Piezoelectric device vs. conventional rotative instruments in impacted third molar surgery: Relationships between surgical difficulty and postoperative pain with histological evaluations

Rullo, Rosario; Addabbo, Francesco; Papaccio, Gianpaolo; d’Aquino, Riccardo; Festa, Vincenzo Maria

doi:10.1016/j.jcms.2012.07.007

Cited by 106 publications

(105 citation statements)

References 15 publications

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“…This should have been performed and reported in the papers. Among the studies included in this systematic review, eight (8) contemplated the variable pain [14,15,[23][24][25][26][27][28]. Although the meta-analysis was not recommended due to the high heterogeneity among the study results, five (5) of them had results favoring the use of piezoelectric motor, when the pain was evaluated.…”

Section: Discussionmentioning

confidence: 99%

“…The metaanalysis showed a high heterogeneity among the studies, even after the completion of sensitivity tests, showing no consistency among the results. Among the studies that evaluated postoperative pain compared to the use of piezoelectric motor and the use of osteotomy with rotary instruments, four (4) had results favoring the use of piezoelectric motor [14,15,23,24]. The other four (4) studies showed no statistically significant differences between the methods evaluated [25,28].…”

Section: Painmentioning

confidence: 99%

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Rotary Instrument or Piezoelectric for the Removal of Third Molars: a Meta-Analysis

Magesty

Galvão

Martins

et al. 2016

J. Maxillofac. Oral Surg.

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Aim The aim of this systematic review and meta-analysis was to compare, in the lower third molar surgery, the osteotomy techniques with rotary instruments and piezoelectric motors. Methods An electronic search was conducted using the following databases: Pubmed, Web of Science, and the Cochrane Oral Health Group Trials Register. Inclusion criteria were: studies in humans, randomized or nonrandomized, comparing the extraction of third molars that required osteotomy and/or odontosection with rotary instrument and osteotomy and/or odontosection with piezoelectric motor assistance. The analysis and inclusion of articles was performed by two reviewers independently. An evaluation of the quality of articles and data extraction was carried out. Results From a total of nine hundred seventy four (974) trials, eleven articles were included in the qualitative analysis, and seven were included in the quantitative analysis. Rotary instruments were faster than the piezoelectric surgery (95 % CI 0.34 to 1.16). The piezoelectric surgery showed better results when compared with roatry instruments when trismus was assessed in 2 (95 % CI 0.65 to 1.69), 3 (95 % CI 0.63 to 1.67) and 5 (95 % CI 0.03 to 2.26) days after surgery. Seven days after surgery, there were no differences between the techniques (95 % CI (-0.022) to (-1.49)). Conclusion The piezoelectric surgery was effective in reducing pain, swelling and trismus in third molar surgery, but the same requires greater surgical time than the rotary instruments.

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Section: Discussionmentioning

confidence: 99%

Section: Painmentioning

confidence: 99%

Rotary Instrument or Piezoelectric for the Removal of Third Molars: a Meta-Analysis

Magesty

Galvão

Martins

et al. 2016

J. Maxillofac. Oral Surg.

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“…14 The piezoelectric device has been useful for application in complex surgical sites, such as the posterior mandible, where the osteotomy lines are of necessity close to vulnerable structures such as nerves and blood vessels; ultrasonic vibrations allow a selective and defined cutting action, leading to a higher level of precision, safety and less tissue damage than using common rotating instruments (burs). [15][16][17] Ultrasonic tools have been reported to be of clinical usefulness in reducing the risk of surgical trauma to the adjacent tissues, and ultrasonic dissection has been classified as a tissueselective technique that might improve the efficiency of dissections reducing the morbidity from collateral iatrogenic injuries. Moreover, the bone wound healing response after osteotomy shows a more positive response with piezoelectric surgical devices, when compared with diamond or carbide burs.…”

mentioning

confidence: 99%

“…16 However, despite the apparent advantages, few studies have been performed to evaluate the use of piezosurgery, in comparison with traditional bur, in third molar surgery, and there have been conflicting results and with limited power. [15][16][17] The purpose of this study was to investigate, in a randomized-controlled clinical trial, the performance of piezosurgery compared with traditional rotating instruments during mandibular third molar removal. The investigators hypothesized that piezosurgery could have an enhanced positive impact in post-operative pain and objective orofacial swelling, also reducing possible adverse events.…”

mentioning

confidence: 99%

A Split-Mouth Randomized Clinical Trial to Evaluate the Performance of Piezosurgery Compared With Traditional Technique in Lower Wisdom Tooth Removal

