Comparison of the Effects of Artificial Intelligence and Human-Generated Images on Dental Anxiety

Comparison of the Effects of Artificial Intelligence and Human-Generated Images on Dental Anxiety | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Comparison of the Effects of Artificial Intelligence and Human-Generated Images on Dental Anxiety İsmail Burak Halat, Emre Balaban, Fatma Ceren, Ruhi Çay, Taha Emre Köse, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7320945/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 12 You are reading this latest preprint version Abstract Background This study investigated the effect of visual artworks on dental anxiety and compared the effects of human-made versus artificial intelligence (AI)-generated artworks during the extraction of impacted mandibular third molars. Material and methods The study included 75 patients, who had a clinical indication for the extraction of impacted mandibular third molars. Patients were randomly divided into five groups: Group 1 and Group 3 experienced human-made artworks, while Group 2 and Group 4 experienced similar artworks created using AI. Group 5 was the control group and received no visual stimuli. Anxiety levels were assessed using the Modified Dental Anxiety Scale, State-Trait Anxiety Scale, and a visual analog scale. Vital signs were measured before, during, and after surgery. Results A significant decrease in postoperative anxiety was observed in all groups (p < 0.05). There was no significant difference in anxiety levels between the AI and human-made artifacts. A significant difference in systolic and diastolic blood pressure was found between preoperative, intraoperative, and postoperative measurements in Group 1 and Group 5. Conclusion This study reaffirms that visual stimuli, regardless of their source, can be a beneficial component for managing dental anxiety. Although no significant difference was found between the effects of human-made and AI-generated artworks on anxiety, a significant decrease in postoperative anxiety was observed across all groups. These findings may shed light on the development of alternative anxiety management strategies. Further research should explore the combined effect of visual and auditory stimuli to enhance their efficacy in mitigating dental anxiety. dental anxiety visual art artificial intelligence wisdom tooth surgery anxiety management Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Background The sympathetic nervous system controls anxiety, which is an adaptive emotional reaction to potentially hazardous or threatening circumstances. ( 1 ) The autonomic nervous system is triggered by anxiety, which raises involuntary body processes like heart rate, blood pressure, respiratory rate, gastrointestinal motility, and cardiac output. ( 1 – 3 ) The sympathetic nervous system is triggered and the fight-or-flight response is initiated when the hypothalamic-pituitary-adrenal (HPA) axis releases adrenaline. ( 1 , 4 ) Numerous physiological alterations are brought on by this reaction, including a decrease in pain threshold, an increase in treatment complications, a slowed rate of recovery, and an increase in pain following treatment. ( 1 – 3 ) Fear and tension prior to, during, or following dental procedures are associated with dental anxiety. ( 5 ) Dental anxiety affects about a quarter of the population. ( 3 ) Many dentists find it difficult to manage anxious patients because they can elicit physical, cognitive, emotional, and behavioral reactions. ( 1 – 3 ) The patient's avoidance of dental care, which has a detrimental impact on both oral and general health, is another significant issue brought on by dental anxiety. ( 2 ) However, excessive anxiety during treatment can result in a loss of patient cooperation and make it difficult for the doctor to carry out treatment procedures. Considering all these situations, for the management of dental anxiety, it is necessary to ascertain the underlying cause of this condition and realize a management strategy be based on the cause. Also, determining the level of anxiety is of great importance for the management of anxiety. ( 6 – 8 ) In this context, proper communication between physicians and patients to create a sense of trust and control, providing patients with sufficient information about the treatment procedures to be performed, taking rest breaks at certain intervals, and allowing patients to communicate with the physician at any time during treatment have been shown as techniques that significantly reduce anxiety levels. ( 9 – 11 ) In addition to these techniques, there is evidence that the anxiety levels of patients with dental anxiety can be controlled with the use of certain alternative visual (2D or 3D) or auditory stimuli. ( 12 – 14 ) Artwork is believed to help patients with anxiety cope with symptoms and improve their quality of life. ( 15 ) Based on long-term experience with anxiety treatment in practice, artwork can improve emotion regulation and self-constructive skills and increase self-awareness. ( 16 , 17 ) The use of artwork includes fine art such as painting, drawing, sculpture, and clay modeling as mediums. The focus is on the process of creating and experiencing, facilitating the expression of memories, feelings, and emotions. It aims to develop and apply self-control and new coping skills. ( 18 ) There are many studies in the literature examining the effect of artwork on the level of anxiety in patients, ( 19 , 20 ) but few studies have examined the effect of visual artwork on the management of dental anxiety. Parallel to advances in technology, artificial intelligence (AI) has gained the ability to think, learn, understand, and solve problems in a human-like manner, transforming it from a human imitation into a creative machine system. As a result of these developments, AI (e.g. Microsoft Copilot) has been used in a wide range of fields, including the creation of artistic elements, and has led to the idea that it can rival man-made art. Based on these ideas, our study aimed to comparatively examine the effects of visual images on dental anxiety. We hypothesized that both visual stimuli would be effective in reducing dental anxiety, but their comparative superiority would be the subject of our investigation. This study addresses a gap in the literature by not only investigating the effect of visual art on dental anxiety but also comparatively analyzing the effects of human-made and artificial intelligence-generated artworks. We believe that our findings will contribute to the literature by informing the development of new anxiety management techniques and inspiring future research in this area. Material and Methods This study was conducted with the approval of Recep Tayyip Erdoğan University Clinical Research Ethics Committee (Decision number: 2025/179). All procedures were conducted in accordance with the principles of the Declaration of Helsinki. Informed consent for participation was obtained from all participants. The participants were selected from 75 systemically healthy patients who presented to Recep Tayyip Erdoğan University Faculty of Dentistry, Department of Oral, Dental, and Maxillofacial Surgery between April 25th 2025, and July 30th, 2025, with impacted 3rd molar teeth. The workflow of the study is presented in Fig. 1 . Inclusion Criteria Patients aged 18–40 years with no systemic disease (ASA-I), patients with impacted mandibular 3rd molars with bone retention in a similar position (class 2, position B according to Pell & Gregory classification; vertical and mesioangular according to Winter classification) with an indication for extraction, and patients who scored intermediate or high level (> 11) on the preoperative MDAS (Modified Dental Anxiety Scale) questionnaire. Exclusion Criteria Patients with systemic diseases that might affect anxiety and physiologic tests, patients with systemic drug use (tricyclic antidepressants, anticholinergics, benzodiazepines, antihypertensives, synthetic glucocorticoids, anticonvulsants) that might affect anxiety, patients who smoked 10 or more cigarettes per day, patients who had undergone previous impacted dental surgery, the presence of acute infection in or around the surgical site, pregnancy, patients with severe vision and hearing problems, and patients receiving antipsychotic and/or anxiolytic treatment. Patient Classification Spielberger's State-Trait Anxiety Inventory Scale (STAI-S) and VAS-A visual analog scale were administered to patients who were admitted to the dental unit to measure the immediate anxiety level. Vital measurements including systolic-diastolic blood pressure, heart rate, and oxygen saturation were performed continuously for 5 minutes, the minimum-maximum values were recorded, and the mean value was recorded as T0 time. The procedures performed until this stage were common for all patient groups. Before the surgical phase, patients were randomized to one of five groups (groups 1 to 5). Group 1 was asked to look at Piet Mondrian's work dated 1930, which was presented on the screen during the procedure (Fig. 2 ); Group 2 was asked to look at the picture created by entering the keywords 'Abstract art, Expressionism, Modern art, Piet Mondrian' into the Microsoft Copilot AI application, which was presented on the screen during the procedure (Fig. 3 ); Group 3 was asked to look at Claude Monet's 1919 work, 'Water Lilies', during the procedure (figure-4); Group 4 was asked to look at the picture created by entering the keywords 'Claude Monet, Nature, Expressionism' into the Microsoft Copilot AI application, which was presented on the screen during the procedure (figure-5); Group 5 was designated as the control group and was not exposed to any visual elements. In all groups, vital signs were measured and the VAS-A scale was applied after anesthesia. The values at this stage were recorded as time T1. After the surgery was completed, the measurement of vital signs was repeated for all patient groups. The patients were asked to describe the degree of anxiety felt during the procedure using the VAS-A scale, MDAS, and STAI-S questionnaires and recorded as time T2. Surgical Procedure In order to prevent skill variation, all surgical procedures were carried out by a single surgeon under local anesthesia. Using buccal and inferior alveolar nerve blockade with an injection solution containing 80 mg of articaine, 2 mL, and 0,01 mg of adrenaline, 2 mL, local anesthesia was accomplished. A full-thickness mucoperiosteal envelope flap was then lifted after a No. 15 scalpel was used to make a horizontal and buccal releasing incision. A surgical micromotor and a round drill made of steel or tungsten carbide were used to remove the buccal bone and split the tooth, if needed, under saline irrigation. Following the removal of the retaining bone tissues surrounding the impacted tooth, a Bein elevator was used to extract the tooth from the alveolar socket by creating a cleavage point between the tooth and the cortical bone in the buccal and mesial regions. Debris, bone, and epithelial remnants in the alveolar socket were extracted from the affected area following tooth extraction. Following a 0.9% NaCl isotonic saline (SF) wash of the alveolar socket, silk sutures were used to close the wound edges, and hemostasis was accomplished. Every patient was prescribed 120 mg (0.12%) chlorhexidine gluconate + 150 mg (0.15%) benzydamine hydrochloride three times a day for seven days beginning on the first day following surgery until the sutures were taken out, 875 mg amoxicillin + 125 mg clavulanic acid twice a day, twelve hours apart, and 25 mg dexketoprofen trometamol twice a day. Statistical Analysis Statistical analyses were performed using the IBM SPSS Statistics 26 program. Differences between two dependent numerical variables were assessed using Wilcoxon analysis, and differences between more than two dependent numerical variables were checked using Friedman analysis. Differences between more than two independent groups were assessed using Kruskal-Wallis H analysis. In the event of differences in Friedman and Kruskal-Wallis analyses, Bonferroni corrected results were used to determine the measurement/group from which the difference originated. Fisher's exact test results were used to examine the relationship between two independent categorical variables because the expected value assumption was not met in the Chi-square analysis. Statistical significance was interpreted at the p ≤ 0.05 level. Results Study Groups and Statistical Methods This study consists of 5 groups: Group 1 using Piet Modrian’s work titled ‘Composition with Large Red Plane, Yellow, Black, Gray, and Blue’, group 2 using an image created by entering the keywords ‘Abstract art, Expressionism, Modern art, Piet Mondrian’ into the Microsoft Copilot AI application, group 3 using the 1919 work titled ‘Water Lilies’ by Claude Monet, group 4 using the image created by entering the keywords ‘Claude Monet, Nature, Expressionism’ into the Microsoft Copilot AI application, and group 5, a control group, which was not exposed to any visual elements. Seventy-five participants were distributed in a completely randomized manner, with 15 people in each group. Demographic Data When the age and sex distribution in the groups was analyzed, it was observed that the average age of the participants in group 5 was higher. In particular, there was a significant difference between group 2 and group 5 (p = 0.033). No significant difference was found between the other groups. In terms of sex distribution, there was no significant difference between the groups, but it was found that the female sex ratio was higher in group 2 and group 4. We conducted our study independently of age and sex parameters. VAS-A (Visual Analogue Scale for Anxiety) There is a statistically significant difference between preoperative, intraoperative, and postoperative VAS-A value measurements in all groups (p < 0.05) (Table. 