歯科口腔外科施術時における情動反応の電気生理学的研究

Abstract

Discussions were made on whether muscular activities of the limbs would be an index to the objective evaluation of anxiety and fear at the time of dental and oral surgery. Furthermore, electrophysiological and psychosomatic investigations were made as to differences in anxiety and fear between normal adults and patients with odontophobia. As stress stimuli, stimulus by presentation of a video showing tooth extraction, electrical stimulation of teeth and stimulus by local anesthesia were used.1. EMGs were measured in the masseter muscle, orbicularis oculi muscle, trapezius muscle extensor digitorum muscle and peroneus longus muscle at times of stimulations as mentioned above. The integral value of the EMG of these muscles showed an increase during the stress stimulus period as compared to the vest period.2. The rate of increase in the EMG integral value was higher in patients with odontophobia (early treatment group) than in normal adults, the former showing strong muscle tension under stress.3. Among patients with odontophobia, those for whom the behavior therapy centered treatment had progressed showed changes in EMG integral value at times of stimulation only in the same degree as normal adults, suggesting the effectiveness of behavior therapy.4. DAS, as a criterion for evaluating anxiety at the actual scene of dental treatment scored 9.05±3.06 in normal adults, whereas it scored high, 15.57±3.10, in patients with odontophobia (those at the early stage of being treated). DAS was lower, 8.33±3.78, in those patients at the advanced stage of being treated.5. With regard to MAS, the proportion of those with great anxiety was estimated as 0% in normal adults, whereas it was estimated as 50% or more in patients with odontophobia. Thus, individuals predisposed to chronic anxiety were presumed to be more prone to odontophobia.These results suggested that that muscular activity could be an index to the objective valuation of the degree of anxiety and fear at the time of dental and oral surgery.