Mantovani

Arduino

Schierano

et al. 2014

Journal of Oral and Maxillofacial Surgery

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This is an author version of the contribution published on:Questa è la versione dell 'autore dell'opera: J Oral Maxillofac Surg. 2014 Oct;72(10):1890-7. doi: 10.1016/j.joms.2014 AbstractPurpose: The surgical removal of mandibular third molars is frequently accompanied by significant post-surgical sequelae, and different protocols have been described to improve such adverse events. The aim of this study was to investigate the performance of piezosurgery compared with traditional rotating instruments during mandibular third molar removal. Methods:A single-centre, randomized, split-mouth study was performed using a consecutive series of unrelated healthy Caucasian patients, attending the Oral Surgery Unit of the University of Turin, for surgical removal of bilateral mandibular third molar teeth. Each patient was treated, at the same appointment, using bur removal on one side of the mandible and a piezoelectric device on the contralateral side. The primary outcomes reported were postoperative pain, objective orofacial swelling and the duration of surgical time; secondary outcomes were sex, age and possible adverse events. Anova or paired t-test were used as appropriate to test any significant differences at baseline according to each treatment subgroups and categorical variables were analysed by χ2 test.Results: The study sample consisted of 100 otherwise healthy patients. The mean pain evaluation reported by patients who underwent surgery with the piezosurgery was significantly lower than that experienced after bur (conventional) removal, reaching a statistical difference after 4 days (P=0.043). The clinical value of orofacial swelling at 7th day, normalized to baseline, was lower in the piezosurgery group (P<0.005).The average time of surgery was significantly lower in the bur than piezosurgery group (P<0.05).Three patients having bur removal experienced short-term complications (two dry sockets and one temporary paraesthesia): both totally resolved by 4 weeks. Conclusions:To date, this prospective investigation is the largest reported split-mouth study on piezosurgery for lower third molar tooth removal, also comparing surgeons with different 3 degrees of experience. It is evident that using a piezoelectric device can enhance the patient experience and reduce post-operative pain and swelling.

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“…Also, it minimizes osteocytes damage, allowing for faster healing of the lesion [31,32]. The use of such surgical approach in the current study resulted in a 8,3% recurrence rate after prolonged followup, without relevant postoperative side effects such as swelling, paresthesia or pain.…”

Section: Discussionmentioning

confidence: 72%

Gorlin-Goltz Syndrome: Conservative Treatment of Keratocystic Odontogenic Tumors, Frequent First Clinical Manifestation in Pediatric Age

Favia¹,

Tempesta²

2016

Hereditary Genet

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Objective: Gorlin-Goltz Syndrome, also known as Nevoid Basal Cell Carcinoma Syndrome, is a rare genetic condition resulting from mutations of the PTCH1 (9q22.3) gene. It involves multiple organs, such as the skin, skeleton and jaws. Aim of this study was to describe Keratocystic Odontogenic Tumors as frequent first clinical manifestation of NBCCS during pediatric age, and theirs conservative treatment, that is really important, especially among young patients. Methods:We report on 20 pediatric patients affected by Gorlin-Goltz Syndrome, presenting totally 60 Keratocystic Odontogenic Tumors. Patients underwent conservative lesion enucleation with maximal permanent teeth preservation. The ostectomy and osteoplasty were made with both conventional rotative instruments and piezoelectric tools, in order to remove damaged bone, epithelial remnants and satellite cysts, and to possibly minimize the recurrence risk. All surgical samples were subjected to histopathological examination and the patients were followed-up for a minimum of 18 months. Results:Overall, 60 Keratocystic Odontogenic Tumors were removed (8 patients with single and the remaining with multiple cysts) with healing of all the surgical wounds without complications. Nevertheless, recurrence of 5 lesions (8.3%) from 3 patients occurred: all of them were >5 cm in maximum diameter and associated with permanent teeth.Conclusion: Keratocystic Odontogenic Tumors in pediatric patients require conservative approaches for permanent teeth preservation. While conventional enucleation leads up to 60% recurrence rates, cavity ostectomy with piezoelectric tools significantly reduced the recurrence risk and allowed preservation of permanent teeth.

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Piezoelectric device vs. conventional rotative instruments in impacted third molar surgery: Relationships between surgical difficulty and postoperative pain with histological evaluations

Cited by 106 publications

References 15 publications

Rotary Instrument or Piezoelectric for the Removal of Third Molars: a Meta-Analysis

Rotary Instrument or Piezoelectric for the Removal of Third Molars: a Meta-Analysis

A Split-Mouth Randomized Clinical Trial to Evaluate the Performance of Piezosurgery Compared With Traditional Technique in Lower Wisdom Tooth Removal

Gorlin-Goltz Syndrome: Conservative Treatment of Keratocystic Odontogenic Tumors, Frequent First Clinical Manifestation in Pediatric Age

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