1). Accordingly, postoperative VAS-A value measurements were statistically significantly lower than the preoperative and intraoperative VAS-A value measurements in all groups. VAS-A values were ranked as preoperative, intraoperative, and postoperative high to low in all groups, respectively. As a result of Kruskal-Wallis H analysis, there was no statistically significant difference between the groups in terms of preoperative, intraoperative, and postoperative VAS-A values (p > 0.05). MDAS and STAI (Modified Dental Anxiety Scale and State-Trait Anxiety Inventory) There was a statistically significant difference between the preoperative and postoperative MDAS and STAI measurements in all groups (p < 0.05) (Table. 2). Postoperative MDAS and STAI measurements were statistically significantly lower than preoperative MDAS and STAI measurements in all groups. As a result of Kruskal-Wallis H analyses, there was no statistically significant difference between the groups in terms of preoperative and postoperative MDAS and STAI measurements (p > 0.05). Vital Signs Systolic and Diastolic Blood Pressure There was a statistically significant difference between the systole and diastole values measured in the preoperative, intraoperative, and postoperative periods in Group 1 and Group 5 (p < 0.05). (Table. 3) In Group 1, postoperative systole and diastole values were statistically significantly lower than intraoperative systole and diastole values. In Group 5, postoperative systole values were statistically significantly lower than intraoperative systole values, and postoperative diastole values were significantly lower than preoperative diastole values. There was a statistically significant difference between the groups in terms of intraoperative systole measurements (p < 0.05). Intraoperative systole values in Group 5 were statistically significantly higher than Group 4. Pulse Rate and O 2 Saturation In all groups except for the control group, there was a statistically significant difference (p < 0.05) in preoperative, intraoperative and postoperative pulse measurements between the periods in intra-group comparisons. (Table. 4) Group 1 and Group 2 postoperative pulse measurements were statistically significantly lower than intraoperative pulse measurements. Postoperative pulse measurements in Group 3 and Group 4 were statistically significantly lower than both intraoperative and preoperative pulse measurements. There was a statistically significant difference between the preoperative, intraoperative, and postoperative O 2 saturation measurements in Group 1 and Group 5 (p < 0.05). Postoperative O 2 measurements in Group 5 and Group 1 were statistically significantly lower than preoperative O 2 measurements. Discussion Anxiety activates the autonomic nervous system and causes adrenaline secretion, which in turn activates the sympathetic nervous system and triggers the "fight or flight" response. This physiologic response may lead to a lower pain threshold, prolonged treatment time, and delayed healing. (3-5) Dental anxiety is a chronic behavioral response that often results from past negative experiences and complicates the treatment process. Anxiety may manifest itself at the cognitive level and with physical, emotional, and behavioral responses. (21) This may lead to a clinical picture that is difficult to manage for both the patient and the physician, especially before and during surgical procedures. In our study, we included people who had not had their wisdom teeth extracted before and had no experience in this subject because past experiences may affect the anxiety of individuals. In this way, the possibility of previous experiences affecting the results of our study was avoided. Accurate measurement of anxiety is of great importance for the development of effective intervention strategies. The MDAS, STAI-S, and VAS-A used in the study provided the opportunity to evaluate the emotional reactions of individuals in a multidimensionally. (22-25) A statistically significant decrease was found between preoperative and postoperative MDAS and STAI measurements in all groups including the control group (p<0.05). Similarly, in VAS-A measurements, postoperative values were significantly lower than preoperative and intraoperative values in all groups (p<0.05) While these results demonstrate that the surgical process itself contributes to a post-treatment reduction in anxiety across all patients, the use of visual stimuli during surgery had no additional effect on anxiety, regardless of the source. This is evidenced by the finding that no significant difference was found between the groups in terms of these measurements (p>0.05). The role of visual and auditory distractions in anxiety management has not yet been investigated in sufficient depth when evaluated together with other methods that have been frequently examined in the literatüre. (1,3,26,27) Mejia-Rubalcava et al. (4) found that anxiety, cortisol levels, and blood pressure decreased significantly after music therapy in patients with dental anxiety compared with a control group. The researchers concluded that music therapy might be an effective control method for anxiety. Gupta and Ahmed (26) found that anxiety and pain decreased in 92% of patients who listened to music during oral surgery and anxiety decreased by 50%. Virtual reality exposure therapy (VRET) is a cognitive behavioral approach that reduces anxiety through systematic desensitization. Gujjar et al. (3) showed that VRET safely and effectively reduced dental anxiety. Yamashita et al. (27) found that the use of VR in impacted third molar extraction reduced anxiety and that the majority of patients would prefer to use VR in the future. In our study, no direct effect of artistic visual stimuli on anxiety was observed. When compared with the studies mentioned above, it is thought that auditory stimuli may be more effective than visual stimuli because VR applications have audio stimuli in addition to visual stimuli and VR causes the person's perception of the environment to change. Studies conducted with such stimuli may have shown a difference, unlike our study. There are similar findings in studies on photographs. Gomez-Urquiza et al. (28) reported that only visual applications had no significant effect on anxiety before non-vital Ear, Nose, and Throat surgeries, whereas a significant decrease in anxiety, systolic pressure, and pulse rate was achieved in the group in which visual and sound were applied together. Saiu et al. (21) examined the level of dental anxiety using auditory and visual stimuli and found no significant difference between the group in which only visual stimuli were applied and the control group. They found a significant difference between the groups in which only auditory stimuli and combined auditory-visual stimuli were used and the control group. The results of these studies are similar to the findings of our study. Giving only visual stimuli to the patients made no significant difference to anxiety levels compared with no stimuli. Intriguingly, although anxiety scores did not differ significantly between the groups, a statistically significant difference was found in intraoperative systolic blood pressure values between Group 4 and Group 5 (p < 0.05), with Group 5 showing higher values. While baseline systolic values in both groups were higher—albeit not statistically significant—and the p-value for the intraoperative difference was close to the threshold for significance, these findings suggest that the difference may not be directly attributable to the visual stimuli. Nonetheless, when considered alongside the observation that pulse rates decreased postoperatively in all groups except the control group, the results imply that visual stimuli may influence certain physiological parameters during surgery, even if these effects are not reflected in subjective anxiety measures such as MDAS, STAI or VAS-A scores. On the other hand, Ulrich's study (29) revealed that patients who saw a view of nature in their hospital rooms recovered faster and used less analgesics. Üstün et al. (30) showed that cartoon-supported visual and auditory distractions provided a decrease in pulse rates in pediatric patients but caused no statistical difference in anxiety levels. In our study, postoperative pulse measurements in both Group 3 and Group 4 were statistically significantly lower than their respective intraoperative and preoperative values. Although pulse rates decreased in all groups except the control group, this reduction was not reflected in MDAS, STAI or VAS-A scores. These findings suggest that the use of visual stimuli during surgery—regardless of the content—may have a pulse-lowering effect, even if it does not translate into a measurable reduction in subjective anxiety levels. Additionally, in our study, a statistically significant difference was observed between the preoperative, intraoperative, and postoperative oxygen saturation (SpO₂) measurements in both Group 1 and Group 5. Similar to the reductions in pulse rate, these physiological changes occurred without corresponding differences in MDAS, STAI or VAS-A anxiety scores. This suggests that changes in oxygen saturation may reflect a physiological response to visual stimuli, even if such effects are not detected by subjective anxiety assessment tools. This indicates a potential disassociation between the subjective experience of anxiety and the body's autonomic response, and it highlights the need for further investigation into the specific mechanisms through which visual stimuli influence physiological parameters during dental procedures. Art is one of the ways in which individuals express and share their emotions with others. (31, 32) While artworks produced by human hands include conscious intention, esthetic concern, and individual interpretation, those produced using AI are generated from predefined data sets through algorithms. (33, 34) In addition, the effect of colors on mood should also be taken into account. Especially when planning our study, we considered the following: - Piet Mondrian's simple geometric compositions created with basic colors can fix the focus of the individual and provide emotional regulation with its distracting effect from visual complexity, (35) - Claude Monet's "Water Lilies" in impressionist style can have a calming effect on the viewer through soft transitions and natural forms, (36, 37) thoughts were found to be insignificant when we look at our results. However, these theoretical expectations were found to be unsupported by our results, as no significant difference in anxiety levels was detected between the groups exposed to these artworks on subjective anxiety scales like MDAS, STAI, and VAS-A. This finding suggests that the anxiolytic effect of art may stem not from the artist's conscious intent or the specific style, but from the universal psychological effects of colors, shapes, or compositions, regardless of whether they are created by a human or an AI. The fact that AI-generated artworks had a comparable effect to human-made ones opens up new avenues for research into the potential of AI in creating personalized or dynamically adaptive visual stimuli to further enhance anxiety management. Conclusion This study sheds light on the development of alternative strategies for dental anxiety management. As shown in previous studies, the use of visual stimuli alone has no effect on dental anxiety. However, the use of visual stimuli contributed to a reduction in anxiety levels. Visual stimuli may not significantly alter self-reported anxiety levels, but can have a beneficial effect on physiological parameters such as pulse rate. Furthermore, this effect was not influenced by whether the artwork was of human or AI origin. These findings highlight the potential of visual stimuli in anxiety management and provide a direction for future research in this area. Abbreviations AI: Artificial Intelligence MDAS: Modified Dental Anxiety Scale STAI: State-Trait Anxiety Inventory STAI-S: State-Trait Anxiety Inventory – State Form VAS-A: Visual Analog Scale for Anxiety HPA: Hypothalamic–Pituitary–Adrenal Axis ASA-I: American Society of Anesthesiologists – Physical Status Classification I SF: Saline Flush (0.9% NaCl Isotonic Solution) SPSS: Statistical Package for the Social Sciences VRET: Virtual Reality Exposure Therapy SpO₂: Peripheral Capillary Oxygen Saturation Declarations Ethics Approval and Consent to Participate Informed consent for participation was obtained from all participants. This study was approved by the Non-Interventional Clinical Research Ethics Committee of Recep Tayyip Erdoğan University under protocol number 2025/179, dated April 25, 2025. Ethics committee decision files are attached. All procedures were conducted in accordance with the principles of the Declaration of Helsinki. Consent for Publication Written informed consent was obtained from all patients. The informed consent form has been provided in both its original language (Turkish) and in English for your review (BGOF) Availability of Data and Materials The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request. (Upon request, participants' personal information can be provided to you, provided that confidentiality is strictly maintained) Competing Interests The authors declare that they have no competing interests. Funding None Authors' contributions Desing of the work: IBH, EB, TEK, RÇ Interpretation of data: IBH, TEK, FÇ, AD Writing the manuscript: IBH, TEK, EB, Final approval: IBH, EB, TEK, AD Acquisition of the data: IBH, FÇ, RÇ, AD Writing of the manuscript, final approval: IBH, EB, TEK Acknowledgements None Clinical trial number: not applicable. References Thoma MV, Zemp M, Kreienbühl L, Hofer D, Schmidlin PR, Attin T, et al. 