Anxiety Trajectories in Mandibular Third Molar Surgery in Relation to Surgical Timing and Personality Traits

This study aimed to compare changes in dental and state anxiety across four assessment stages between patients undergoing same-session and scheduled mandibular third molar surgery and to explore whether Big Five personality traits moderated these changes.

This observational study included 69 patients (same-session, n = 36; scheduled surgery, n = 33), with surgical timing determined by patient preference. Before the surgical timing decision (T0), participants completed STAI-Trait, TIPI, MDAS, and STAI-State. MDAS and STAI-State assessments were repeated after the decision (T1), immediately before local anaesthesia (T2), and immediately after surgery (T3). Baseline-adjusted generalised estimating equations evaluated group × time effects across the three post-decision assessments (T1-T3); primary contrasts were Holm-adjusted and personality analyses were exploratory with false-discovery-rate adjustment.

No statistically significant differences in baseline characteristics were detected between the groups. Adjusted group × time interactions were significant for MDAS (Wald χ²(2) = 17.39; Holm p < 0.001) and STAI-State (χ²(2) = 11.16; Holm p = 0.004). The key between-group change contrasts were MDAS T3 - T2 (β = -1.52; Holm p < 0.001) and STAI-State T2 - T1 (β = -5.21; Holm p = 0.003), with both indicating greater decreases or smaller increases in the same-session group. Exploratory agreeableness moderation of STAI-State trajectories survived FDR correction (χ²(2) = 10.70; q = 0.048).

Surgical pathways were associated with different perioperative anxiety trajectories, with the most pronounced between-group differences occurring at different assessment intervals for dental and state anxiety. Personality moderation was exploratory; nonrandomised group selection precludes causal attribution.