Does audiovisual information affect anxiety and perceived pain levels in miniscrew application? — a within-person randomized controlled trial

Creative Commons License

Calik Koseler B., YILANCI H., Ramoglu S. I.

Progress in Orthodontics, vol.20, no.1, 2019 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 20 Issue: 1
  • Publication Date: 2019
  • Doi Number: 10.1186/s40510-019-0281-1
  • Journal Name: Progress in Orthodontics
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Keywords: Anxiety, Miniscrew, Pain
  • Istanbul Medipol University Affiliated: Yes


Background: Anxiety can cause difficulties during surgical procedures. The main objective of this study was to evaluate changes in patients’ anxiety and perceived pain levels after receiving audiovisual and verbal information about miniscrew application. Materials and methods: Eighty-eight patients (30 males and 58 females) with a mean age of 18.18 ± 5.39 years who had fixed orthodontic treatment and required miniscrew anchorage took part in this questionnaire-based randomized controlled trial. The participants were randomly allocated to two groups and either watched a video depicting miniscrew application (study group, 44 patients) or were informed verbally about the procedure (control group, 44 patients) before miniscrew placement. The audiovisual information was given via a video containing footage of local anesthesia injection, topical antiseptic application, and miniscrew insertion. The Spielberger State-Trait Anxiety Inventory (STAI) was used to measure anxiety immediately before miniscrew application. Self-drilling miniscrews (8 mm length, 1.5 mm diameter; Aarhus System Miniscrews, American Orthodontics, Washington, USA) were placed in posterior buccal interdental region. Each patient received only one miniscrew. Postoperative pain (PP) was determined using a 100-mm horizontal visual analog scale (VAS). Results: State and total anxiety scores were significantly higher in the study group than in the control group (p = 0.009 and p = 0.011 respectively). The mean PP scores (SD) for control and study groups were 12.86 (14.22) and 12.8 (16.22), respectively. The results of Mann–Whitney U test showed no significant difference (p > 0.05). Participants’ PP scores did not have a significant effect on state, trait, or total anxiety scores. There was a weak but significant positive correlation between trait anxiety and state anxiety scores in both groups. Conclusion: Using an audiovisual method to inform patients about miniscrew placement increased anxiety levels but did not affect pain perception.