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Tables Table-1: VAS-A score comparisons between groups and within groups VAS-A Preoperative (A) Intraoperative (B) Postoperative (C) Avg. ±SD Min-Max Avg. ±SD Min-Max Avg. ±SD Min-Max Statistical Test (Fr) p Diff. (Bf) Group-1 n=15 6,67±1,95 4-10 5,93±1,87 3-9 3,13±1,60 1-6 24,102 <0,001* C<A, B Group-2 n=15 6,13±2,13 3-10 4,73±1,98 1-8 2,20±1,21 0-5 25,552 <0,001* C<A, B Group-3 n=15 6,33±1,54 4-9 5,60±2,06 3-9 2,73±1,49 1-5 24,105 <0,001* C<A, B Group-4 n=15 7,73±1,98 5-10 6,53±1,88 3-9 2,80±1,52 0-5 24,034 <0,001* C<A, B Group-5 n=15 7,13±1,81 3-10 6,40±2,29 3-10 2,80±1,82 0-6 29,947 <0,001* C<A, B KW;p 6,718;0,152 6,944;0,139 2,789;0,594 Fr: Friedman Analysis; KW: Kruskal Wallis H; Bf: Bonferroni; Avg.: Average; SD: Standard Deviation; Min: Minimum; Max: Maximum; Diff.: Difference *:p<0,05 Table-2: MDAS and STAI score comparisons between groups and within groups MDAS Preoperative Postoperative Avg. ±SD Min-Max Avg. ±SD Min-Max Statistical Test (Z) p Group-1 n=15 14,07±2,99 11-21 9,00±3,70 5-17 -3,422 0,001* Group-2 n=15 13,67±1,99 12-18 8,13±2,88 5-14 -3,427 0,001* Group-3 n=15 14,53±2,92 10-20 8,53±3,27 5-18 -3,355 0,001* Group-4 n=15 13,93±2,40 10-19 8,40±3,25 5-17 -3,378 0,001* Group-5 n=15 14,13±2,92 11-20 8,60±3,20 5-15 -3,417 0,001* KW;p 0,613;0,962 0,334;0,987 STAI Preoperative Postoperative Avg. ±SD Min-Max Avg. ±SD Min-Max Statistical Test (Z) p Group-1 n=15 45,67±8,62 32-61 34,53±8,35 23-53 -3,184 0,001* Group-2 n=15 44,33±8,23 30-63 33,07±7,81 22-49 -3,352 0,001* Group-3 n=15 47,87±10,62 33-72 36,27±8,16 22-53 -3,073 0,002* Group-4 n=15 48,93±9,06 34-65 35,93±8,04 20-46 -3,411 0,001* Group-5 n=15 48,93±7,05 32-61 30,13±8,98 18-45 -3,409 0,001* KW;p 4,092;0,394 5,968;0,202 Z: Wilcoxon; KW: Kruskal Wallis H; *: p<0,05; Avg.: Average; SD: Standart Deviation; Min: Minimum; Max: Maximum Table-3: Comparisons of systole and diastole blood pressure measurements between groups and within groups SYSTOLE Preoperative (A) Intraoperative (B) Postoperative (C) Avg. ±SD Min-Max Avg. ±SD Min-Max Avg. ±SD Min-Max StatisticalTest (Fr) p Diff. (Bf) Group-1 n=15 123,07±18,18 95-163 123,53±15,65 102-159 113,40±9,88 95-134 6,241 0,044* C<B Group-2 n=15 119,00±16,20 100-152 120,40±12,55 95-144 108,87±28,14 11-123 3,193 0,203 - Group-3 n=15 123,60±15,81 98-147 123,47±15,83 104-147 115,60±9,61 104-135 5,932 0,052 - Group-4 n=15 114,73±10,91 101-138 113,13±12,85 101-144 112,33±10,65 99-137 2,678 0,262 - Group-5 n=15 122,33±11,41 98-138 127,07±12,62 110-158 123,33±23,34 104-199 9,458 0,009* CGrup-4) 3,926;0,416 DİASTOLE Preoperative (A) İntraoperative (B) Postoperative (C) Avg. ±SD Min-Max Avg. ±SD Min-Max Avg. ±SD Min-Max Statistical Test (Fr) p Diff. (Bf) Group-1 n=15 74,73±12,65 58-97 73,40±9,59 57-93 67,60±6,01 55-75 7,424 0,024* C<B Group-2 n=15 69,40±8,27 53-83 72,07±12,30 53-101 67,20±7,55 57-83 1,661 0,436 - Group-3 n=15 73,60±10,49 50-91 70,87±9,39 54-85 70,00±8,25 59-85 4,983 0,083 - Group-4 n=15 71,53±11,76 59-103 69,40±7,88 58-85 67,80±6,37 58-81 4,800 0,091 - Group-5 n=15 70,67±8,89 57-86 70,53±12,86 50-90 62,87±11,78 40-90 6,749 0,034* C<A KW;p 2,268;0,687 1,126;0,890 4,924;0,295 Fr:Friedman Analysis; Bf: Bonferroni; KW: Kruskal Wallis H; Avg.: Average; SD: Standart Deviation; Min: Minimum; Max: Maximum; Diff.: Difference; *: p<0,05 Table-4: Comparisons of Pulse rate and O 2 saturation measurements between groups and within groups PULSE Preoperative (A) Intraoperative (B) Postoperative (C) Avg. ±SD Min-Max Avg. ±SD Min-Max Avg. ±SD Min-Max Statistical Test (Fr) p Diff. (Bf) Group-1 n=15 98,60±14,57 78-130 101,60±11,96 78-120 86,00±7,34 73-98 17,733 <0,001* C<B Group-2 n=15 97,33±18,07 72-127 101,80±21,01 65-148 88,13±13,71 70-117 17,733 <0,001* C<B Group-3 n=15 98,40±17,41 98-147 98,20±17,54 70-129 86,33±12,94 68-112 15,966 <0,001* C<A, B Group-4 n=15 99,07±13,06 72-118 99,53±15,67 74-125 87,20±12,87 61-109 14,931 <0,001* C<A, B Group-5 n=15 93,00±13,26 75-115 101,60±17,45 78-142 93,13±13,62 73-122 5,932 0,052 - KW;p 1,777;0,777 0,411;0,982 2,895;0,575 SpO 2 Preoperative (A) Intraoperative (B) Postoperative (C) Avg. ±SD Min-Max Avg. ±SD Min-Max Avg. ±SD Min-Max StatisticalTest (Fr) p Diff. (Bf) Group-1 n=15 99,40±0,74 98-100 99,60±0,74 98-100 98,60±1,64 94-100 8,968 0,011* C<B Group-2 n=15 99,47±0,74 98-100 99,73±0,46 99-100 99,27±0,96 97-100 5,615 5,615 - Group-3 n=15 97,53±5,50 78-100 99,60±0,51 99-100 99,07±1,33 95-100 5,024 0,081 - Group-4 n=15 99,47±0,52 99-100 99,13±0,74 98-100 99,60±0,83 97-100 5,091 0,091 - Group-5 n=15 99,13±1,19 96-100 99,00±3,07 88-100 98,67±1,35 95-100 6,343 0,042* C<B KW;p 3,910;0,418 7,918;0,095 7,719;0,102 Fr:Friedman Analysis; Bf: Bonferroni; KW: Kruskal Wallis H; Avg.: Average; SD: Standart Deviation; Min: Minimum; Max: Maximum; Diff.: Difference; *: p<0,05; Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Editorial decision: Revision requested 03 Apr, 2026 Reviews received at journal 30 Mar, 2026 Reviewers agreed at journal 25 Mar, 2026 Reviews received at journal 25 Mar, 2026 Reviewers agreed at journal 24 Mar, 2026 Reviewers agreed at journal 20 Mar, 2026 Reviews received at journal 11 Nov, 2025 Reviewers agreed at journal 22 Oct, 2025 Reviewers invited by journal 21 Oct, 2025 Editor assigned by journal 28 Aug, 2025 Submission checks completed at journal 28 Aug, 2025 First submitted to journal 14 Aug, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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2","display":"","copyAsset":false,"role":"figure","size":8998063,"visible":true,"origin":"","legend":"\u003cp\u003ePiet Mondrian, ‘Composition with Red, Blue, and Yellow’, 1930\u003c/p\u003e","description":"","filename":"FIGURE2.png","url":"https://assets-eu.researchsquare.com/files/rs-7320945/v1/99ebbe30a85c5989cbb71e68.png"},{"id":94987592,"identity":"6cc29a8d-1355-4abf-b9d3-0422620097ba","added_by":"auto","created_at":"2025-11-03 07:02:08","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":10660907,"visible":true,"origin":"","legend":"\u003cp\u003eMicrosoft Copilot, ‘Abstract art, Expressionism, Modern art, Piet Mondrian’\u003c/p\u003e","description":"","filename":"FIGURE3.png","url":"https://assets-eu.researchsquare.com/files/rs-7320945/v1/599a58ab4ae2081fa08ae0a4.png"},{"id":94989040,"identity":"0c84f70b-3d31-4594-8ad1-4e7a7bd4a831","added_by":"auto","created_at":"2025-11-03 07:11:50","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":8509621,"visible":true,"origin":"","legend":"\u003cp\u003eClaude Monet, ‘Water Lilies’, 1919\u003c/p\u003e","description":"","filename":"FIGURE4.png","url":"https://assets-eu.researchsquare.com/files/rs-7320945/v1/d8f7b3f3894826fe9b289d2f.png"},{"id":94945303,"identity":"bb5c128f-afa1-4a7b-aee2-6877a4ad7af9","added_by":"auto","created_at":"2025-11-02 09:23:06","extension":"png","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":7996471,"visible":true,"origin":"","legend":"\u003cp\u003eMicrosoft Copilot, ‘Claude Monet, Nature, Expressionism’\u003c/p\u003e","description":"","filename":"FIGURE5.png","url":"https://assets-eu.researchsquare.com/files/rs-7320945/v1/624962e735f89098fb70bb95.png"},{"id":94991103,"identity":"769a1e76-bc1d-45e9-b125-dfd5cbaded6e","added_by":"auto","created_at":"2025-11-03 07:19:27","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":37900926,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7320945/v1/b4a59151-639f-4c3c-9892-1055086c48c5.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Comparison of the Effects of Artificial Intelligence and Human-Generated Images on Dental Anxiety","fulltext":[{"header":"Background","content":"\u003cp\u003eThe sympathetic nervous system controls anxiety, which is an adaptive emotional reaction to potentially hazardous or threatening circumstances. (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e) The autonomic nervous system is triggered by anxiety, which raises involuntary body processes like heart rate, blood pressure, respiratory rate, gastrointestinal motility, and cardiac output. (\u003cspan additionalcitationids=\"CR2\" citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e) The sympathetic nervous system is triggered and the fight-or-flight response is initiated when the hypothalamic-pituitary-adrenal (HPA) axis releases adrenaline. (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e) Numerous physiological alterations are brought on by this reaction, including a decrease in pain threshold, an increase in treatment complications, a slowed rate of recovery, and an increase in pain following treatment. (\u003cspan additionalcitationids=\"CR2\" citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e)\u003c/p\u003e\u003cp\u003eFear and tension prior to, during, or following dental procedures are associated with dental anxiety. (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e) Dental anxiety affects about a quarter of the population. (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e) Many dentists find it difficult to manage anxious patients because they can elicit physical, cognitive, emotional, and behavioral reactions. (\u003cspan additionalcitationids=\"CR2\" citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e) The patient's avoidance of dental care, which has a detrimental impact on both oral and general health, is another significant issue brought on by dental anxiety. (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e) However, excessive anxiety during treatment can result in a loss of patient cooperation and make it difficult for the doctor to carry out treatment procedures.\u003c/p\u003e\u003cp\u003eConsidering all these situations, for the management of dental anxiety, it is necessary to ascertain the underlying cause of this condition and realize a management strategy be based on the cause. Also, determining the level of anxiety is of great importance for the management of anxiety. (\u003cspan additionalcitationids=\"CR7\" citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e) In this context, proper communication between physicians and patients to create a sense of trust and control, providing patients with sufficient information about the treatment procedures to be performed, taking rest breaks at certain intervals, and allowing patients to communicate with the physician at any time during treatment have been shown as techniques that significantly reduce anxiety levels. (\u003cspan additionalcitationids=\"CR10\" citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e) In addition to these techniques, there is evidence that the anxiety levels of patients with dental anxiety can be controlled with the use of certain alternative visual (2D or 3D) or auditory stimuli. (\u003cspan additionalcitationids=\"CR13\" citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e)\u003c/p\u003e\u003cp\u003eArtwork is believed to help patients with anxiety cope with symptoms and improve their quality of life. (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e) Based on long-term experience with anxiety treatment in practice, artwork can improve emotion regulation and self-constructive skills and increase self-awareness. (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e) The use of artwork includes fine art such as painting, drawing, sculpture, and clay modeling as mediums. The focus is on the process of creating and experiencing, facilitating the expression of memories, feelings, and emotions. It aims to develop and apply self-control and new coping skills. (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e) There are many studies in the literature examining the effect of artwork on the level of anxiety in patients, (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e) but few studies have examined the effect of visual artwork on the management of dental anxiety.