Comparison of a piezoelectric and a standard surgical handpiece in third molar surgery

Abstract

Aim: The aim was to compare the use of a piezoelectric handpiece versus a standard surgical handpiece in removal of impacted third molars under general anaesthesia. Materials and methods: Thirty patients undergoing routine third molar removal were included in the study. Panoramic radiographs were used to assess the positioning of the impacted third molars. The patients were randomly subdivided and the split mouth technique was used in which each side (left or right) of the mouth was randomly assigned to two treatment groups. Hence each patient served as their own control. In one group, a piezoelectric handpiece was used, while a conventional handpiece was used for the second group. All aspects of preoperative care, general anaesthesia, surgery and postoperative care were standardised for the two groups. The following parameters were recorded; time of surgery, bleeding during surgery, post-operative swelling, post-operative pain, associated complications and post-operative nerve injury. Results: No statistically significant difference was found between the groups in terms of pain and swelling. There was less bleeding with the use of the piezoelectric device as compared with the standard surgical handpiece; however, the surgical time was longer. There were no reports of trauma to the lips or intra-oral soft tissue. There were two incidences (6.7%) of post-operative paraesthesia in the standard surgical handpiece group. Conclusions: The use of a piezoelectric device is an acceptable alternative to the standard surgical handpiece in third molar surgery. Its use is advocated in difficult cases especially where there is inferior alveolar nerve approximation. Clinical relevance Scientific rationale for studyTo compare piezoelectric handpiece with a standard surgical handpiece in removal of impacted third molars in terms of post-operative pain, swelling, bleeding and nerve injuries. Principal findingsBoth modalities showed similar post-operative pain and swelling. Intraoperative bleeding was less in the piezoelectric device; however, the surgical time was longer. There was no post-operative paraesthesia in the piezoelectric group while 6.7% incidence in the standard handpiece group. Practical implicationsPiezoelectric handpiece is best reserved for difficult and deeply impacted third molars with nerve approximation otherwise standard surgical handpiece remains the gold standard.