro de 2026

Última atualização enviada que atendeu aos critérios de controle de qualidade

13 de setembro de 2026

Última verificação

1 de setembro de 2026

Mais Informações

Termos relacionados a este estudo

Plano para dados de participantes individuais (IPD)

Planeja compartilhar dados de participantes individuais (IPD)?

SIM

Descrição do plano IPD

De-identified individual participant data underlying the results reported in the published article will be made available by the corresponding author upon reasonable request.

Prazo de Compartilhamento de IPD

Data will be available beginning after publication of the main study results and will remain available for five years following publication.

Critérios de acesso de compartilhamento IPD

Requests should be submitted to the corresponding author at ismailburak.halat@erdogan.edu.tr and should include a scientifically sound research proposal. Requests will be evaluated for compatibility with participant consent, ethics approval, and applicable data-protection requirements. Data will be shared with qualified researchers for approved scientific purposes, and a data-use agreement may be required.

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