\u003c/p\u003e\u003cp\u003eParallel to advances in technology, artificial intelligence (AI) has gained the ability to think, learn, understand, and solve problems in a human-like manner, transforming it from a human imitation into a creative machine system. As a result of these developments, AI (e.g. Microsoft Copilot) has been used in a wide range of fields, including the creation of artistic elements, and has led to the idea that it can rival man-made art.\u003c/p\u003e\u003cp\u003eBased on these ideas, our study aimed to comparatively examine the effects of visual images on dental anxiety. We hypothesized that both visual stimuli would be effective in reducing dental anxiety, but their comparative superiority would be the subject of our investigation. This study addresses a gap in the literature by not only investigating the effect of visual art on dental anxiety but also comparatively analyzing the effects of human-made and artificial intelligence-generated artworks. We believe that our findings will contribute to the literature by informing the development of new anxiety management techniques and inspiring future research in this area.\u003c/p\u003e"},{"header":"Material and Methods","content":"\u003cp\u003e This study was conducted with the approval of Recep Tayyip Erdoğan University Clinical Research Ethics Committee (Decision number: 2025/179). All procedures were conducted in accordance with the principles of the Declaration of Helsinki. Informed consent for participation was obtained from all participants. The participants were selected from 75 systemically healthy patients who presented to Recep Tayyip Erdoğan University Faculty of Dentistry, Department of Oral, Dental, and Maxillofacial Surgery between April 25th 2025, and July 30th, 2025, with impacted 3rd molar teeth. The workflow of the study is presented in Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003eInclusion Criteria\u003c/h2\u003e\u003cp\u003ePatients aged 18\u0026ndash;40 years with no systemic disease (ASA-I), patients with impacted mandibular 3rd molars with bone retention in a similar position (class 2, position B according to Pell \u0026amp; Gregory classification; vertical and mesioangular according to Winter classification) with an indication for extraction, and patients who scored intermediate or high level (\u0026gt;\u0026thinsp;11) on the preoperative MDAS (Modified Dental Anxiety Scale) questionnaire.\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003eExclusion Criteria\u003c/h3\u003e\n\u003cp\u003ePatients with systemic diseases that might affect anxiety and physiologic tests, patients with systemic drug use (tricyclic antidepressants, anticholinergics, benzodiazepines, antihypertensives, synthetic glucocorticoids, anticonvulsants) that might affect anxiety, patients who smoked 10 or more cigarettes per day, patients who had undergone previous impacted dental surgery, the presence of acute infection in or around the surgical site, pregnancy, patients with severe vision and hearing problems, and patients receiving antipsychotic and/or anxiolytic treatment.\u003c/p\u003e\n\u003ch3\u003ePatient Classification\u003c/h3\u003e\n\u003cp\u003eSpielberger's State-Trait Anxiety Inventory Scale (STAI-S) and VAS-A visual analog scale were administered to patients who were admitted to the dental unit to measure the immediate anxiety level. Vital measurements including systolic-diastolic blood pressure, heart rate, and oxygen saturation were performed continuously for 5 minutes, the minimum-maximum values were recorded, and the mean value was recorded as T0 time. The procedures performed until this stage were common for all patient groups. Before the surgical phase, patients were randomized to one of five groups (groups 1 to 5).\u003c/p\u003e\u003cp\u003eGroup 1 was asked to look at Piet Mondrian's work dated 1930, which was presented on the screen during the procedure (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e);\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eGroup 2 was asked to look at the picture created by entering the keywords 'Abstract art, Expressionism, Modern art, Piet Mondrian' into the Microsoft Copilot AI application, which was presented on the screen during the procedure (Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e);\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eGroup 3 was asked to look at Claude Monet's 1919 work, 'Water Lilies', during the procedure (figure-4);\u003c/p\u003e\u003cp\u003eGroup 4 was asked to look at the picture created by entering the keywords 'Claude Monet, Nature, Expressionism' into the Microsoft Copilot AI application, which was presented on the screen during the procedure (figure-5);\u003c/p\u003e\u003cp\u003eGroup 5 was designated as the control group and was not exposed to any visual elements. In all groups, vital signs were measured and the VAS-A scale was applied after anesthesia. The values at this stage were recorded as time T1. After the surgery was completed, the measurement of vital signs was repeated for all patient groups. The patients were asked to describe the degree of anxiety felt during the procedure using the VAS-A scale, MDAS, and STAI-S questionnaires and recorded as time T2.\u003c/p\u003e\n\u003ch3\u003eSurgical Procedure\u003c/h3\u003e\n\u003cp\u003eIn order to prevent skill variation, all surgical procedures were carried out by a single surgeon under local anesthesia. Using buccal and inferior alveolar nerve blockade with an injection solution containing 80 mg of articaine, 2 mL, and 0,01 mg of adrenaline, 2 mL, local anesthesia was accomplished. A full-thickness mucoperiosteal envelope flap was then lifted after a No. 15 scalpel was used to make a horizontal and buccal releasing incision. A surgical micromotor and a round drill made of steel or tungsten carbide were used to remove the buccal bone and split the tooth, if needed, under saline irrigation. Following the removal of the retaining bone tissues surrounding the impacted tooth, a Bein elevator was used to extract the tooth from the alveolar socket by creating a cleavage point between the tooth and the cortical bone in the buccal and mesial regions. Debris, bone, and epithelial remnants in the alveolar socket were extracted from the affected area following tooth extraction. Following a 0.9% NaCl isotonic saline (SF) wash of the alveolar socket, silk sutures were used to close the wound edges, and hemostasis was accomplished. Every patient was prescribed 120 mg (0.12%) chlorhexidine gluconate\u0026thinsp;+\u0026thinsp;150 mg (0.15%) benzydamine hydrochloride three times a day for seven days beginning on the first day following surgery until the sutures were taken out, 875 mg amoxicillin\u0026thinsp;+\u0026thinsp;125 mg clavulanic acid twice a day, twelve hours apart, and 25 mg dexketoprofen trometamol twice a day.\u003c/p\u003e\u003cdiv id=\"Sec7\" class=\"Section2\"\u003e\u003ch2\u003eStatistical Analysis\u003c/h2\u003e\u003cp\u003eStatistical analyses were performed using the IBM SPSS Statistics 26 program. Differences between two dependent numerical variables were assessed using Wilcoxon analysis, and differences between more than two dependent numerical variables were checked using Friedman analysis. Differences between more than two independent groups were assessed using Kruskal-Wallis H analysis. In the event of differences in Friedman and Kruskal-Wallis analyses, Bonferroni corrected results were used to determine the measurement/group from which the difference originated. Fisher's exact test results were used to examine the relationship between two independent categorical variables because the expected value assumption was not met in the Chi-square analysis. Statistical significance was interpreted at the p\u0026thinsp;\u0026le;\u0026thinsp;0.05 level.\u003c/p\u003e\u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec9\" class=\"Section2\"\u003e\u003ch2\u003eStudy Groups and Statistical Methods\u003c/h2\u003e\u003cp\u003eThis study consists of 5 groups: Group 1 using Piet Modrian\u0026rsquo;s work titled \u0026lsquo;Composition with Large Red Plane, Yellow, Black, Gray, and Blue\u0026rsquo;, group 2 using an image created by entering the keywords \u0026lsquo;Abstract art, Expressionism, Modern art, Piet Mondrian\u0026rsquo; into the Microsoft Copilot AI application, group 3 using the 1919 work titled \u0026lsquo;Water Lilies\u0026rsquo; by Claude Monet, group 4 using the image created by entering the keywords \u0026lsquo;Claude Monet, Nature, Expressionism\u0026rsquo; into the Microsoft Copilot AI application, and group 5, a control group, which was not exposed to any visual elements. Seventy-five participants were distributed in a completely randomized manner, with 15 people in each group.\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003eDemographic Data\u003c/h3\u003e\n\u003cp\u003eWhen the age and sex distribution in the groups was analyzed, it was observed that the average age of the participants in group 5 was higher. In particular, there was a significant difference between group 2 and group 5 (p\u0026thinsp;=\u0026thinsp;0.033). No significant difference was found between the other groups. In terms of sex distribution, there was no significant difference between the groups, but it was found that the female sex ratio was higher in group 2 and group 4. We conducted our study independently of age and sex parameters.\u003c/p\u003e\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e\u003ch2\u003eVAS-A (Visual Analogue Scale for Anxiety)\u003c/h2\u003e\u003cp\u003eThere is a statistically significant difference between preoperative, intraoperative, and postoperative VAS-A value measurements in all groups (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05) (Table. 1). Accordingly, postoperative VAS-A value measurements were statistically significantly lower than the preoperative and intraoperative VAS-A value measurements in all groups. VAS-A values were ranked as preoperative, intraoperative, and postoperative high to low in all groups, respectively. As a result of Kruskal-Wallis H analysis, there was no statistically significant difference between the groups in terms of preoperative, intraoperative, and postoperative VAS-A values (p\u0026thinsp;\u0026gt;\u0026thinsp;0.05).\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec12\" class=\"Section2\"\u003e\u003ch2\u003eMDAS and STAI (Modified Dental Anxiety Scale and State-Trait Anxiety Inventory)\u003c/h2\u003e\u003cp\u003eThere was a statistically significant difference between the preoperative and postoperative MDAS and STAI measurements in all groups (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05) (Table. 2). Postoperative MDAS and STAI measurements were statistically significantly lower than preoperative MDAS and STAI measurements in all groups. As a result of Kruskal-Wallis H analyses, there was no statistically significant difference between the groups in terms of preoperative and postoperative MDAS and STAI measurements (p\u0026thinsp;\u0026gt;\u0026thinsp;0.05).\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec13\" class=\"Section2\"\u003e\u003ch2\u003eVital Signs\u003c/h2\u003e\u003cp\u003e\u003cstrong\u003eSystolic and Diastolic Blood Pressure\u003c/strong\u003e\u003cp\u003eThere was a statistically significant difference between the systole and diastole values measured in the preoperative, intraoperative, and postoperative periods in Group 1 and Group 5 (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05). (Table. 3) In Group 1, postoperative systole and diastole values were statistically significantly lower than intraoperative systole and diastole values. In Group 5, postoperative systole values were statistically significantly lower than intraoperative systole values, and postoperative diastole values were significantly lower than preoperative diastole values. There was a statistically significant difference between the groups in terms of intraoperative systole measurements (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Intraoperative systole values in Group 5 were statistically significantly higher than Group 4.\u003c/p\u003e\u003c/p\u003e\u003cp\u003e\u003cstrong\u003ePulse Rate and O\u003csub\u003e2\u003c/sub\u003e Saturation\u003c/strong\u003e\u003cp\u003eIn all groups except for the control group, there was a statistically significant difference (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05) in preoperative, intraoperative and postoperative pulse measurements between the periods in intra-group comparisons. (Table. 4) Group 1 and Group 2 postoperative pulse measurements were statistically significantly lower than intraoperative pulse measurements. Postoperative pulse measurements in Group 3 and Group 4 were statistically significantly lower than both intraoperative and preoperative pulse measurements. There was a statistically significant difference between the preoperative, intraoperative, and postoperative O\u003csub\u003e2\u003c/sub\u003e saturation measurements in Group 1 and Group 5 (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Postoperative O\u003csub\u003e2\u003c/sub\u003e measurements in Group 5 and Group 1 were statistically significantly lower than preoperative O\u003csub\u003e2\u003c/sub\u003e measurements.\u003c/p\u003e\u003c/p\u003e\u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eAnxiety activates the autonomic nervous system and causes adrenaline secretion, which in turn activates the sympathetic nervous system and triggers the \"fight or flight\" response. This physiologic response may lead to a lower pain threshold, prolonged treatment time, and delayed healing. (3-5) Dental anxiety is a chronic behavioral response that often results from past negative experiences and complicates the treatment process. Anxiety may manifest itself at the cognitive level and with physical, emotional, and behavioral responses. (21) This may lead to a clinical picture that is difficult to manage for both the patient and the physician, especially before and during surgical procedures. In our study, we included people who had not had their wisdom teeth extracted before and had no experience in this subject because past experiences may affect the anxiety of individuals. In this way, the possibility of previous experiences affecting the results of our study was avoided.\u003c/p\u003e\n\u003cp\u003eAccurate measurement of anxiety is of great importance for the development of effective intervention strategies. The MDAS, STAI-S, and VAS-A used in the study provided the opportunity to evaluate the emotional reactions of individuals in a multidimensionally. (22-25) A statistically significant decrease was found between preoperative and postoperative MDAS and STAI measurements in all groups including the control group (p\u0026lt;0.05). Similarly, in VAS-A measurements, postoperative values were significantly lower than preoperative and intraoperative values in all groups (p\u0026lt;0.05) While these results demonstrate that the surgical process itself contributes to a post-treatment reduction in anxiety across all patients, the use of visual stimuli during surgery had no additional effect on anxiety, regardless of the source. This is evidenced by the finding that no significant difference was found between the groups in terms of these measurements (p\u0026gt;0.05).\u003c/p\u003e\n\u003cp\u003eThe role of visual and auditory distractions in anxiety management has not yet been investigated in sufficient depth when evaluated together with other methods that have been frequently examined in the literatüre. (1,3,26,27) Mejia-Rubalcava et al. (4) found that anxiety, cortisol levels, and blood pressure decreased significantly after music therapy in patients with dental anxiety compared with a control group. The researchers concluded that music therapy might be an effective control method for anxiety. Gupta and Ahmed (26) found that anxiety and pain decreased in 92% of patients who listened to music during oral surgery and anxiety decreased by 50%. Virtual reality exposure therapy (VRET) is a cognitive behavioral approach that reduces anxiety through systematic desensitization. Gujjar et al. (3) showed that VRET safely and effectively reduced dental anxiety. Yamashita et al. (27) found that the use of VR in impacted third molar extraction reduced anxiety and that the majority of patients would prefer to use VR in the future.\u003c/p\u003e\n\u003cp\u003eIn our study, no direct effect of artistic visual stimuli on anxiety was observed. When compared with the studies mentioned above, it is thought that auditory stimuli may be more effective than visual stimuli because VR applications have audio stimuli in addition to visual stimuli and VR causes the person's perception of the environment to change. Studies conducted with such stimuli may have shown a difference, unlike our study. There are similar findings in studies on photographs. Gomez-Urquiza et al. (28) reported that only visual applications had no significant effect on anxiety before non-vital Ear, Nose, and Throat surgeries, whereas a significant decrease in anxiety, systolic pressure, and pulse rate was achieved in the group in which visual and sound were applied together. Saiu et al. (21) examined the level of dental anxiety using auditory and visual stimuli and found no significant difference between the group in which only visual stimuli were applied and the control group. They found a significant difference between the groups in which only auditory stimuli and combined auditory-visual stimuli were used and the control group. The results of these studies are similar to the findings of our study. Giving only visual stimuli to the patients made no significant difference to anxiety levels compared with no stimuli.\u003c/p\u003e\n\u003cp\u003eIntriguingly, although anxiety scores did not differ significantly between the groups, a statistically significant difference was found in intraoperative systolic blood pressure values between Group 4 and Group 5 (p \u0026lt; 0.05), with Group 5 showing higher values. While baseline systolic values in both groups were higher—albeit not statistically significant—and the p-value for the intraoperative difference was close to the threshold for significance, these findings suggest that the difference may not be directly attributable to the visual stimuli. Nonetheless, when considered alongside the observation that pulse rates decreased postoperatively in all groups except the control group, the results imply that visual stimuli may influence certain physiological parameters during surgery, even if these effects are not reflected in subjective anxiety measures such as MDAS, STAI or VAS-A scores.\u003c/p\u003e\n\u003cp\u003eOn the other hand, Ulrich's study (29) revealed that patients who saw a view of nature in their hospital rooms recovered faster and used less analgesics. Üstün et al. (30) showed that cartoon-supported visual and auditory distractions provided a decrease in pulse rates in pediatric patients but caused no statistical difference in anxiety levels. In our study, postoperative pulse measurements in both Group 3 and Group 4 were statistically significantly lower than their respective intraoperative and preoperative values. Although pulse rates decreased in all groups except the control group, this reduction was not reflected in MDAS, STAI or VAS-A scores. These findings suggest that the use of visual stimuli during surgery—regardless of the content—may have a pulse-lowering effect, even if it does not translate into a measurable reduction in subjective anxiety levels.\u003c/p\u003e\n\u003cp\u003eAdditionally, in our study, a statistically significant difference was observed between the preoperative, intraoperative, and postoperative oxygen saturation (SpO₂) measurements in both Group 1 and Group 5. Similar to the reductions in pulse rate, these physiological changes occurred without corresponding differences in MDAS, STAI or VAS-A anxiety scores. This suggests that changes in oxygen saturation may reflect a physiological response to visual stimuli, even if such effects are not detected by subjective anxiety assessment tools. This indicates a potential disassociation between the subjective experience of anxiety and the body's autonomic response, and it highlights the need for further investigation into the specific mechanisms through which visual stimuli influence physiological parameters during dental procedures.\u003c/p\u003e\n\u003cp\u003eArt is one of the ways in which individuals express and share their emotions with others. (31, 32) While artworks produced by human hands include conscious intention, esthetic concern, and individual interpretation, those produced using AI are generated from predefined data sets through algorithms. (33, 34) In addition, the effect of colors on mood should also be taken into account. Especially when planning our study, we considered the following:\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e- Piet Mondrian's simple geometric compositions created with basic colors can fix the focus of the individual and provide emotional regulation with its distracting effect from visual complexity, (35)\u003c/p\u003e\n\u003cp\u003e- Claude Monet's \"Water Lilies\" in impressionist style can have a calming effect on the viewer through soft transitions and natural forms, (36, 37)\u003c/p\u003e\n\u003cp\u003ethoughts were found to be insignificant when we look at our results.\u003c/p\u003e\n\u003cp\u003eHowever, these theoretical expectations were found to be unsupported by our results, as no significant difference in anxiety levels was detected between the groups exposed to these artworks on subjective anxiety scales like MDAS, STAI, and VAS-A. This finding suggests that the anxiolytic effect of art may stem not from the artist's conscious intent or the specific style, but from the universal psychological effects of colors, shapes, or compositions, regardless of whether they are created by a human or an AI. The fact that AI-generated artworks had a comparable effect to human-made ones opens up new avenues for research into the potential of AI in creating personalized or dynamically adaptive visual stimuli to further enhance anxiety management.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis study sheds light on the development of alternative strategies for dental anxiety management. As shown in previous studies, the use of visual stimuli alone has no effect on dental anxiety. However, the use of visual stimuli contributed to a reduction in anxiety levels. Visual stimuli may not significantly alter self-reported anxiety levels, but can have a beneficial effect on physiological parameters such as pulse rate. Furthermore, this effect was not influenced by whether the artwork was of human or AI origin. These findings highlight the potential of visual stimuli in anxiety management and provide a direction for future research in this area.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eAI: Artificial Intelligence\u003c/p\u003e\n\u003cp\u003eMDAS: Modified Dental Anxiety Scale\u003c/p\u003e\n\u003cp\u003eSTAI: State-Trait Anxiety Inventory\u003c/p\u003e\n\u003cp\u003eSTAI-S: State-Trait Anxiety Inventory – State Form\u003c/p\u003e\n\u003cp\u003eVAS-A: Visual Analog Scale for Anxiety\u003c/p\u003e\n\u003cp\u003eHPA: Hypothalamic–Pituitary–Adrenal Axis\u003c/p\u003e\n\u003cp\u003eASA-I:\u0026nbsp;American Society of Anesthesiologists – Physical Status Classification I\u003c/p\u003e\n\u003cp\u003eSF: Saline Flush (0.9% NaCl Isotonic Solution)\u003c/p\u003e\n\u003cp\u003eSPSS: Statistical Package for the Social Sciences\u003c/p\u003e\n\u003cp\u003eVRET: Virtual Reality Exposure Therapy\u003c/p\u003e\n\u003cp\u003eSpO₂: Peripheral Capillary Oxygen Saturation\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics Approval and Consent to Participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eInformed consent for participation was obtained from all participants. This study was approved by the Non-Interventional Clinical Research Ethics Committee of Recep Tayyip Erdoğan University under protocol number 2025/179, dated April 25, 2025.\u0026nbsp;Ethics committee decision files are attached. All procedures were conducted in accordance with the principles of the Declaration of Helsinki.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for Publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWritten informed consent was obtained from all patients.\u003c/p\u003e\n\u003cp\u003eThe informed consent form has been provided in both its original language (Turkish) and in English for your review (BGOF)\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of Data and Materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets used and/or analysed during the current study are available from the corresponding author on reasonable request. (Upon request, participants' personal information can be provided to you, provided that confidentiality is strictly maintained)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting Interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNone\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors' contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eDesing of the work: IBH, EB, TEK, RÇ\u003c/p\u003e\n\u003cp\u003eInterpretation of data: IBH, TEK, FÇ, AD\u003c/p\u003e\n\u003cp\u003eWriting the manuscript: IBH, TEK, EB,\u003c/p\u003e\n\u003cp\u003eFinal approval: IBH, EB, TEK, AD\u003c/p\u003e\n\u003cp\u003eAcquisition of the data: IBH, FÇ, RÇ, AD\u003c/p\u003e\n\u003cp\u003eWriting of the manuscript, final approval: IBH, EB, TEK\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNone\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eClinical trial number:\u0026nbsp;\u003c/strong\u003enot applicable.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eThoma MV, Zemp M, Kreienb\u0026uuml;hl L, Hofer D, Schmidlin PR, Attin T, et al. 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Relationship between color and emotion: a study of college students. \u003cem\u003eColl Stud J\u003c/em\u003e. 2004;38(3):396\u0026ndash;405.\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003e\u003cstrong\u003eTable-1:\u003c/strong\u003e VAS-A score comparisons between groups and within groups\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"655\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 65px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eVAS-A\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 124px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePreoperative (A)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIntraoperative (B)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePostoperative (C)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" style=\"width: 183px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 58px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAvg. \u0026plusmn;SD\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMin-Max\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAvg. \u0026plusmn;SD\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMin-Max\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAvg. \u0026plusmn;SD\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMin-Max\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 65px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eStatistical Test (Fr)\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 65px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003ep\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDiff.\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(Bf)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 65px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGroup-1 n=15\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 58px;\"\u003e\n \u003cp\u003e6,67\u0026plusmn;1,95\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e4-10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e5,93\u0026plusmn;1,87\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e3-9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e3,13\u0026plusmn;1,60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e1-6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 65px;\"\u003e\n \u003cp\u003e24,102\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 65px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0,001*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eC\u0026lt;A, B\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 65px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGroup-2\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en=15\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 58px;\"\u003e\n \u003cp\u003e6,13\u0026plusmn;2,13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e3-10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e4,73\u0026plusmn;1,98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e1-8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e2,20\u0026plusmn;1,21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0-5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 65px;\"\u003e\n \u003cp\u003e25,552\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 65px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0,001*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eC\u0026lt;A, B\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 65px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGroup-3\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en=15\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 58px;\"\u003e\n \u003cp\u003e6,33\u0026plusmn;1,54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e4-9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e5,60\u0026plusmn;2,06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e3-9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e2,73\u0026plusmn;1,49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e1-5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 65px;\"\u003e\n \u003cp\u003e24,105\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 65px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0,001*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eC\u0026lt;A, B\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 65px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGroup-4\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en=15\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 58px;\"\u003e\n \u003cp\u003e7,73\u0026plusmn;1,98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e5-10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e6,53\u0026plusmn;1,88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e3-9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e2,80\u0026plusmn;1,52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0-5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 65px;\"\u003e\n \u003cp\u003e24,034\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 65px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0,001*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eC\u0026lt;A, B\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 65px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGroup-5\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en=15\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 58px;\"\u003e\n \u003cp\u003e7,13\u0026plusmn;1,81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e3-10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e6,40\u0026plusmn;2,29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e3-10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e2,80\u0026plusmn;1,82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0-6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 65px;\"\u003e\n \u003cp\u003e29,947\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 65px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0,001*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eC\u0026lt;A, B\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 65px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eKW;p\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 124px;\"\u003e\n \u003cp\u003e6,718;0,152\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e6,944;0,139\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e2,789;0,594\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" style=\"width: 183px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"10\" valign=\"top\" style=\"width: 655px;\"\u003e\n \u003cp\u003eFr: Friedman Analysis; KW: Kruskal Wallis H; Bf: Bonferroni; Avg.: Average; SD: Standard Deviation; Min: Minimum; Max: Maximum;\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eDiff.: Difference *:p\u0026lt;0,05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eTable-2:\u003c/strong\u003e MDAS and STAI score comparisons between groups and within groups\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"482\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eMDAS\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePreoperative\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePostoperative\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAvg. \u0026plusmn;SD\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMin-Max\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAvg. \u0026plusmn;SD\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMin-Max\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eStatistical Test (Z)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003ep\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGroup-1\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en=15\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e14,07\u0026plusmn;2,99\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e11-21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e9,00\u0026plusmn;3,70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e5-17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e-3,422\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0,001*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGroup-2\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en=15\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e13,67\u0026plusmn;1,99\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e12-18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e8,13\u0026plusmn;2,88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e5-14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e-3,427\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0,001*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGroup-3\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en=15\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e14,53\u0026plusmn;2,92\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e10-20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e8,53\u0026plusmn;3,27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e5-18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e-3,355\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0,001*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGroup-4\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en=15\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e13,93\u0026plusmn;2,40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e10-19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e8,40\u0026plusmn;3,25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e5-17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e-3,378\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0,001*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGroup-5\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en=15\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e14,13\u0026plusmn;2,92\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e11-20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e8,60\u0026plusmn;3,20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e5-15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e-3,417\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0,001*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eKW;p\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e0,613;0,962\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e0,334;0,987\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eSTAI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePreoperative\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePostoperative\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAvg. \u0026plusmn;SD\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMin-Max\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAvg. \u0026plusmn;SD\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMin-Max\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eStatistical Test (Z)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003ep\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGroup-1\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en=15\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e45,67\u0026plusmn;8,62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e32-61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e34,53\u0026plusmn;8,35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e23-53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e-3,184\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0,001*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGroup-2\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en=15\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e44,33\u0026plusmn;8,23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e30-63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e33,07\u0026plusmn;7,81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e22-49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e-3,352\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0,001*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGroup-3\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en=15\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e47,87\u0026plusmn;10,62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e33-72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e36,27\u0026plusmn;8,16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e22-53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e-3,073\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0,002*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGroup-4\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en=15\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e48,93\u0026plusmn;9,06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e34-65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e35,93\u0026plusmn;8,04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e20-46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e-3,411\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0,001*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGroup-5\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en=15\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e48,93\u0026plusmn;7,05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e32-61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e30,13\u0026plusmn;8,98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e18-45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e-3,409\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0,001*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eKW;p\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e4,092;0,394\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e5,968;0,202\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"7\" valign=\"top\" style=\"width: 482px;\"\u003e\n \u003cp\u003eZ: Wilcoxon; KW: Kruskal Wallis H; *: p\u0026lt;0,05; Avg.: Average; SD: Standart Deviation; Min: Minimum; Max: Maximum\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eTable-3:\u003c/strong\u003e Comparisons of systole and diastole blood pressure measurements between groups and within groups\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"690\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eSYSTOLE\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 160px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePreoperative (A)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 152px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIntraoperative (B)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePostoperative (C)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 75px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAvg. \u0026plusmn;SD\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMin-Max\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAvg. \u0026plusmn;SD\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMin-Max\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAvg. \u0026plusmn;SD\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMin-Max\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eStatisticalTest (Fr)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003ep\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDiff.\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(Bf)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGroup-1\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en=15\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 75px;\"\u003e\n \u003cp\u003e123,07\u0026plusmn;18,18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e95-163\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003e123,53\u0026plusmn;15,65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e102-159\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e113,40\u0026plusmn;9,88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e95-134\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e6,241\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0,044*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eC\u0026lt;B\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGroup-2\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en=15\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 75px;\"\u003e\n \u003cp\u003e119,00\u0026plusmn;16,20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e100-152\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003e120,40\u0026plusmn;12,55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e95-144\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e108,87\u0026plusmn;28,14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e11-123\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e3,193\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e0,203\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGroup-3\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en=15\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 75px;\"\u003e\n \u003cp\u003e123,60\u0026plusmn;15,81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e98-147\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003e123,47\u0026plusmn;15,83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e104-147\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e115,60\u0026plusmn;9,61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e104-135\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e5,932\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e0,052\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGroup-4\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en=15\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 75px;\"\u003e\n \u003cp\u003e114,73\u0026plusmn;10,91\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e101-138\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003e113,13\u0026plusmn;12,85\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e101-144\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e112,33\u0026plusmn;10,65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e99-137\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e2,678\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e0,262\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGroup-5\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en=15\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 75px;\"\u003e\n \u003cp\u003e122,33\u0026plusmn;11,41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e98-138\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003e127,07\u0026plusmn;12,62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e110-158\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e123,33\u0026plusmn;23,34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e104-199\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e9,458\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0,009*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eC\u0026lt;B\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eKW;p\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 160px;\"\u003e\n \u003cp\u003e4,198;0,380\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 152px;\"\u003e\n \u003cp\u003e9,596;\u003cstrong\u003e0,048*\u0026nbsp;\u003c/strong\u003e(Grup-5\u0026gt;Grup-4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e3,926;0,416\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eDİASTOLE\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 160px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePreoperative (A)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 152px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eİntraoperative (B)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePostoperative (C)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 75px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAvg. \u0026plusmn;SD\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMin-Max\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAvg. \u0026plusmn;SD\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMin-Max\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAvg. \u0026plusmn;SD\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMin-Max\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eStatistical Test (Fr)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003ep\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDiff.\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(Bf)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGroup-1\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en=15\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 75px;\"\u003e\n \u003cp\u003e74,73\u0026plusmn;12,65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e58-97\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003e73,40\u0026plusmn;9,59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e57-93\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e67,60\u0026plusmn;6,01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e55-75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e7,424\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0,024*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eC\u0026lt;B\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGroup-2\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en=15\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 75px;\"\u003e\n \u003cp\u003e69,40\u0026plusmn;8,27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e53-83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003e72,07\u0026plusmn;12,30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e53-101\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e67,20\u0026plusmn;7,55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e57-83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e1,661\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e0,436\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGroup-3\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en=15\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 75px;\"\u003e\n \u003cp\u003e73,60\u0026plusmn;10,49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e50-91\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003e70,87\u0026plusmn;9,39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e54-85\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e70,00\u0026plusmn;8,25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e59-85\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e4,983\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e0,083\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGroup-4\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en=15\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 75px;\"\u003e\n \u003cp\u003e71,53\u0026plusmn;11,76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e59-103\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003e69,40\u0026plusmn;7,88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e58-85\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e67,80\u0026plusmn;6,37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e58-81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e4,800\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e0,091\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGroup-5\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en=15\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 75px;\"\u003e\n \u003cp\u003e70,67\u0026plusmn;8,89\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e57-86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003e70,53\u0026plusmn;12,86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e50-90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e62,87\u0026plusmn;11,78\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e40-90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e6,749\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0,034*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eC\u0026lt;A\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eKW;p\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 160px;\"\u003e\n \u003cp\u003e2,268;0,687\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 152px;\"\u003e\n \u003cp\u003e1,126;0,890\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e4,924;0,295\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"10\" valign=\"top\" style=\"width: 690px;\"\u003e\n \u003cp\u003eFr:Friedman Analysis; Bf: Bonferroni; KW: Kruskal Wallis H; Avg.: Average; SD: Standart Deviation; Min: Minimum; Max: Maximum; Diff.: Difference; *: p\u0026lt;0,05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eTable-4:\u003c/strong\u003e Comparisons of Pulse rate and O\u003csub\u003e2\u0026nbsp;\u003c/sub\u003esaturation measurements between groups and within groups\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"700\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003ePULSE\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 161px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePreoperative (A)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 152px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIntraoperative (B)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePostoperative (C)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" style=\"width: 170px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAvg. \u0026plusmn;SD\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMin-Max\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAvg. \u0026plusmn;SD\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMin-Max\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAvg. \u0026plusmn;SD\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMin-Max\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eStatistical Test (Fr)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003ep\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDiff.\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(Bf)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGroup-1\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en=15\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e98,60\u0026plusmn;14,57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e78-130\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003e101,60\u0026plusmn;11,96\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e78-120\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e86,00\u0026plusmn;7,34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e73-98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e17,733\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0,001*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eC\u0026lt;B\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGroup-2\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en=15\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e97,33\u0026plusmn;18,07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e72-127\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003e101,80\u0026plusmn;21,01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e65-148\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e88,13\u0026plusmn;13,71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e70-117\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e17,733\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0,001*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eC\u0026lt;B\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGroup-3\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en=15\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e98,40\u0026plusmn;17,41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e98-147\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003e98,20\u0026plusmn;17,54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e70-129\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e86,33\u0026plusmn;12,94\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e68-112\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e15,966\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0,001*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eC\u0026lt;A, B\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGroup-4\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en=15\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e99,07\u0026plusmn;13,06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e72-118\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003e99,53\u0026plusmn;15,67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e74-125\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e87,20\u0026plusmn;12,87\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e61-109\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e14,931\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0,001*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eC\u0026lt;A, B\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGroup-5\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en=15\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e93,00\u0026plusmn;13,26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e75-115\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003e101,60\u0026plusmn;17,45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e78-142\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e93,13\u0026plusmn;13,62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e73-122\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e5,932\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e0,052\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e-\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eKW;p\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 161px;\"\u003e\n \u003cp\u003e1,777;0,777\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 152px;\"\u003e\n \u003cp\u003e0,411;0,982\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e2,895;0,575\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" style=\"width: 170px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eSpO\u003csub\u003e2\u003c/sub\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 161px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePreoperative (A)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 152px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIntraoperative (B)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePostoperative (C)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" style=\"width: 170px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAvg. \u0026plusmn;SD\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMin-Max\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAvg. \u0026plusmn;SD\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMin-Max\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAvg. \u0026plusmn;SD\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMin-Max\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eStatisticalTest (Fr)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003ep\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDiff.\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(Bf)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGroup-1\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en=15\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e99,40\u0026plusmn;0,74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e98-100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003e99,60\u0026plusmn;0,74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e98-100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e98,60\u0026plusmn;1,64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e94-100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e8,968\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0,011*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eC\u0026lt;B\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGroup-2\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en=15\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e99,47\u0026plusmn;0,74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e98-100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003e99,73\u0026plusmn;0,46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e99-100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e99,27\u0026plusmn;0,96\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e97-100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e5,615\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e5,615\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGroup-3\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en=15\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e97,53\u0026plusmn;5,50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e78-100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003e99,60\u0026plusmn;0,51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e99-100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e99,07\u0026plusmn;1,33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e95-100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e5,024\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e0,081\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGroup-4\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en=15\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e99,47\u0026plusmn;0,52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e99-100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003e99,13\u0026plusmn;0,74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e98-100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e99,60\u0026plusmn;0,83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e97-100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e5,091\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e0,091\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGroup-5\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en=15\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e99,13\u0026plusmn;1,19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e96-100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003e99,00\u0026plusmn;3,07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e88-100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e98,67\u0026plusmn;1,35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e95-100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e6,343\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0,042*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eC\u0026lt;B\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eKW;p\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 161px;\"\u003e\n \u003cp\u003e3,910;0,418\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 152px;\"\u003e\n \u003cp\u003e7,918;0,095\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e7,719;0,102\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" style=\"width: 170px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"10\" valign=\"top\" style=\"width: 700px;\"\u003e\n \u003cp\u003eFr:Friedman Analysis; Bf: Bonferroni; KW: Kruskal Wallis H; Avg.: Average; SD: Standart Deviation; Min: Minimum; Max: Maximum; Diff.: Difference;\u003c/p\u003e\n \u003cp\u003e*: p\u0026lt;0,05;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-oral-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"ohea","sideBox":"Learn more about [BMC Oral Health](http://bmcoralhealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/ohea/default.aspx","title":"BMC Oral Health","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"dental anxiety, visual art, artificial intelligence, wisdom tooth surgery, anxiety management","lastPublishedDoi":"10.21203/rs.3.rs-7320945/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7320945/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e\u003cp\u003eThis study investigated the effect of visual artworks on dental anxiety and compared the effects of human-made versus artificial intelligence (AI)-generated artworks during the extraction of impacted mandibular third molars.\u003c/p\u003e\u003ch2\u003eMaterial and methods\u003c/h2\u003e\u003cp\u003eThe study included 75 patients, who had a clinical indication for the extraction of impacted mandibular third molars. Patients were randomly divided into five groups: Group 1 and Group 3 experienced human-made artworks, while Group 2 and Group 4 experienced similar artworks created using AI. Group 5 was the control group and received no visual stimuli. Anxiety levels were assessed using the Modified Dental Anxiety Scale, State-Trait Anxiety Scale, and a visual analog scale. Vital signs were measured before, during, and after surgery.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eA significant decrease in postoperative anxiety was observed in all groups (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05). There was no significant difference in anxiety levels between the AI and human-made artifacts. A significant difference in systolic and diastolic blood pressure was found between preoperative, intraoperative, and postoperative measurements in Group 1 and Group 5.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e\u003cp\u003eThis study reaffirms that visual stimuli, regardless of their source, can be a beneficial component for managing dental anxiety. Although no significant difference was found between the effects of human-made and AI-generated artworks on anxiety, a significant decrease in postoperative anxiety was observed across all groups. These findings may shed light on the development of alternative anxiety management strategies. Further research should explore the combined effect of visual and auditory stimuli to enhance their efficacy in mitigating dental anxiety.\u003c/p\u003e","manuscriptTitle":"Comparison of the Effects of Artificial Intelligence and Human-Generated Images on Dental Anxiety","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-11-02 09:23:01","doi":"10.21203/rs.3.rs-7320945/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2026-04-03T06:08:21+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-03-30T05:57:06+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"305726713488241353779854812516511833634","date":"2026-03-25T10:37:10+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-03-25T09:01:29+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"296518551339244849147915447481935246409","date":"2026-03-24T07:26:35+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"124617154440972157544148248850284698006","date":"2026-03-20T22:51:43+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-11-11T19:52:22+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"329210368107881344224880510052736406900","date":"2025-10-22T19:21:05+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-10-21T22:22:13+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-08-28T14:28:55+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-08-28T14:25:15+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Oral Health","date":"2025-08-14T11:51:16+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-oral-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"ohea","sideBox":"Learn more about [BMC Oral Health](http://bmcoralhealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/ohea/default.aspx","title":"BMC Oral Health","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"c7562a67-ef09-4567-ab1a-bb068511a602","owner":[],"postedDate":"November 2nd, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-05-22T05:38:34+00:00","versionOfRecord":[],"versionCreatedAt":"2025-11-02 09:23:01","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7320945","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7320945","identity":"rs-7320945","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}